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CHAPTER 4:
EMOTIONAL PROBLEMS

  • Fear, Anxiety and Confidence
  • Depression
  • Anger and Grief

Persons who have serious illnesses are often bothered by emotional problems. The most common problems are fear, anxiety, depression, and anger. There are a number of helpful ways to manage these problems.

Fear, Anxiety and Confidence

Everyone feels fearful and anxious when they are uncertain about what will happen in the future. People often first feel disbelief when they learn that they have a health problem that makes the future unclear. The commonest causes for fear and anxiety are worrying about being a burden, pain, and losing control. By taking control of the of these causes people can get control of their fear and anxiety.

What seem like BIG causes of fear and anxiety can usually be managed by breaking the causes down into smaller problems. The HowsYourHealth Problem Solving tool is designed to do that. Once the causes of fear and anxiety seem managable, confidence with management and control increase and make future problems and concerns less overwhelming.


Depression

Depression is a common feeling for persons who have serious illnesses or who are uncertain about their future. Because many persons find that talking about their feelings and plans helps depression, it often does not last a long time. It is time to take action when feelings of extreme sadness or despair last for at least two weeks or more and interferes with working, eating, or sleeping. Other symptoms include hopelessness, loss of interest in usually enjoyable activities, excessive crying, suicidal pre-occupation, guilt, lack of energy, inability to concentrate and irritability.

If you find yourself withdrawing from family and friends, feeling overwhelmed, exhausted, helpless, hopeless and blaming yourself for having these feeling then you need to ask for help. Depression is highly treatable and not seeking treatment can lead to needless suffering. It is often not possible to simply "snap out of it."

The following are some things you can do when you suspect or family members suspect that you are depressed:

Anger and Grief

Anger is one of the first emotions people experience after learning they have a serious illness. They often feel that life is not fair and that this should not have happened to them. Anger is a normal stage of grief and loss.

You may not be comfortable with these feeling of anger. But it is normal and should be talked about. In fact, about 3 in 10 persons who are very ill have "temper tantrums." If you feel your anger is beyond your ability to control, seek help from your family and health care practitioner.

Grief describes a person's response to a potential or actual loss. There are many types of grief.

Anticipatory grief is the process by which friends and family come to terms with the potential loss of an important person in their life. Common feelings representing anticipatory grief are anger, guilt, anxiety, irritability, sadness, feelings of loss, and decreased ability to perform usual tasks.

Acute grief is a sudden, often dramatic reaction to the actual loss of a significant person. Acute grief can result from a sudden death or from an expected death in which there was phase of anticipatory grief. Acute grief is characterized by intense crying spells, anxiety, denial, "numbness," a sense of a lack of reality, and physical symptoms.

"Normal" grief is a period of time during which a person gradually adapts to a loss. Since death often changes people, a return to pre-loss state is not always possible. Instead, a more realistic goal is an altered life in which the person has adapted to the loss.

There is no defined period of time within which people are expected to "recover" from grief as long as they are progressing in other ways in their lives. Though guidelines are difficult to determine, some progress in the person's grief should occur within the first 1 to 2 months. Clear improvements in at least some areas of the person's grief should show by the 4 month after the loss.

Complicated grief is marked by a failure to return to pre-loss levels of performance or states of emotional well-being after the loss of a significant person. Complicated grief may be difficult to identify because grief experiences vary significantly among individuals. However, a person suffering from complicated grief usually does not show marked improvements at the 1 to 2 month or 4 month marker.

It is often difficult to distinguish between depression and complicated grief. Both conditions can have similar symptoms such as feelings of guilt, thoughts of death, and slower thinking and movement). However depression symptoms usually begin later, after 1 to 2 months of grief, and persist for several months after the loss.

Though the grieving individual may receive some emotional support from their physician, a vast majority of support that people receive after a loss comes from friends and family. In all stages and forms of grief, emotional support and counseling are helpful.

If the grief is severe or complicated, medications may also be helpful. Please talk to your regular doctor or nurse. Professional counseling may be needed for both depression and complicated grief.

We have tried to make the How's Your Health error-free. However, those involved in its preparation can not warrant that all of the information is accurate and complete. When you use How's Your Health as a guide for your health and medical care, be sure to discuss any questions about it with your doctor, nurse, or other health care worker.