Emotional Well-Being and Sickle Cell Disease
Posted On Sep 16, 2016
One of my greatest interests in health psychology is understanding how emotional health impacts overall physical well-being, and vice-versa. In particular, I am always curious about how our reactions to any medical diagnosis can exacerbate or worsen the symptoms. In turn, how can effective coping strategies help us heal, adapt, and possibly prevent exacerbation of physical symptoms? I was recently invited by the Sickle Cell Association of Texas: Marc Thomas Foundation to present a webinar on how effective stress management skills (with a specific emphasis on mindfulness skills) could greatly benefit individuals with Sickle Cell Disease (SCD) to effectively manage pain, including during crises. As I prepared my webinar, I came across a plethora of research highlighting that individuals with SCD experience a number of stress-related consequences, which only further places them at risk for ongoing pain. A vicious cycle ensues…
Various researchers (e.g., Porter et al., 2000) have found that stress is a significant predictor of pain in SCD, especially 2 days prior to a crisis. Thus the importance of effective stress management skills…think of it as your daily multi-vitamin. Get into the habit of thinking about what small things you can do to reduce the “baseline” stress level, every single day. The more stocked your stress-management toolbox is, the greater the capacity to manage stressors, including pain.
Most concerning to me was the ample data on the prevalence of depression among individuals with SCD, some estimates as high as 21% of individuals with SCD meeting criteria for major depression. Depressive symptoms can include irritability, feelings of guilt, insomnia, feelings of helplessness, and withdrawal. The greater the depressive reaction during a crisis, the more predictive it is of depression, and even anxiety, well beyond the crisis event. In other words, even after the worst pain is attenuated, the emotional consequences can still persist! As I continued to dig further in my research, I learned that up to 70% of individuals with SCD also have some sort of sleep disturbance. If individuals have both sleep disturbance and depression, it places them at greatest risk to experience the most chronic pain as compared to those with SCD not experiencing sleep or mood symptoms.
Lastly, individuals meeting criteria for major depression not only experience more hospital admissions, but also spend more days in the hospital. Thus, ineffective stress management skills, which can lead to greater emotional distress and increases the risk of pain, makes individuals with SCD sicker and slower to recover.
Bottom line…learn effective stress management skills to help prevent emotional distress. The lower the emotional distress, the better for pain and aids the ability to recover faster after SCD crises.