Ioannis G. Griveas, MD, PhD

W hen patients seek medical attention for CKD, they want relief from the physical anxiety caused by their illness. Mental health care is just as important as physical care. Recognizing feelings that are common to other CKD patients can help you feel less isolated and receive the support you need. Patients are able to tell their doctors what they are feeling physically: pain, fatigue, dizziness, etc. However, many people do not feel comfortable telling their healthcare team what they are feeling emotionally. Your psychological balance is an important part of CKD management. There are common feelings that patients experience when they are initially diagnosed with a chronic illness, although these feelings may be present at any time during treatment.

Fear and anxiety

Fear and anxiety are common emotions when you are diagnosed with a chronic illness such as CKD. We believe that our body has betrayed us. Kidney function is something you take for granted. You no longer have control over your kidney process. You have to rely on dialysis to do your kidney work. You will be wondering how this disease will affect you. You may be worried about the impact on how you take care of your family. Will your loved ones adjust to see you connected to a machine? Will they dislike the constant reminder that you are not as healthy as you once were?

Refusal

When something bad happens to us, we try to deal with it. We make decisions that can help us adjust or understand what has happened. But when the mental trauma is serious and threatens to overwhelm us, sometimes we deny that something has happened. Although this happens in extreme cases, it can happen if you have been diagnosed with a chronic illness. You can refuse to accept the fact that you are sick, or if you do, you can refuse to believe that you are seriously ill. You may not think that the recommended medications and treatments are necessary.

 Anger

 Anger feelings are common in patients with CKD. We have gone “crazy” with what has happened to us. We are angry that we are letting our health deteriorate at this point. Sometimes we are angry with the medical community for not taking better care of us or for not diagnosing the disease earlier. Many patients direct this anger at their family members. Anger and resentment can get to the point of adversely affecting your relationship with your family and your healthcare team.

Not feeling well

The feeling of “I’m not well” is a normal part of CKD. Lack of energy and nausea are common symptoms of CKD. But when we feel mentally down, we often feel sad that our body is not functioning properly. We all go through ups and downs in life. But if these feelings develop into despair, frustration or despair and last for more than two weeks, you should tell your doctor. This can be a sign of depression.

 How do I deal with all this?

CKD and the “new” information that accompanies it can “take over” a patient. There is new information you need to know to start a new treatment program. Your energy will be directed to your healing and physical well-being. This can be tedious.

But you also need to control your mental state. You can not let emotions such as fear or anxiety “control” you. Knowledge of CKD and dialysis can help you familiarize yourself with your illness and its treatment. You will not feel so scared or anxious if you know what to expect. A sense of calm can help you sort things out and be able to deal with your illness more effectively. Feelings of denial are a serious problem in your long-term health prognosis. Refusal leads to what is called “non-compliance” – that is, you ignore the health care team ‘s instructions on dialysis treatment, diet and fluid intake. Health professionals at the unit often see patients undergoing dialysis as being at risk, especially if they did not pay attention to what they ate and how much water they drank. But sometimes dialysis can not reverse the effects of non-compliance. Hospitalization may be required.

Do not leave things to chance. CKD is a serious disease. Listen carefully to the team that cares for you and follow their recommendations. If you do not understand something, ask questions. Anger can isolate you and prevent you from seeking help or comfort from people who care about your health. While expressing your anger can help reduce it, it can lead to more frustration because you do not understand its root. You can hit people who are not the cause of your anger. This can limit the relationships with those around you. Talking about why you are angry can help you determine the cause.

Depression can affect how you decide on your treatment. Because a dialysis patient must be actively involved in their daily fluid and nutrition therapy, you need to have a clear mind to make the best decisions. Depression can make you procrastinate, or even deliberately make irrational decisions. If your doctor diagnoses you with severe depression, he or she may prescribe some antidepressants. But first, he must know how you are feeling. He can not know if you do not tell him. Talking to someone about your feelings is essential. Do not feel that you have to find a way to deal with it yourself. Most patients benefit from discussing their feelings with their healthcare team, family, friends and other CKD patients. Help is out there. You just need the courage to make the initial contact.