The body and psyche are inseparable. When a problem occurs in one, it is reflected in the other. Unfortunately, the treatment of a disease is often primarily focused on physical symptoms, while psychological aspects are ignored or treated with secondary importance. Some diseases are often associated with losses, stigma, severe pain, financial burden, and other factors that can significantly worsen the quality of life in patients and relatives. These factors are indirectly involved in the disease process.
Disease is a very broad concept
The origin of a disease may be bacterial, viral, pathogens affecting the immune system, DNA mutation, etc. Some diseases are congenital while others develop through time. Some develop suddenly and others gradually. Some are curable, while others are incurable. Some diseases are accompanied by severe pain that can last a lifetime and others have little pain. And so we could go on. When we talk about physical illness, we are talking about a very heterogeneous group with different needs.
After the onset of a disease, changes in behaviour and feelings in patients can occur. In order to understand the patient it is good to know what they are facing. Unusual behaviour can be an adaptation to the changes brought by the disease and may also be reflected on the emotional level. Depressive symptoms, stress, and even thoughts that life has no more meaning occur more frequently with some diseases than in the physically healthy population.
Authors report that in 11% to 50% of patient deaths, suicide is the cause.
The most vulnerable groups are patients with cancer, individuals with dysfunctions in the central nervous system (CNS), and elderly with chronic conditions. Others report an elevated risk of suicide in patients with coronary heart disease, chronic obstructive pulmonary disease, and osteoporosis.
Disease and vulnerability to suicide
Not only with disease, but also patients with surgical procedures become more vulnerable for suicidal behaviour. Research has found this to be true in bariatric surgery patients and in the treatment of patients with motor disabilities using deep brain stimulation. The risk of suicidal behaviour also depends on the time elapsed since diagnosis or health intervention. Thus, it is necessary to monitor changes in mental health throughout the disease process until recovery.
Medical staff in the health system are primarily interested in physical illness in terms of its origins, physical dysfunctions, and if organs and systems can be cured.
However, the patient is part of a much wider system than only the health system. They are a member of an immediate family – son or daughter, father or mother, sister or brother. They can also be a co-worker, friend, neighbour, coach, advisor to people in need, teacher, etc. The disease can affect these areas, which may bring joy, a sense of competence, love, and a sense of identity to the individual.
Illness and medical therapy can bring large and important changes to all areas of an individual’s life. Therefore, it is important that the patient has the opportunity to talk about these changes and what this means to them.
It is necessary to help them make sense of everything that is going on and to accept losses. For example, an athlete may never be allowed to train again, an alpinist will no longer be able to climb, or an adolescent must give up enjoyable habits and activities that other peers can do. For these reasons it is important to notice possible changes in well-being and suicidal thoughts and to refer individuals to professional help in a timely manner.