Health and Wellbeing

Table of Contents

Michelle Barratt Psychology is a Toowong and Redland Bay / Wynnum – Manly Clinical Psychology Practice, and aims to provide treatment for Health and Wellbeing in Brisbane at the highest standard. The practice values implementing support and treatment that not only endeavours to support their clients feel safe, heard and understood, but also strives to offer effective treatment that will empower clients to learn new skills to support them in the future. If you are unsure about what you are dealing with, please don’t hesitate to contact us to support you through the next step of either working out what to do or how to proceed with an appointment.

Author: Michelle Barratt

Being the Carer For Someone WIth Parkinsons

However a PD diagnosis and caring for a loved one with PD is not all bad!!!

Parkinson’s medication is very effective in the early stages of the disease (up to 10 years). The medications alleviate (more aptly masks) the motor symptoms. Metaphorically, the mediations act like oil applied to a stiff, rusty door hinge. The action of the oil allows the door to open with greater ease, thus ‘freed up’. Thus the medications allow the person with Parkinson’s to move reasonably freely and maintain relatively ‘normal’ functioning, and quality of life. Unfortunately the effectiveness of medications wane as the disease progresses.

Hence the early stages of the disease is known as the ‘honeymoon period’. Many person’s with Parkinson’s and their loved ones capitalise on this period. They do some or all of things that they had been putting off, such as working their way through bucket list (e.g. getting in a campervan and travelling around Australia whilst they are still able too, or visit relatives overseas).

In fact there is evidence in the literature that shows caring for a loved one with a debilitating or terminal illness (e.g. cancer) can have positive effects. That is many caregivers not only survive the demands of care-giving, but thrive in the care-giving situation, and as a result experience personal and relationship growth.

Many caregivers have reported:

  • Improved Relationships with the person with Parkinson’s and others (e.g. bringing people closer together)
  • Enhanced Perspectives, such as a greater appreciation for life and others. Such as feeling grateful for what they have in life or perceiving the caregiving situation as an opportunity to give back to the person with Parkinsons.
  • Personal Growth such as, becoming stronger , more self-reliant, and improved interpersonal skills (e.g. become more patient, less self-focused, more empathetic, more compassionate, more assertive).

This emphasizes human strength and resilience. How people become stronger in the face of adversity. Many caregivers used the diagnosis as a time for self-reflection, and re-evaluation. To generate goals (e.g. travel whilst still able, spending more time with family, not ‘sweating the small stuff’) and take action, aligned with life values.

However, literature also shows that some carers do not cope and feel at times:

  • Isolated and alone
  • Scared that they are dealing with the unknown and at times feel
  • Resentment for having to give up so much of their lives and careers to support the person with Parkinson’s.
  • Feel exhausted and that
  • They have lost a huge part of their life and how things used to be – things just don’t seem normal anymore.

A culmination of these issues and feelings can also lead to burn out and compromise the care of the person with Parkinsons as well as the carer developing their own Mental Health concerns. If you have a loved one who has been diagnosed with a debilitating or terminal illness. You may wish to talk to a psychologist, to assist in positive adjustment to the disease… make an appointment…

Author: Michelle Barratt

Chronic Physical Disease and The Forgotten Mental Health Impact

According to Australian Bureau of Statistics (2018) 47% of Australians have one or more chronic conditions. Chronic conditions/disease are defined as a chronic disease or a condition that usually lasts for 3 months or longer and may get worse over time. Chronic diseases include mental and behavioural conditions; back problems; arthritis; asthma; diabetes mellitus; heart, stroke and vascular disease; osteoporosis; chronic obstructive pulmonary disease (COPD); cancer and kidney disease. As we age, we are more likely to experience a chronic disease.

Physical health and mental health are interrelated. “Without mental health there can be no true physical health” (Brock, 1954) and vice versa. Yet often when a person is diagnosed with or has a chronic physical condition the primary focus is on managing and stabilizing the physical or medical aspects of the disease and the impact of the diagnosis and long-term psychological impacts of having a chronic condition are often not addressed.
A person living with a chronic illness or condition will experience a wide range of emotional responses according to where they are in the phase of their illness – initial diagnosis, chronic stage, or terminal. A diagnosis of a chronic disease/condition can have a profound impact on most people. However, a person who is experiencing stressful life events before their initial diagnosis, and who have a history of depression, may be at a higher risk of psychological distress when they are initially diagnosed with a chronic illness or condition (Maunsell et al,1989). Half of all Australians living with a chronic health condition experience depression or anxiety (SANE, 2006). The psychological impact of a chronic disease/condition for an individual may include:

  • Feelings of grief and loss related to the loss of:
    • good health
    • body parts or body functions (e.g., sexual)
    • freedom, independence
    • career, income
    • self-efficacy, self-control, self esteem
    • mental health, cognitive function
    • pride, joy, hope, dignity
    • certainty
  • Fear related to:
    • Pain of medical procedures, disability, recurrence, and death
    • rejection by significant others
    • uncertainty or being in limbo
    • loss of friends, family, work
    • isolation/ loneliness
  • Depression
  • Anxiety
  • Feelings of hopelessness, stress, shame, and guilt
  • Sleep Disorders (e.g., Insomnia)

It is also important to acknowledge the profound psychological impact a chronic disease/condition may have on family, friends and other relationships as these relationships are pivotal to providing ongoing support and connections.

