Psychology of Chronic Illness Myasthenia慢性病心理学重症肌无力.pptVIP

Suzanne Ruff, PhD Health Psychologist Cleveland VA Medical Center Cleveland, Ohio Chronic Medical Conditions There are three tasks in managing a chronic medical condition Care for your condition, learn about your condition Manage any emotional changes that your condition may bring about Return to your pre-diagnosis life as fully and as soon as possible Partner with your medical caregivers and your family and friends Stages of diagnosis Pre-diagnosis Anxiety Signs and symptoms not recognized YOU know there is something wrong Medical providers may not know what is wrong You may begin to second guess yourself – especially in a condition with varying symptoms Anger You can’t do what you used to do You want your life back Stages of diagnosis Diagnosis Relief It’s not all in my head Anxiety Can be heightened – especially with relatively rare condition Diagnosis known, but prognosis uncertain Anger “Why me?” Depression Later in time Stages of diagnosis After diagnosis, mood varies with: acuity of disease, number and severity of flares support available medical care available ability to return to life before diagnosis 1978 study on mood variation with significant event Spinal cord injury Winning the lottery Stages of diagnosis Most people return to their baseline mood about a year after injury or winning the lottery Psychology of chronic illness What does this mean to patients with a chronic medical condition? Chronic medical conditions can lead to depression over time Often unrecognized Overlap of symptoms No pathognomic feature in depression Most common is anhedonia, not a sad mood Lack of restorative sleep, daytime fatigue Cognitive changes Diagnosis and treatment Recognize symptoms Mood, somatic symptoms, cognitive symptoms, Anhedonia Relationships Activities Meaning and purpose in life Seek responsible treatment Partner with your medical providers and especially MG provider Think about therapy rather than medications Psychological therapies Cognitive Behavioral