Picture from http://www.mentalhealth.asn.au
It's Mental Health Week (7-13th October). There are many interesting activities and initiatives undertaken this week to promote awareness and understanding of mental health issues. I've attached a list of some of starter resources at the bottom of this post if you'd like to read more or get involved.
This week I've been thinking about mental health in the setting of chronic illness and the issues involved. Some of the prevalence figures for depression and anxiety in the presence of chronic illnesses can be quite high but also quite variable. It can be hard to get a real picture of the extent of the problem because psychological disorders such as depression and anxiety can often be overlooked. Some of the symptoms of such disorders may be simply attributed to the disease process, particularly symptoms such as fatigue and lethargy.
Conversely, the potential is also for these conditions to be falsely diagnosed, with symptoms of a medical condition closely matching the diagnostic criteria for a psychological disorder. I experienced this myself when my thyroid disease (Graves) was misdiagnosed as anxiety. It is always important to make sure that medical conditions commonly known to cause symptoms similar to psychological disorders are ruled out.
The presence of psychological disorders in chronic illness can also change. For example, following a heart attack, you often see initial levels of anxiety rise and fall dependent on where the individual is in the recovery process. Depression will often set in much later, usually post-discharge from hospital.
People are also often reluctant to consider psychological conditions in the context of illness and this can be understandable, particularly for those in the process of getting diagnosed. Many people fear that being treated for depression or anxiety will mean that the diagnosis process will come to an end or that continuing symptoms will simply be written off to the psychological diagnosis and so continue to suffer needlessly.
Sadly, this can be true. I've seen patients under investigation for medical illness for concurrent psychological evaluation. In many cases, there is a genuine concern by the referring doctor to ensure all bases are covered for the good of their patient. Unfortunately, sometimes this isn't communicated well to the patient. In some cases, you can tell that the patient has simply been handed over. Regardless of the particular illness circumstances, people usually aren't very happy to end up in the hands of a psychologist, which is a shame because, beyond the treatment of psychological disorders, psychologists can also help with many aspects of coping with chronic illness.
While I've referred to depression and anxiety, it is important to be aware that other psychological conditions can be seen concurrent with physical illness.
In Mental Health Week, I wonder what can be done to improve the psychological burden of chronic illness. If you have an experience you'd like to share or a suggestion to make, please do so.
Mental Health Week Resources