When receiving a diagnosis or living with a chronic condition or disease it is important that an individual can utilize healthy coping strategies, seek psychological help, and utilize their support systems to ensure they move toward the reconstruction of a new sense of self.

Strategies may include:

  • Eating a healthy diet.
  • Getting as much physical activity as possible.
  • Avoiding negative coping mechanisms like alcohol and substance abuse.
  • Exploring stress-relief activities like meditation and yoga.
  • Journaling
  • Letting go of obligations that are not currently important
  • Knowledge is power – the more information one has, the more empowered one feel about their disease/condition. Learn about it to better manage it.
  • Staying in touch with family and friends. Social connections lower anxiety and depression, regulates our emotion, lead to higher self-esteem and improve our immune systems and happy hormones.
  • Asking for help. Counselling options include support groups, individual counselling and/or family and couples counselling.

Author: Dee Pakendorf

What is Parkinsons Disease

Parkinson’s Disease (PD) is a terrible, life-limiting disease. It is the second most common neurological disorder, after dementia. PD is commonly diagnosed in people aged 65 and over. It is estimated by 2020 the average person will live to the ripe ‘old’ age of 80. Hence, given the aging population, PD is on the rise. Notwithstanding 10% of people are diagnosed with Early Onset Parkinson’s Disease (EOPD), aged 40–55 years.

We are becoming more aware of PD. This could be attributed to famous people being diagnosed with PD. Such as boxing legend Muhammad Ali , diagnosed aged 42; Actor, Michael J. Fox, most famous for his in ‘Family Ties’ or ‘Back to the future’, diagnosed aged 30; Country singer and songwriter Johnny Cash; Pope John Paul II; NBA basketball player Brian Grant, diagnosed aged 3;. Eleven time Grammy Award-winning singer Linda Ronstadt diagnosed aged 67; Bob Hopkins was diagnosed in 2012, and most recently Scottish comedian, Billy Connelly was diagnosed in 2013, aged 70 years.​

PD is a movement disorder.

It was traditionally known as the ‘shaking disease’, because the tremor was the most apparent and common feature of the disease. However it is becoming increasingly acknowledged that PD is “much more than just the shakes”.​

PD can be characterised slow and stiff movements. Overtime as symptoms worsen, walking (taking small steps – shuffling), talking (soft, quiet, small voice) and thinking becomes increasingly difficult. For some they have the facial mask, and as a result can appear emotionless or grumpy.

Perhaps unsurprisingly, PD greatly effects the a person’s self-esteem. Overtime with increased disability imposed by the disease, patients with Parkinson’s may feel ‘small’ and ‘insignificant’ and ultimately wind up feeling useless, worthless, depressed and anxious. Ultimately, everything about them changes – changing how they look, function and ultimately overtly behave.

Parkinson’s Disease and Mental Health

Parkinson’s Disease symptoms are not limited to motor (physical) symptoms. There are significant non-motor symptoms (psychological or cognitive) that can accompany PD, including depression, apathy (lack of motivation), anhedonia (inability to experience pleasure), anxiety, pain, hallucinations, autonomic dysfunction (loss of smell), and in advanced stages some develop full blown dementia. Thus, it is not hard to see just how debilitating this disease can become – More often than not, it is debilitating to not only the patient with Parkinson’s but to those around them who are left feeling helpless, bewildered and sad.

In addition, due to the wide spectrum of symptoms, it affects everyone differently. Thus PD is unique to each individual, which makes it hard to generalise, diagnose, and treat. Many go for prolonged periods before the diagnosis is made. This can be an anxious and uncertain time, knowing that something is wrong, but not knowing what. Many, like Linda Ronstadt, are misdiagnosed. She was initially treated for a frozen shoulder (restricted movement and stiffness), until PD-related symptoms became more apparent. Therefore receiving the diagnosis can be ‘bitter-sweet’. Given PD is incurable, progressive and relentless in nature. Overtime symptoms worsen, can diminish those affected quality of life.

