When Being Physically Unwell Causes Mental Health Concerns:

annetteshondernew

Dr. Annette Schonder
Psychologist, Sociologist,
American Board
Certified Clinical Counselor
Certified Clinical Hypnotherapist
Phone: 00971-4-4574240

According to the World Health Organization (WHO) global life expectancy has risen. The National Bureau of Economic Research reports that the reason for this increase, since 1960, is due to the management of cardiovascular disease and the prevention of death caused by low birth weight. More and more, increases in life expectancy are due to medical care, including high tech medical treatments. Eating better and quitting smoking trends also have a positive impact on longevity.

When medical care is available, medical professionals seamlessly treat people from the prenatal period through old age. There are wide range of medical services to choose from, such as preventative healthcare, life-saving healthcare, acute and chronic disease management, and elective procedures. The clear advantages of ever-increasing medical interventions are healthier and longer lives; however, in the course of a lifetime many patients experience emotional trauma due to the sudden onset of illness, accidents, and necessary but unpleasant medical procedures. It is important for patients and heath care providers to understand how physical and mental health are intertwined, and to recognize when medical patients will benefit from mental healthcare provided by psychiatrists, psychologists, or counselors.

Leo Pozuelo (2013) from the Cleveland Clinic reported on heart disease and depression. He said, “It is common for you to feel sad or depressed after a heart attack, cardiac surgery or procedure, recent hospitalization, or new diagnosis of heart disease.” He explained that these feelings are due to not knowing what to expect or feeling too tired to do simple tasks. The great majority of patients gradually recover mentally within a few weeks, when they return to their usual activities. Yet, there are some patients who experience depression and other symptoms. Pozuelo reports, “Up to 15 percent of patients with cardiovascular disease and up to 20 percent of patients who have undergone coronary artery bypass graft (CABA) surgery experience major depression. When these symptoms persist for 2 or more weeks, treatment by a mental healthcare professional, such as a psychiatrist, psychologist, psychotherapist, or counselor will be required.

It is not unusual for patients to develop mental health problems when they are faced with:
• a sudden illness
• conditions and treatments that are painful, debilitating, or disfiguring
• a life-threatening disease or medical event
• emergency treatment for traumatic accidents

The psychological impact can become evident when symptoms of mental health disorders appear. It is important for healthcare providers, patients, loved ones and friends to be aware that mental health problems can arise in a patient to initiate prompt treatment when necessary. It is vital to receive early treatment by a psychiatrist, psychologist, psychotherapist, or counselor to restore mental health and avoid an escalation of the symptoms. Furthermore, it is critical to note that psychological well-being is crucial when it comes to physical healing, being able to cope with the recovery process, and being able to restructure one’s life when necessary.
At this point, it is important to note that family members and friends can be at risk for mental health problems as well, because of witnessing traumatic accidents or being confronted with medical events.

Mental health symptoms can include intrusive thoughts, or memories of the traumatic event, distressing dreams and sleep difficulties, flashbacks, inability to remember, avoidance behaviors, low mood, depression, anxiety, anger, guilt, and general feelings of unhappiness. Furthermore, a patient can have unrealistic feelings and beliefs about what happened, might be hypervigilant, suffer from low concentration, and have physical complaints, including headaches, dizziness, and light and noise sensitivity. In some patients this cluster of symptoms is experienced, which lends itself to the diagnosis of Acute Stress Disorder (ASD). Other patients might experience a more distinct mental health disorder, such as depression, anxiety, or fear of treatments (possibly phobia).

When someone suffers from these mental health symptoms, their entire lives are affected. They feel depressed and do not experience joy in life. They might begin to avoid important medical appointments, or work meetings. Insomnia can decrease focus even more and cause overpowering fatigue and listlessness. There might also be impulsive and reckless acting out behaviors, such as gambling, substance abuse, and dangerous driving.

A psychologist, psychotherapist, or counselor can assess the patient to establish a diagnosis. Part of the assessment is to determine if a patient will benefit from seeing a psychiatrist. A referral to the psychiatrist is made when the psychologist, psychotherapist, or counselor believes the patient will benefit from medication. At CHMC, a collaborative effort between the patient, the therapist, and the psychiatrist unfolds to provide state-of-the-art treatment.

During counseling, the therapist will draw on various methods to promote healing:

• Crisis Management
• Debriefing
• Cognitive Behavioral Therapy (CBT)
• Acceptance and Commitment Therapy (Mindfulness)
• Stress Management and Reduction Techniques
• Behavior Rehearsal
• Processing

List of References:

Diagnostic and statistical manual of mental disorders: DSM-5. (2013). Arlington, VA: American Psychiatric Association.
National Bureau of Economic Research,
http://www.nber.org/digest/mar02/w8556.html

Ponzuelo, L. (2013), Cleveland Clinic:
https://my.clevelandclinic.org/health/articles/depression-heart-disease-heart-health

Simpson, J., & Moriarty, G. (2013). Multimodal Treatment of Acute Psychiatric Illness. doi:10.7312/Columbia/9780231158831.001.0001

World Health Organization http://www.who.int/gho/mortality_burden_disease/life_tables/situation_trends_text/en/