Podcast Summary: Hadley Presents – Vision Loss and Depression

Host: Ricky Enger
Guest: Dr. John Shepherd, Board Certified Ophthalmologist and Director, Weigel Williamson Center for Visual Rehabilitation
Date: September 25, 2025

Episode Overview

In this insightful episode, host Ricky Enger welcomes Dr. John Shepherd to discuss the often-overlooked intersection of vision loss and depression. The conversation aims to demystify why depression is so prevalent among people with acquired vision loss, help listeners recognize its signs, and highlight practical strategies and resources for coping and finding hope—emphasizing that help is available and recovery is possible.

Key Discussion Points & Insights

1. Prevalence of Depression in Vision Loss

• Depression is significantly more common in individuals with irreversible vision loss compared to the general population.
  • “The rate of depression in individuals with irreversible vision loss... skews more towards 30%. That would mean that individuals with low vision have three times the likelihood of having depression compared to the general population.”
    — Dr. Shepherd [02:00]
• This rate is comparable to that seen in patients with serious, life-threatening illnesses (e.g., cancer).
  • “...that’s actually the same rate of depression seen in outpatients being treated for life threatening diseases such as cancer and cerebrovascular disease.”
    — Dr. Shepherd [02:30]

2. Why Depression Happens with Vision Loss

• Depression is closely linked to the loss of ability to participate in daily and valued activities, not just to the diagnosis itself.
  • “Depression correlates with the level of disability, that is the level of difficulty that an individual has being able to participate in their favored daily living activities.”
    — Dr. Shepherd [02:51]
• Activities affected include reading, driving, preparing food, walking safely, recognizing faces, watching TV, and managing finances.

3. Onset and Recognition of Depression

• Depression often sets in gradually and can take months or even over a year to develop.
  • “In general, it comes on very slowly and we might even say insidiously over time.”
    — Dr. Shepherd [04:11]
• As daily tasks become increasingly difficult or impossible, the sense of loss can compound.
  • “As the I can'ts outweigh the I cans, the greater the likelihood of depression is of developing.”
    — Dr. Shepherd [04:53]
• Depression is often unrecognized or minimized; commonly held stereotypes about “what depression looks like” can be misleading.

4. Symptoms and Screening

• Common symptoms include:
  • Little interest or pleasure in activities
  • Feeling down, hopeless, or listless
  • Fatigue
  • Trouble concentrating
  • Feelings of diminished worth
  • “The average individual is not really going to sense this going on. Might minimize the significance of the symptoms.” — Dr. Shepherd [05:56]
• Important to listen to feedback from family or social contacts, and seek medical advice if symptoms arise.
  • “It's important to ask those that are around you a lot in your social circles... You might even ask them if they see those things in you...”
    — Dr. Shepherd [07:12]
• Primary care providers—not eye doctors—can do depression screening and determine next steps.

5. Treatment Options

• Medical: Various antidepressant medications may be prescribed.
• Counseling: Referral to mental health professionals for therapies like cognitive behavioral therapy (CBT) can be very helpful.
• “Certainly there are a number of different medications ... The primary care doctor may refer you to a counseling professional... Cognitive behavioral therapy... can be very helpful.”
  — Dr. Shepherd [09:22]
• Low Vision Rehabilitation: Directly addressing the functional challenges of vision loss (through adaptation and assistive technologies) can greatly reduce depression.
  • “If the irreversible vision loss is a big part of the cause of depression, then low vision rehabilitation services have been studied in regards to treating depression and have been shown to be extremely helpful.”
    — Dr. Shepherd [10:15]

6. What Does Low Vision Rehabilitation Include?

• Extensive assessment of functional challenges and adaptation strategies.
• Use of assistive devices and technology (e.g., magnifiers, telescopic lenses, adaptive equipment, smartphones).
• Rehabilitation programs developed and implemented with occupational therapists, both in-clinic and at home.
• Referrals to community resources and online support, such as Hadley’s programs.
  • “We work with the wealth of resources that are available to the patient... Those types of services make a dent on depression.”
    — Dr. Shepherd [12:57]

7. Ongoing Adaptation and Sharing Resources

• As vision continues to change, new resources and techniques are available; do not give up if previous strategies no longer help.
  • “So often the magnifier that you might use becomes to where it doesn't help you. That doesn't mean there isn't something else out there that may help you as the disease progresses.”
    — Dr. Shepherd [14:14]
• Eye care providers are experts at managing diseases—but may not always address practical daily challenges or refer to low vision services.
  • “Evidence shows that they're not as great and skilled at managing the impairment caused by the disease...”
    — Dr. Shepherd [15:15]
• Share your positive experiences with vision rehab/services with your eye doctor to help them support future patients.
  • “If you've worked with a low vision specialist, Hadley, any other services... share with them how helpful that they have been...”
    — Dr. Shepherd [16:08]

Notable Quotes & Memorable Moments

• Dr. Shepherd on recognizing depression:
  “Depression can happen kind of insidiously. We don't recognize that it's happening... It's one of those things where we tend to minimize and what happens with depression is we have an irreversible vision loss... and it can tend to be a downward spiral.” [05:56]
• Dr. Shepherd on the impact of resources:
  “Being aware of the resources and managing the challenges caused by irreversible vision loss certainly goes at the core of why depression with irreversible vision loss occurs.” [12:57]
• Ricky Enger on acknowledging feelings:
  “When you have a major life change like this, you're going to have feelings, and they're not always going to be positive feelings, but there are reasons that you're feeling the way you do. And I think more importantly to point out, there are ways that you can address some of those things and you don't have to feel that way forever.” [13:23]

Practical Takeaways & Resources

• Take symptoms of depression seriously—seek input from friends/family and consult your primary care doctor, not solely your eye care provider.
• Treatment works: Medical, psychological, and functional rehabilitation options are all available and often best used together.
• Keep seeking help: As your vision changes, continue to look for new strategies and technologies.
• Advocate and educate: Share helpful resources and services you’ve used with your own eye care provider to benefit others.

Hadley Support Programs (Mentioned)

• Peer-to-Peer Program: Connect with someone who shares your experiences for direct support.
• Adjusting and Coping Together Groups: Structured support groups to process strong emotions and find coping mechanisms.
• For information on these services, call 800-323-4238.

Timestamps for Key Segments

• [02:00] – Prevalence of depression with vision loss
• [02:51] – Why depression happens in this group
• [04:11] – How/when depression develops after vision loss
• [05:56] – Symptoms and recognizing depression
• [09:22] – Overview of depression treatment options
• [10:15] – Low vision rehabilitation explained
• [13:23] – Addressing feelings and closing thoughts
• [14:14] – Adapting to ongoing vision changes
• [15:15] – Encouraging providers to refer to resources
• [16:08] – How to “pay it forward” by sharing your experience

Final Thoughts

Dr. Shepherd and Ricky Enger deliver a message of hope and practical empowerment: While depression is a common, natural response to life-altering vision loss, there are effective, multifaceted ways to cope and regain quality of life. Listeners are encouraged to recognize their symptoms, seek both medical and community help, and share beneficial resources widely so others can also find their path forward.