KT for Good: How lifestyle diseases take a toll on mental health
The impact of the diagnosis will have a bearing on the person and his or her family and friends.
A healthy you means a healthy society. Khaleej Times' latest campaign under the 'KT For Good' umbrella highlights common lifestyle diseases. In Part 8 of our series, Dr Anil Kumar P N tackles how chronic conditions affect patients' mental health
Diabetes, high blood pressure, heart disease and obesity are classified as chronic conditions - which means these are long-standing conditions.
While the traditional management of these issues includes medications, diet and exercise, the psychological aspects of these diseases are overwhelming and often neglected.
Psychological disturbances significantly contribute to poorly perceived health status in these chronic conditions.
The impact of the diagnosis will have a bearing on the person and his or her family and friends. They have to adapt to the changes it asks for and they will be compelled to reach goals they have never thought of before.
The novelty of the diagnosis and the changes expected can at times become a burden they would have to carry 24/7. As they cope with the diagnosis and treatment, these patients develop psychological issues, such as depression, anxiety and anger.
Depression in adults with diabetes is very common - two times greater than for people without diabetes. One in five patients with chronic heart disease or heart failure is depressed, a prevalence that is at least three times greater than in the general population. However, given that depression is not always detected by the healthcare provider, it frequently remains untreated.
This compounds adverse cardiovascular outcomes and increased healthcare costs. Depression directly affects blood glucose control - and high blood glucose results in increased risk of diabetic vascular complications (heart disease and stroke) and nervous system and kidney problems.
Depression in persons with diabetes is associated with poorer diet and medication adherence, leading to functional impairment and higher healthcare costs.
|Depression in adults with diabetes is two times greater than for persons without diabetes
1 in 5 patients with chronic heart disease or heart failure is depressed, a prevalence that is at least 3 times greater than in the general population.
Depression directly affects blood glucose control - and high blood glucose results in the increased risk of diabetic vascular complications (heart disease and stroke) and nervous system and kidney problems
Prevalence of anxiety in people with diabetes is 30% - 40%
Research indicates that women with diabetes have significantly higher levels of anxiety than men (55% vs 33%
Anxiety, frustration and anger about having these conditions contribute to increased blood pressure and also impact interpersonal relationships
Other affective disorders, such as anxiety and anger, often emerge as well. The prevalence of anxiety in persons with diabetes has been reported to be as high as 30 to 40 per cent.
Research indicates that women with diabetes have significantly higher levels of anxiety than men (55 per cent vs 33 per cent).
Anxiety, frustration and anger about having these conditions contribute to increased blood pressure and also impact interpersonal relationships.
Patients "encounter challenges in relationships" when friends and family members try to control the management of their disease - especially when it comes to food - or offer unsolicited advice.
It is the duty of healthcare professionals, family and friends to stand by and support these individuals during the difficult times.
Lifestyle changes like regular exercise, weight loss and dietary management have shown significant improvements akin to pharmacological interventions. Providing patients with the right information and support through structured education and peer group network will also be of great benefit.
Discussions about their psychological well-being can identify whether an individual needs further support. In my vast experience in dealing with these conditions, honest discussions with patients that address more than their physical health may assist in building a trusted, professional relationship.
Such measures, when taken early in the natural course of the condition, will result in a more fruitful and positive outcome.
The chronic conditions have reached epidemic proportions, with obesity and diabetes driving the risks higher than ever. The health policies to prevent childhood obesity, easy access to lifestyle modifications, and improving awareness would be key to the health of our future generations.
How to improve mental health
Exercise and increase activity level: When an option, walk to destinations instead of driving. Take your dog for a walk. Go for a leisurely bike ride. Take stairs instead of elevators.
Quit smoking: When you smoke, you take in a variety of toxins, and it may be that many of those toxins contribute to mood problems. Moreover, the physical health problems caused by smoking - heart disease, coughing, emphysema, frequent colds, exercising difficulty - can lead to mood problems and mental health challenges
Eat healthy: Your diet directly affects your physical health, and your physical health can undermine your mental health
Seek medical care even for minor issues: Even something as minor as a toothache or bladder infection can temporarily undermine your ability to manage stress, so prompt medical care for physical issues is always a wise choice
Practise meditation daily: By meditating, breathing deeply, or simply focusing on cultivating mindfulness for 20 to 30 minutes each day, you can steadily improve your ability to tolerate frustration, control your temper, and manage anxiety
Have a regular sleep schedule: Most sleep experts recommend between seven and nine hours of sleep per night, but the real key to success isn't just the right amount of sleep; it's a regular sleep schedule. By going to bed at the same time each night and getting up around the same time each day, you make it easier for your body to regulate its sleep-wake cycle and improve your mental and physical health.
Dr Anil Kumar PN, Consultant Endocrinologist andDiabetologist, Prime Hospital
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