People with medical illness, such as cardiac disease, diabetes and cancer are vulnerable, and often feel depressed, anxious or resentful. In addition, even the best family relationships can suffer from the disruption caused by illness.
Some emotional reactions to illness, such as depression, can increase the risk of more health problems. For instance, studies have shown that depressed cardiac patients are less likely to participate in rehabilitation and are more likely to have further episodes of cardiac illness. Similarly, people who have phobias of surgery, needles or anaesthesia may avoid procedures which would benefit their health.
Finally, pain is often experienced by individuals who are medically ill. Pain contributes to tension and irritability, and is harder to cope with when a person is emotionally distressed.
Many clients benefit from Health Psychology treatments to help them cope with medical illness and pain, to prepare emotionally for medical/surgical procedures, and to participate in rehabilitation. In addition, a psychologist can often help clients in their efforts to resume family roles and work responsibilities.
Obesity and Weight Management
Obesity is an important health problem. Being significantly overweight increases the risk of developing illnesses, such as cardiac disease, stroke, diabetes, kidney failure, and osteoarthritis. Moreover, many individuals who are obese suffer from social stigma which affects their self-esteem.
Obesity is often difficult to overcome because eating is a self-nurturing activity which is embedded in our lifestyle and culture. Numerous factors contribute to obesity including:
- excessive caloric intake
- choice of high fat or high glycemic index foods
- habits, such as overeating, and eating for emotional reasons
- high stress which leads to fatigue and reduces energy to prepare healthy meals
- motivational barriers that make it hard to change eating habits
- sedentary lifestyle
- biological factors, such as metabolism
Psychological treatment is often helpful for clients trying to achieve healthier weights. There are well established strategies to help clients move from contemplating weight loss to preparing an action plan.
Once a weight loss program is started the psychologist helps the client to remain motivated and to cope better with stress and emotional concerns which contributed to overeating or poor food choices. When a healthier weight is achieved, the psychologist assists the client to maintain this weight over time.
Smoking cigarettes significantly increases the risk for illnesses, such as cancer, stroke, and cardiac disease. However, it is a difficult habit to quit and people often make several attempts before they are successful.
Several factors make it difficult to stop smoking, including:
- the addictive properties of cigarettes
- pleasurable aspects of the habit
- high stress
- motivational barriers that make it hard to change habits
- peer groups and other social contexts where smoking is encouraged
A psychologist can assist clients to quit smoking. A first step is to help clients become more psychologically prepared to quit smoking and to identify barriers to stopping. When the client is ready to quit smoking, a thorough action plan is developed.
Once the smoking cessation program starts, the psychologist supports the client to remain motivated. Clients are taught coping strategies to manage the stress associated with quitting and to deal with emotional concerns and situations which may increase urges to smoke. When the goal of quitting smoking is achieved therapy shifts to strategies for maintaining this success.
Ageing has its challenges. As individuals age they encounter higher rates of medical illness, including cancer, diabetes, and cardiac disease which are disruptive. In addition, age-related illnesses, including macular degeneration, arthritis, osteoporosis, and chronic obstructive pulmonary disease result in functional limitations that restrict activity and interfere with quality of life.
Living with age- related illnesses can result in emotional problems which are often overlooked. Depression and anxiety are very common among older individuals.
A combination of Cognitive-Behavioural therapy and Health Psychology treatments is often useful in helping seniors cope with a wide range of concerns, including depression, medical illness, losses in physical functioning, visual impairment, sudden changes in work status, and losses in family roles.
End of Life Issues
People nearing the end of life experience a wide range of emotional concerns, such as anxiety, loneliness and frustration. These feelings are often overlooked by family and friends who may feel more comfortable attending to the dying individual’s medical or residential needs.
As individuals become more physically frail and less able to do things for themselves, they may lose self-esteem and feel that they are a burden on others.
People nearing the end of life often strive for personal meaning. They may want to complete tasks which they value, such as projects or estate planning. Physical symptoms such as pain, fatigue, difficulty breathing, and limited mobility are often aspects of end-stage illnesses which hinder these efforts, and contribute to emotional distress.
People who are dying often benefit from the support of a therapist who is empathic and experienced discussing end of life issues. Health Psychology treatments, such as relaxation techniques and psychological pain management strategies, may help to alleviate some of the tension and discomfort the dying individual is experiencing. Cognitive-behavioural therapy can help change thinking patterns which may be adding to feelings of guilt and depression. Some sessions may involve family members to enhance communication and understanding of the client’s needs.