Wednesday 5 September 2012

How to explain the psychological aspects of LTC

I recently gave a lecture to Cambridge medical students about the realities of living with long term health conditions and the theory of self-management. One of the point I really want to get across was the impact that LTC have on your mental health, and the close interaction between the two. What I wanted to dispel was the "it's all in the mind" attitude. I needed to convey this idea in a context they could comprehend - in their language.

I came up with the term "psychological and emotional side effects". I am sure others have thought of this before, but it really summed up the issue for me! The stress, anxiety, depression, anger and sadness that all accompanies a LTC really are all side effects. Like some drugs, the side effects can make the initial complaint worse - that certainly applies with these particular side effects!

The analogy applies up to the treatment of the troublesome side effects. If induced by medication, there are several options: medication can stop; doses lowered; more medications to stop the side effects; or relief that it means the medications are working - unfortunately none of these apply to the emotional and psychological side effects of long term conditions. The precipitating factor can not be removed, or reduced, and treating them with more medications doesn't deal with the root of the problem. These side effects are quite normal, but debilitating and distressing nonetheless.
Managing these side effects require a great investment from the person themselves. They need to acknowledge the cause, and develop coping strategies - which is where self-management comes in. As well as managing medications, these patients have to learn how to control the psychological and emotional side effects by teaching their brain to work productively alongside these unwelcome symptoms - the most debilitating part of a LTC.

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