How are you? The usual answers are: “I am okay” or “I am fine”. But, how are you really doing? Are you sad? Are you afraid? Are you depressed? Are you feeling anxious? Are you angry? Are you happy? Let us focus on emotional well-being. What is emotional well-being? Many scholars believe that emotional well-being refers to a state of mental health characterized by positive emotions, resilience, and the ability to manage one’s thoughts and feelings in a healthy way. In other words, try to focus more on the positive and less on the negative. Negative thoughts and emotions can affect both the physical and mental well-being of individuals. The reduction of stress and anxiety can help to improve a better quality of life. Confident expectation of a positive present and future is always hopeful!
The following information is retrieved from DaVita Kidney Care (www.davita.com) and Fresenius Kidney Care (www.fresenius.com).
From DaVita Kidney Care
Your Emotions and Chronic Kidney Disease
When patients seek medical attention for chronic kidney disease (CKD), they want relief from the physical unease it causes. But many people do not realize there is psychological unease that results when diagnosed with a chronic disease like CKD. Caring for your mental health is just as important as caring for your physical state. Recognizing emotions that are common to other patients with CKD can help you feel less isolated and get you the support you need.
Patients are able to tell their doctors what they are physically feeling: pain, fatigue, dizziness, etc. However, many people do not feel comfortable telling their healthcare team about what they are mentally feeling. Your psychological recovery is an important part of managing CKD. The following are common emotions patients experience when they have been initially diagnosed with a chronic illness, although these emotions can be present at any time during treatment.
Fear and Anxiety
Fear and anxiety are common emotions when you have been diagnosed with a chronic disease like CKD. We feel our own bodies have betrayed us. Functioning kidneys are something you’ve taken for granted. Now, you are no longer in control of your renal process. You must rely on dialysis to do your kidneys’ job. You will wonder how this disease will affect you. You may worry about its impact on how you care for and provide for your family.
Treatment for CKD sometimes compounds the anxiety. Whether you will undergo hemodialysis or peritoneal dialysis (PD), each requires surgery to create an access. Choices need to be made if you will go to a clinic for dialysis or be treated at home. You may worry about the disruption to your family life, especially if you opt for treatment at home. Will your loved ones adjust to seeing you attached to a machine? Will they dislike the constant reminder that you are not as healthy as you once were?
Denial
When something bad happens to us, we try to cope. We make decisions that can help us adjust to or understand what has happened. But when the trauma is severe and threatens to overwhelm us, we sometimes deny anything has happened. Although this occurs in extreme cases, this can happen if you have been diagnosed with a chronic illness. You may refuse to accept the fact you are ill, or if you do, you may refuse to believe you are seriously ill. Perhaps you do not believe the
recommended medications and treatments are necessary.
Anger
Feelings of anger are common among CKD patients. We are mad that this has happened to us. We are mad at ourselves for allowing our health to deteriorate to this point. Sometimes we are mad at the medical community for not taking better care of us or not diagnosing the disease earlier. Many patients direct this anger at their family members or spouse. Anger and resentment can build to the point where it strains the relationship between you, your health care team and your family.
Feeling Down
Feeling down is a normal part of chronic kidney disease. Lack of energy and nausea are common symptoms of CKD. But when we are feeling mentally down, often we feel sad our bodies are not functioning as they should. We all go through ups and downs in life. But if these feelings develop into hopelessness, despondency or despair and last over two weeks, you should tell your doctor. This may be a sign of depression. If you feel you do not wish to live any longer or have thoughts of ending your life, you must tell someone immediately.
How do I deal with all of this?
CKD can overwhelm a patient. There is new information to become aware of, a new treatment plan to begin. Your energy will be directed to your treatment and physical well-being. This can be exhausting. But you must also take control of your mental state.
You cannot allow feelings like fear or anxiety to bulldoze your mental landscape. Knowledge about chronic kidney disease and dialysis can help you become familiar with your illness and its treatment. You won’t feel as fearful or anxious if you know what to expect. Feeling calm can help you sort out things and you’ll be able to deal with your disease more effectively.
Feelings of denial are a severe problem in the long-term prognosis for your health. Denial leads to what is called “non-compliance”—that is, disregard for your healthcare team’s instructions regarding dialysis treatment, diet and fluid intake. Healthcare workers often see patients who come to dialysis in distress. They have missed several dialysis treatments or have not been following their fluid requirements. They often rely on dialysis to make them feel better. But sometimes dialysis cannot reverse the effects of non-compliance. Hospitalization may be required. Do not let this be you. CKD is a serious illness. Listen carefully to your healthcare team and follow their recommendations. If you do not understand something, ask questions.
Anger can isolate and prevent you from seeking help or solace from people who care about your health. Although expressing your anger can help it diminish, it may lead to more frustration because you do not understand the root of it. You may be lashing out at people who are not the cause of your anger. This can strain relations with those around you. Talking about why you are angry can help you determine its cause.
Depression can affect how you make decisions regarding your treatment. Since a patient on dialysis must be actively involved in their day-to-day treatment regarding fluid intake and diet, you must have a clear mind in order to make the best decisions. Depression can make you put off decisions, or even purposely make unwise ones. If your doctor diagnoses you with major depression, he may prescribe some anti-depressants. But first, he must know what you are feeling. He cannot know unless you tell him.
Talking to someone about your emotions is essential. Do not feel that you must find a way to deal with this by yourself. Most patients benefit from discussing their feelings with their healthcare team, family, friends and other CKD patients. Your social worker can refer you to a support group. A support group can help you put things in perspective. Reading about other people who lead active lives while on dialysis can be uplifting and give you hope.
DaVita home dialysis patients can join virtual support groups through the DaVita Care Connect® app. These groups are led by DaVita® Home Dialysis support specialists and encourage live conversations between patients to ask questions and share experiences. Sessions are available for DaVita patients at no extra cost and can be scheduled daily or weekly within the DaVita Care Connect app.
Help is out there. You just need the courage to make the initial contact.
From Fresenius Kidney Care
Focusing On Your Emotional Health
Looking after your personal well-being while on dialysis isn’t always the top priority—especially when you’re new to dialysis and learning to balance life and treatment. Devoting some energy toward focusing on your emotions and your self-image as well as your physical health can help you truly feel your best.
How can i achieve a good quality of life on dialysis?
Asking yourself what’s more important can be a good place to start. Finding ways to look after yourself emotionally and spiritually while keeping up with the things you like to do can help you maintain a fulfilling lifestyle that’s built around more than treatment. While dialysis is always a priority, so is personal satisfaction.
Get support when you need it
It’s natural to experience a range of feelings about going on dialysis and maintaining treatment, so learning ways to manage your emotions and build a solid support system is important to achieving the dialysis quality of life you want. Your relationships with family and friends can give you strength through the ups and downs. Good communication about what you’re going through will be key.
Putting you first
Just as you are the most important person on your care team, you’re also the most impactful person in creating a fulfilling life on dialysis. Give yourself time to find what works for you personally. Evaluate your feelings along the way and make changes when you need to. Remember that you’re not alone—your care team is here for you.
