HOW LIFESTYLE DISEASES TAKE A TOLL ON MENTAL HEALTH
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.
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 physi- cal 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.