Parkinson’s disease and their Carers

As mentioned above, the effects of Parkinson’s are not only felt by the suffers but by their loved ones, who often, by choice or necessity become primary carers. Many of these effects on the loved ones are negative. They may feel burdened as many responsibilities fall on them, because in later stages of the disease, patients with Parkinson’s are forced to relinquish employment, household and driving responsibilities. Some loved ones have to retire prematurely, in order to provide more care and assistance for patients with Parkinson’s – thus at times having to cut their careers short and directly having an impact on them financially, emotionally and environmentally. For example, many also experience a diminished quality of life (e.g. no time to socialise because they are too busy caring for persons with Parkinson’s).

All in all responsibilities and capacities for everyone involved changes which can bring about adjustment issues for all parties.

Author: Michelle Barratt

Diabetes

Why is Support needed?

Carers of either; children, adolescents or adults living with the diagnosis of Diabetes Type 1 or Diabetes Type 2 can at times be extremely overwhelming and tiresome and often burnout can occur (please see: Diabetes Type 1 and Type 2 Counselling).​

What Is Diabetes Type 1 or Type 2?

Type 1 Diabetes

  • Type 1 Diabetes is an autoimmune disorder characterised by the abrupt onset of symptoms that result from the lack of insulin production by the beta cells of the pancreas. The disorder may appear following a viral infection and likely has a genetic contribution as well.
  • In Type 1 diabetes, the immune system falsely identifies cells in the pancreas as invaders and, accordingly, destroys these cells, compromising or eliminating their ability to produce insulin.
  • Type 1 diabetes usually develops relatively early in life; it forms in childhood or adolescence & is called insulin dependent diabetes mellitus (IDDM).
  • The cells of the pancreas that normally produce insulin have been disabled & can no longer produce insulin.
  • Therefore, individuals with Type 1 Diabetes normally require insulin injections to prevent health complications
  • 5-10% of the diabetes population are diagnosed with Type 1 Diabetes the rest are Type 2.

Type 2 Diabetes

  • Type 2 is the most common form of diabetes, affecting 85-90% of all people with diabetes. While it usually affects older adults, more and more younger people, even children, are getting type 2 Diabetes.
  • In Type 2 Diabetes, the pancreas makes some insulin but it is not produced in the amount your body needs and it does not work effectively.
  • Type 2 Diabetes results from a combination of genetic and environmental factors. Although there is a strong genetic predisposition, the risk is greatly increased when associated with lifestyle factors such as high blood pressure, overweight or obesity, insufficient physical activity, poor diet and the classic ‘apple shape’ body where extra weight is carried around the waist.
  • Type 2 Diabetes can often initially be managed with healthy eating and regular physical activity. However, over time most people with Type 2 Diabetes will also need tablets and many will also need insulin. It is important to note that this is just the natural progression of the disease, and taking tablets or insulin as soon as they are required can result in fewer complications in the long-term.
  • There is currently no cure for Type 2 Diabetes.

While there is no single cause of Type 2 Diabetes, there are well-established risk factors. Some of these can be changed and some cannot.

You are at a higher risk of getting Type 2 Diabetes if you:

  • have a family history of diabetes
  • are older (over 55 years of age ) – the risk increases as we age
  • are over 45 years of age and are overweight
  • are over 45 years of age and have high blood pressure
  • are over 35 years of age and are from an Aboriginal or Torres Strait Islander background
  • are over 35 years of age and are from Pacific Island, Indian subcontinent or Chinese cultural background
  • are a woman who has given birth to a child over 4.5 kgs (9 lbs), or had gestational diabetes when pregnant, or had a condition known as Polycystic Ovarian Syndrome.

Symptoms of Type 2 Diabetes

In type 2 Diabetes, many people have no symptoms at all, while other signs are dismissed as a part of ‘getting older’. By the time type 2 Diabetes is diagnosed, the complications of diabetes may already be present. Symptoms include:

  • Being excessively thirsty
  • Passing more urine
  • Feeling tired and lethargic
  • Always feeling hungry
  • Having cuts that heal slowly
  • Itching, skin infections
  • Blurred vision
  • Gradually putting on weight
  • Mood swings
  • Headaches
  • Feeling dizzy
  • Leg cramps.

Preventing Type 2 Diabetes

It is estimated, that, up to 60% of Type 2 Diabetes can be prevented. People at risk of Type 2 Diabetes can delay and even prevent this disease by following a healthy lifestyle. This includes:

  • Maintaining a healthy weight
  • Regular physical activity
  • Making healthy food choices
  • Managing blood pressure
  • Managing cholesterol levels
  • Not smoking.

Managing Type 2 Diabetes

While there is currently no cure for type 2 Diabetes, the disease can be managed through lifestyle modifications and medication. For more information on managing type 2 diabetes, refer to the section of this website below.

https://www.diabetesaustralia.com.au/

Author: Michelle Barratt

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