Every day people around us are struck with a sudden or gradual loss of ability. Sometimes they are young, often they are older. The losses arise from various issues, such as cardiac conditions, Alzheimer’s, cancer, diabetes, Parkinson’s, brain injuries, stroke, injuries leading to chronic pain, aging and the list goes on. You undoubtedly know, love or possibly care for somebody with at least one of these medical conditions. They are all very different conditions and have a different course in each individual, but they all have one thing in common: they change people’s lives in ways they are often very unprepared for. The changes often center on losing the ability to do certain things (e.g. drive, fully care for themselves, remember things well, work, bike).
I have had patients present in my office with all of the above medical conditions and often with concurrent mental health diagnoses of depression and/or anxiety. I let them know that there are many ways to adapt and learn to cope with illness and loss of ability. It is not always easy and sometimes requires more patience and creativity than patients realize they will need at the outset, but it is always possible.
Psychologist Richard Wanlass, Ph.D. states that an important first step in adapting to loss of ability is to deal with related grief feelings, which can vary among and within this population. However, he also cautions that while grieving is an important step in the process, so are the steps that keep one moving forward. I find it very important early on for patients to try to talk about and focus on the many things they CAN still do instead of the things they can’t do anymore. This can require a good bit of practice and cognitive restructuring with the patient. In his work with traumatic brain injured patients, Dr. Donald Ruff takes this practice a step further and focuses on what the person still believes in or what their “core values” are. Many times these core values can help those who have lost the ability to do certain things to shape a new sense of identity and sense of purpose.
Mood improvement with these patients usually involves suggesting ways to change their behaviors and/or change their thoughts. There are many different ways to try to do both of these and some research shows their effects can be additive.
Here are a few ways to improve mood via behavior change:
- Increase pleasant events/activities in ones schedule – this can require some of that creative thinking I mentioned earlier in that you may need to think about ways to modify activities you used to enjoy to accommodate some loss of ability or try out brand new activities that you are currently able to engage in (brainstorm with friends or relatives, if needed).
- Physical Exercise – consult healthcare providers about this and think outside the box, and outside the gym; i.e. walk in your house or on your property, do housework, gardening, chair yoga or other sitting exercises.
- Do things for others – can be as small as a friendly smile or greeting and can include caring for pets or plants.
- Laugh and smile – at something, or even nothing, because it has been shown to improve mood, boost the immune system and lower levels of stress hormones.
- Change “the channel” – change your surroundings (e.g. step outside, put more lights on, open the blinds, visit a friend) to try to break negative thinking and mood.
Here are a few ways to improve mood by changing thoughts:
- Change Self-Critical Thoughts – can be done by practicing transforming them into more positive and accepting thoughts.
- Focus on what there still is to be grateful for despite losses – this has been shown to relate to better sleep, stronger immune systems and fewer visits to the doctor.
- Focus on the positive – the purposeful practice of experiencing and remembering events with the positive in the forefront helps break negative thinking cycles and low mood.
There are also many ways to help reduce stress and anxiety, which tend to be very prevalent in people experiencing a disability. This includes practicing: muscle relaxation, breathing relaxation, mindfulness, meditation, imagery and positive coping statements. Also very useful is the exploration of how to best manage expectations for oneself and others in the face of lost abilities. This often takes some time and openness to vulnerability, but tends to help reduce anger and frustration.
Depending on if there are memory losses and ongoing chronic pain symptoms, there are numerous additional techniques that can be taught to help with these as well. It’s often helpful to include spouses and loved ones in these sessions to help with follow through outside of sessions. Additionally, I often recommend support groups for the patients and families/caregivers. Many websites specific to disorders exist that provide a great deal of educational and support resources, including:
Make use of as many techniques and resources as possible; I think you’ll be glad you did.