Mood, emotion, temperament these are words to describe how you are feeling both in the moment and, more importantly, how you are feeling overall. In the cystic fibrosis (CF) clinic, physicians, nurses, physiotherapists and dietitians ask about your physical health – “How you are breathing, sleeping, eating, and completing your treatments?” An equally important inquiry is “How are you feeling?”
Mental health is an integral and essential component of health. It is a state of well-being in which an individual realizes his or her abilities to cope with the normal stresses of life. The individual is able to work productively and make a contribution to his or her community.
The World Health Organization (WHO)1 constitution states: “Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.”
Research has shown that patients with chronic diseases (defined as a condition that persists for longer than three months) can often have anxiety and depression. It is estimated that up to one third of individuals with a serious medical condition will experience depression. Depression is one of the most common complications of chronic illness like cystic fibrosis.
As an individual with CF, you need to be aware of this and ensure that you identify and communicate these feelings so that you can receive support.
Adolescents and adults may experience occasional periods of feeling down. For some individuals with a good support network, these feelings can improve. For others, symptoms may occur over prolonged periods of time and feelings of self-doubt and sadness may become overwhelming.
Depression is identified by a variety of symptoms. If you have five or more of the following symptoms present over a two week period, it’s important that you consult your health care provider. He/she will ask you questions about your wellbeing and overall mood.
- Changes in weight/appetite
- Guilt, hopelessness or worthlessness
- Inability to concentrate, remembering things or making decisions
- Fatigue/loss of energy
- Loss of interest in sex and other activities once enjoyed
- Sleep disturbances
- Restlessness or decreased activity
- Physical aches and pains with no medical cause
- Thoughts of suicide or death
Another common mental health concern that may, or may not, accompany depression is anxiety. Anxiety is a feeling of worry that may include nervousness or agitation. Everyone may experience this on a short term basis, but prolonged feelings of anxiety, may lead to cognitive, physical and behavioural symptoms.
One of the most common forms of anxiety is Generalized Anxiety Disorder (GAD). GAD is defined as excessive anxiety and worry i.e. apprehensive expectation, occurring more days than not for at least six months. It could relate to, a number of events or activities such as work or school performance. The individual is unable to control the worry and the anxiety, GAD is associated with at least three of the following six symptoms:
- Restlessness or feeling ‘keyed up’ or on edge
- Being easily fatigued
- Difficulty concentrating or mind going blank
- Muscle tension
- Sleep disturbance such as difficulty falling or staying asleep, or restless, unsatisfying sleep.
The anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning2.
Similar to depression, it is important to consult your health care practitioner if you feel you are developing symptoms of GAD. Prolonged worry or anxiety can affect your ability to complete tasks. Appropriate help can ensure you have the tools to assist with day to day stress.
The good news is you don’t have to deal with these problems on your own. There are many resources available to help you. Your CF team can guide you to professionals who can help link you to counselors, psychiatrists, psychologists and social workers
If you have depression or anxiety reach out to a health care professional today!
2 Diagnostic and statistical manual of mental disorders: DSM-5. 5th ed. Washington, D.C.: American Psychiatric Association, 2013.
Contributions from: Dr. Harvey Rabin, MD FRCPC, Lisa Smith, RN, BScN, MSc and Ena Gaudet RN, BScN.