Mental health

Grandmother and grandchild building a snowman

Body and mind are one: How do you deal with your emotions?

Mental health is as important as physical health. A stable emotional state is all the more critical when physical health is impaired. It is good to know the signs of emotional distress and when to seek support. How are you coping?

For 25 years, R. A. has been a patient in the dialysis program of the Nefromed centre in Piatra Neamț, Romania. We want to begin this article with her story. “Five years ago, I fell and fractured my pelvis. I was terrified of being paralysed. My fears intensified to such extent that I was later diagnosed with panic attacks caused by posttraumatic stress. I experienced a variety of symptoms such as anxiety, fear of darkness, fear of loneliness, insomnia, palpitations, hypertension. I also avoided being around other people.

Without cause, I had sudden occurrences of profuse sweating. I had lost my appetite. The fear of going insane was growing, a fear that I felt I could not share with anyone. The state of panic was almost permanent, making it difficult to concentrate. My mind was constantly spinning. After the fracture had healed, I visited different medical practitioners. I went to see a cardiologist, a neurologist, an endocrinologist. I so wanted to get out of this state, I even talked with a priest. The clinic’s psychologist recommended that I see a psychiatrist, but that seemed too strange. A couple of days later, however, walking along a street, I noticed the sign of a psychiatrist’s cabinet. We shared the same first name. I took that as a sign and immediately decided to see a psychiatrist. What can I say? It proved to be the solution to my poor state.

A short while after starting the treatment advised by the psychiatrist, I began to sleep and eat again; I began to feel better and to see life with new eyes. I warmly recommend to anyone going through similar situations not to hesitate and talk to a psychiatrist. It may be difficult to open up at first but I firmly suggest this, because now I understand the importance of psychiatric treatment. Moreover, the psychiatric treatment may consist of just small things, which – like in my case – can make significant changes.”

Mental health can affect physical health

Mental health is just as important as the health of any vital organ in our body, heart, kidneys, lungs, or any other. Patients undergoing dialysis can experience different levels of emotional struggle. Their thoughts often revolve around side effects and consequences of chronic kidney disease. They may also be exposed to a broad range of psychological stress symptoms that affect their mental state and, implicitly, their general quality of life.

Through these symptoms, the most frequent of which are fears, the emotional sufferings described above can become more intense and complicated. It is also what happens when minor frustrations are magnified to burdensome dimensions. Such a development may generate problems of increasing degrees regarding psychological functions which may then even impair the patient’s treatment compliance.

Enjoy the small pleasures of life

Life is so much about taking pleasure in the little things around us. Listening to beautiful music, watching birds picking at seeds in the birdhouse in front of the window, investing oneself in a gratifying hobby or hearing the laughter of children – there is so much that can make us smile, bring some joy or a state of cheerful serenity. An awareness for moments like these is all the more important in times of illness. Take the time to see and hear what can warm your heart. Enjoyable moments are a balm for our soul.

How to discern mental symptoms

Take fears and recurring symptoms seriously, though, and do not hesitate to seek support. Consulting with a psychiatrist is just like seeing any other doctor. The psychiatrist evaluates the symptoms and mental state of the individual, and he is the only one capable of prescribing the medical treatment for improving psychological symptoms. A prolonged state of depression or anxiety can lead to sequelae and may result in the poor functioning or the dysfunction of some organs, as we have seen in the story of R. A. Most important of all: Stay optimistic! People around you are surely willing to help. Talk to your fellow patients, your nurses or your family and friends. You are not alone with your emotions.

[Translate to COM English:] Older friends together

Living with a kidney disease means not only coping with the physical symptoms of the illness but also the emotional effects that many arise. Regular treatment results in a more structured week and at times it is necessary to rely on other people like carers and loved ones for support. Adapting to treatment and its side-effects may be uncomfortable, while adjusting to a daily dialysis treatment routine takes time and can lead to some tension.

There are many ways of switching off and restoring balance, be it through hobbies, asking the experts and joining patient organizations.

Family and close friends – a vital factor

[Translate to COM English:] Happy family

Including family and friends in your healthcare team can help you navigate the tremendous changes chronic illness brings, boost your quality of life, and even improve your health! Do not be afraid to ask for help when the going gets rough.

Loved ones can help make your home a comfortable, healthy place and provide emotional support. They can also help you adjust to your new lifestyle and stick to your diet and treatment plan. All of this has positive effects on how your disease progresses. Patients living on their own can create an “extended family” of close friends, neighbours, volunteers and maybe even a pet. If you belong – or feel drawn to – a spiritual community, ask to speak to someone at your local place of worship.

Finding something you enjoy

[Translate to COM English:] Older friends playing cards

Participating in group activities is another key to physical and mental health. Whether you’d like to volunteer as a tutor, sing in a choir, join a gym or participate in religious services, getting involved can help you feel good and find new friends. What activity you choose is up to you! Family members should also continue pursuing their own interests and activities, even if you can’t always join them.

Asking those in the know

[Translate to COM English:] Patient and social worker

Coping with emotions, getting informed, and last but not least managing your diet – it’s a good idea to include specialists in your strong support team. Counsellors, psychologists and social workers are experienced in helping people deal with life-changing challenges like chronic illness. Your local kidney advocacy group can act as your personal information network. And nutritionists can help you discover new techniques, ingredients and recipes that are both delicious and healthy.

You can have some ideas and suggestions here:

Good Food

Good Food Recipe Library

Patient organizations

There are many organizations designed to help individuals and families deal with the challenges of kidney disease. Ask your physician, psychologist or social worker about the services available in your area. There are plenty of good books and websites, as well.

Managing kidney disease can be a challenge, but you don’t have to do it alone. Family and friends are waiting to help. Dialysis centres and support groups also have resources available to help you navigate your path to “new normal”.

The first step is often the hardest: asking for support. But like most things, it gets easier with practice!

References

Petronela Moroșanu, clinical psychologist and psychotherapist, Nefromed Dialysis Centre, Piatra Neamț, Romania
Carmen Pop, Patient Care Manager, Fresenius Nephrocare Romania
Mitrofan, Iolanda – Psihoterapie: Repere teoretice, metodologice si aplicative, Bucharest, SPER Publishing House, 2008

Self-image and body-image

[Translate to COM English:] Elderly couple with their bicycles

Physical exercise

Your exercise programme doesn’t need to be about sporting excellence. You should concentrate on lighter exercise

Living with Dialysis