Psychological problems are coming to your doorstep, [Protect yourself and your family] World Mental Health Day | The body is sick

October 10 is World Mental Health Day. This year, the World Health Organization uses "Mental health is a universal human right" as its theme to emphasize the importance of mental health. While daily people pay attention to physical health, they should also pay attention to the care of the soul. Many physical diseases will have psychological problems, especially anxiety, depression, etc. Anxiety and depression disorders are often accompanied by physical discomfort.

Clinically, it is very easy to miss or misdiagnose physical diseases combined with psychological problems/disorders. Some patients may only have some somatic symptoms at the beginning, which have not yet reached the level of diagnosis of anxiety or depressive disorders, but they have already had an impact on recovery and treatment. Therefore, we should increase our understanding and attention of physical diseases combined with anxiety and depression, and identify them as early as possible. and intervention.

Psychological problems such as anxiety and depression can lead to somatization

First, let’s understand “somatization”, which is physical discomfort experienced and reported by oneself that cannot be confirmed and explained by medical examination and knowledge. This type of symptom is the physical response of the patient's inner conflict and emotional experience. The symptoms are diverse, such as pain in the head, neck, chest, abdomen, limbs, etc.; nausea, vomiting, abdominal distension, abdominal pain, constipation, and diarrhea. Gastrointestinal discomforts such as frequent urination, difficulty urinating, frigidity, erection or ejaculation disorders, and other genitourinary discomforts; respiratory and circulatory system discomforts such as shortness of breath, chest tightness, palpitations, and hypochondriacal ideas.

Anxiety usually refers to an emotional experience showing tension, fear and uneasiness in the absence of corresponding objective factors. It can also be the body's adaptation to the environment when people face some upcoming or possible disasters or major life events in the environment. A complex emotional response to change.

Research shows that among all anxiety patients receiving treatment, 5% to 42% are caused by physical diseases, of which 25% are secondary to neurological diseases, 25% are due to endocrine causes, and circulatory system diseases, chronic infections, etc. are also often combined. anxiety.

Depression refers to an inner state of experience characterized by low mood, which can be accompanied by symptoms such as low mental motivation, slow thinking and association, and a reduction in verbal and behavioral activities. In severe cases, psychotic symptoms such as hallucinations and delusions may occur.

The 2007 WHO Burden of Disease Survey found that depression ranks first in its impact on health, far greater than any other chronic disease. The incidence of depression in patients with physical diseases is 25% to 45%, and depressive disorders also directly affect the prognosis of the disease.

Accept the diagnostic concept of "comorbid diseases" to achieve physical and mental health

Anxiety and depression combined with physical illness may cause the following harms:

➢Impact on physical diseases: making the symptoms of physical diseases more complex and making the disease more difficult to cure.

➢Impact on social functions: Patients with depression and anxiety often show decreased social activities and interests, and lack of motivation, which leads to decreased social functions and lower quality of life in patients with physical diseases.

➢Effects on the brain and cognition: Depression is an important risk factor for memory impairment and dementia. The reduction of cognitive function can further affect its social function.

Patients should accept the “comorbidity” diagnostic concept. In fact, with the development of the modern "biological-psychological-social" medical model, the concept of "comorbidity" has brought changes to clinical diagnosis and treatment. Clinicians are no longer limited to a single diagnosis to guide treatment, but need to start from the biological perspective. Treat diseases from multiple, psychological and social dimensions, focusing on the "comorbidity" of physical diseases and psychological problems, especially depression and anxiety.

The main treatment goals for physical diseases combined with psychological problems/disorders are:

For patients with physical illness combined with mild anxiety and depression, non-drug treatments are first adopted. For example, psychotherapy mainly includes cognitive behavioral therapy, interpersonal psychotherapy, etc., such as behavioral activation technology and exercise therapy in CBT. Physical therapy methods include repetitive transcranial magnetic stimulation, acupuncture, and massage.

In addition, patients with physical diseases combined with anxiety and depression should pay attention to drug treatment. When physical diseases are combined with moderate to severe anxiety and depression, or when simple non-drug treatments are ineffective, drug treatment can be chosen. Somatic diseases combined with anxiety and depression should arouse the great attention of clinicians; antidepressant drugs with high safety and few adverse reactions should be selected to treat depression accompanied by physical symptoms. At the same time, drug dependence should be reduced and reactions such as excessive sedation should be avoided.