The missing link in chronic disease care | The Ethical Nag

A good piece on mental health and depression with people with chronic disease. Interestingly enough, journal writing is one of the proposed techniques (my blog and book played that role for me):

The rate for depression occurring along with serious physical health issues is quite high. For example:

  • Heart attack: 40%-65%
  • Coronary artery disease (without heart attack): 18%-20%
  • Parkinson’s disease: 40%
  • Multiple sclerosis: 40%
  • Stroke: 10%-27%
  • Cancer: 25%
  • Diabetes: 25%

Identifying psychosocial problems in those already diagnosed with chronic illnesses like these can be a tough challenge. We know that physical symptoms such as disturbed sleep, impaired appetite, and lack of energy may already exist as a result of the disease. ….

A number of studies suggest that even mild depression can reduce a person’s motivation to seek medical care or to follow even basic recommended treatment or lifestyle improvement plans. Depression and hopelessness also undermine the patient’s ability to cope with pain and may have a corrosive effect on personal relationships.

But isn’t it time that we also need to add awareness of these psychological stressors of chronic disease diagnoses to the medical toolbox?

Dr. David Spiegel wrote a JAMA editorial called “Healing Words” – about a study that found patients living with chronic disease improved after writing in a journal about enduring the stress of illness, compared to patients who wrote about neutral topics:

“For patients living with two or more chronic diseases, being able to discuss the anxieties, uncertainties and fears, losses and sadness that usually accompany severe illness is generally helpful, despite the pressure commonly exerted by family and friends for the patient to always keep a positive outlook.

“If we could produce similar outcome evidence about a new drug, it is likely that it would be in widespread use within a short time. Why? We would think we understood the mechanism (whether we did or we did not) and there would be a mediating industry to promote its use.

“But manufacturers of paper and pencils are not likely to push writing in a journal as a treatment addition for the management of asthma or rheumatoid arthritis.“

The missing link in chronic disease care | The Ethical Nag.


2 thoughts on “The missing link in chronic disease care | The Ethical Nag

  1. Hello Andrew and thanks for featuring my Ethical Nag article here. Journallling (and blogging!) can indeed be useful tools for patients living with chronic illness, but there is also a need to get the medical profession onboard in identifying and acknowledging the overlooked depression and anxiety that accompanies so many of these diagnoses.

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