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Mental Health with Physical Health Issues

AffyAvo April 18th, 2015

How does one know there's a mental health disorder when they are dealing with a physical issue?

Sadness, frustration, anger, etc. are to be expected with many physical challenges or diagnoses. That's also true of other events, such as dealing with a divorce, death, etc but on top of that the physical symptoms can be present for both. Too complicate matters further, some physical health conditions also have direct mental symptoms such as mood swings.

At this point it's no longer a concern for me, despite having bad days I'm past the dark time and I did seek mental help to help me past the difficult emotions as one way of taking care of myself. I wasn't diagnosed with something like depression, although I don't think I was being directly evaluated for it either.

Looking back, it's amazing how far I have come. I never felt completely hopeless, but I had a really hard time looking to the future. I certainly didn't want to go through life feeling as miserable as I felt for a while, but I hung onto the hope that it would get better. Little things also had a huge impact on my moods. When things started to get a bit better I could make comparisons to bipolar disorder; a day where I physically felt better or my IV training was successful would leave me feeling amazing, until symptoms showed up again or I had a challenge with my IV. I don't know how someone could accurately assess how much of that is normal for the situation.

On a site like this, I realize that we can't diagnose people and am not looking for tips on how to do that. I'm just curious how this is done in a professional setting, as well as hearing from those who were diagnosed with both physical and mental conditions, especially if the mental one came after the physical.

Maybe this question is going beyond the scope of what's reasonable to discuss here - but are there general guidelines for things someone or those close to them to watch for when dealing with a physical challenge that differ from those who are healthy and able bodied?

@Randy_ @HiddenGrace @Jaelin @EmpatheticDude

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EmpatheticDude April 19th, 2015

It's an interesting question, and mostly a philosophical one. Than you for tagging me in. I'm sorry, by the way, that it's personal for you, that you're suffering.

From the (U.S>) mental health side of things, the Diagnostic and StatisicalManual of Mental Disorders (DSM) has a grouping known as "somatoform disorders" that--broadly speaking--deals with aches and pains that cannot be traced to a physical cause.

From the medical side of things:"ideopathic" or "cause unknown" pain and body symptoms are often lumped into categories called syndromes, things like Ellers-Daniels, chrones disease, fibromyalgia, complex regional pain syndrome. The difference between a syndrome and a disorder is that a syndrome consists of a generalized cluster of symptoms that have observable physical manifestations, for which there does not seem to be a cause or an explanation, or the causes are very poorly understood.

In general, Western, allopathic medicine divides illnesses into set of symptoms and which body parts they effect. The mind and body, emotional states and physical states are only just now beginning to be seen as inextricablyintertwined. Now it is finally understood that depression is comorbid with almost every type of chronic physical illness: which caused which can be a chicken-and-egg argument. We often don't know.

In my profession of occupational therapy, we have the unique perspective of viewing human beings holistically, that is, we don't see people as just the sum of their parts. Nor we we view dysfunction as the result of one part of another breaking. We see everything as linked and directly impacting daily activities. So for example, if someone is having problems studying in school, we will address the physical, psychological, environmental, sociocultural and other contextual factors that may be causing the problem. We believe viewing humans as complex beings is both more humanizing and pragmatic; it makes us more effect "problem solvers."

Of course, the things I just stated have already been tenets of Ayerveda, Traditional Chinese Medicine, and Native American medical healing traditions for many thousands of years. Look to any of these for additional fascinating insights about human health, and the connections between the emotional, physical, and spiritual. These traditions are full of wisdom that have yet to be fully respected.

Good luck with your ailments.

AffyAvo OP April 19th, 2015

Thanks, you've given me some great things to think about.

While I like certain holistic therapies, when it comes to issuesI feel I like to break it down into specific problems. With fatigue - if someone could give me accurate numbers like it's 20% mental, 60% lack of inhibitor, 10% anemia and 10% typical tiredness I would love to get it! I feel like information like that would help me decide how to treat the issue as well as know when to push through. Maybe just working on accepting the holistic nature of some of my symptoms would be beneficial, as I won't be getting a printout like that any time soon.

miracle47 April 29th, 2015

Hi, my name is Marian and thanks a million for sharing because I'm an example of understanding how doctors treat you have you're diagnosed with a psychiatric disorder after you've had physical disabilities all of your life. It took this week for several individuals, who will become part of my new treatment team (physical and psychological) to coordinate and help me feel physically and emotionally WHOLE again. It all started on the (TRIGGER)** fifteen year anniversary of my husband's murder inside our home on my birthday. I finally had to give up myself and demand my old treatment team tolisten but it did happen two days before my birthday, which wasten days ago so I fired all of them except the one individual, who was recovering from hip surgery. He has always been on board trying his hardest to assist me in dealing with all of my physical and psychological disabilities on a holistic approach. He ended up having to have emergency surgery because of the hip and didn't want to leave me or his other patients during his four month rehab. I actually understood the sacrifice he has done for me over the last ten months listening to the physical challenges and not being able to find a specialist to deal with all the serious disabilities that makes my life feel like crap.

I finally broke down on the telephone two days before the anniversary and demanded they help me feel physically better but all of them didn't really care. I finally decided to contact my doctor, who was on medical leave and asked him to talk with his replacement about the fears I had about starting all over explaining the psychological and physical pain I was experiencing before the anniversary. He was willing to discuss it on the telephone with her if I would make an appointment for consultation at a new neurologist office. I told him YES I was willing to go to any lengths in order to feel better. His replacement contacted me every single day until one week ago to make sure I wasn't too depressed, suicidal or just needing a listening ear since the anniversary I usually wanting to end it so bad.

I think late Saturday night I was trying to get out of bed but hit head so hard she think I might had a seizure while hitting my head on the bed post. She wanted me to meet her at the ER but my regular doctor told her during a conversation that if she had ever suggested hospital or ER I would most likely refuse or wait until I can see them in their office. I wish now that I had taken her advice because during these four days until this morning the constant pain and trying to take things that were suggested by others didn't help but made it worse. I know next time got to trust my doctor and even a total stranger give them a chance.

I saw this wonderful doctor this morning and was actually early for the appointment and it went so well we discussed her being my new primary care doctor. I did suffer a small concussion but if the pain gets any worse before my neurologist appointment next Tuesday she wants me to call her and meet her at the ER. I'll next time because I know "she" doctor has my best interest plus understands this physical pain causes the psychological health to get all out of whack.

Thanks for allowing me to share brief part of my chronic pain experience this afternoon.

Kristynsmama May 31st, 2015

Thanks for posting this and @empatheticdude thanks for a great response that explains things so well. For me and me only, it was normal to feel depression and anxiety after a new diagnosis for a few months. What determined the difference between normal dealing with my illness and psychatricproblems was how well i was able to manage the feelings, how long it lasted, if i had a history of depression prior to my medical diagnosis. If in doubt, the best thing to do is to visit with a psychiatrist because they can make an accurate diagnosis and determine if medication could be helpful in dealing with the depression even if its a result of medical diagnoses.a psychiatrist can add a notation on your diagnosis if it is resulting from a medical condition.

~Angel