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Many (if not all) medical disorders effect mental health and conversely mental illness can lead to exacerbation or worsening of medical disorders. To discuss all would be beyond the scope of this website. I will limit myself to some of the more common ones. DELIRIUM (Acute Confusion) This is a common condition, occurring in 10-20% of all hospital admissions. Particularly so in the elderly, those with pre-existing cognitive impairment, drug therapy, regular alcohol use, and those who have just had surgery. It presents with sudden confusion associated with symptoms such as:
The cause can be an underlying infection, electrolyte or fluid imbalance etc. Management is usually of the cause. Antipsychotics may be used for managing agitation and perceptual disturbance. If Alcohol withdrawl is the cause then benzodiazepines like diazepam should be used. DIABETES People with diabetes are more likely to get depression compared to general population. In addition, individuals with depression may be at greater risk for developing diabetes. Treatment for depression helps people manage symptoms of both diseases, thus improving the quality of their lives. Research shows that depression leads to poorer physical and mental functioning, so a person is less likely to follow a required diet or medication plan. Treating depression with psychotherapy, medication, or a combination of these treatments can improve a patient's well-being and ability to manage diabetes. Causes underlying the association between depression and diabetes are unclear. Depression may develop because of stress but also may result from the metabolic effects of diabetes on the brain. Studies suggest that people with diabetes who have a history of depression are more likely to develop diabetic complications than those without depression. In people who have diabetes and depression, psychotherapy and antidepressant medications have positive effects on both mood and sugar control. People with diabetes who develop depression, as well as people in treatment for depression who subsequently develop diabetes, should make sure to tell any physician they visit about the full range of medications they are taking so that potentially harmful drug interactions can be avoided. HEART DISEASE Depression can strike anyone. However, research over the past two decades has shown that people with heart disease are more likely to suffer from depression than otherwise healthy people, and conversely, that people with depression are at greater risk for developing heart disease.Furthermore, people with heart disease who are depressed have an increased risk of death after a heart attack compared to those who are not depressed. Depression may make it harder to take the medications needed and to carry out the treatment for heart disease. Treatment for depression helps people manage both diseases, thus enhancing survival and quality of life. Depression and anxiety disorders may affect heart rhythms, increase blood pressure, and alter blood clotting. They can also lead to elevated insulin and cholesterol levels. These risk factors, with obesity, form a group of signs and symptoms that often serve as both a predictor of and a response to heart disease. Furthermore, depression or anxiety may result in chronically elevated levels of stress hormones, such as cortisol and adrenaline. As high levels of stress hormones are signaling a "fight or flight" reaction, the body's metabolism is diverted away from the type of tissue repair needed in heart disease. Antidepressant medications, particularly the selective serotonin reuptake inhibitors, are generally well-tolerated and safe for people with heart disease. There are, however, possible interactions among certain medications and side effects that require careful monitoring. Therefore, people being treated for heart disease who develop depression, as well as people in treatment for depression who subsequently develop heart disease, should make sure to tell any physician they visit about the full range of medications they are taking. CANCER As with other serious illnesses, such as HIV, heart disease, or stroke, cancer can be accompanied by depression, which can affect mind, mood, body and behavior. Treatment for depression helps people manage both diseases, thus enhancing survival and quality of life. People who face a cancer diagnosis will experience many stresses and emotional upheavals. Fear of death, interruption of life plans, changes in body image and self-esteem, changes in social role, lifestyle, and medical bills are important issues to be faced. Still, not everyone with cancer becomes depressed. Depression can exist before the diagnosis of cancer or may develop after the cancer is identified. While there is no evidence to support a causal role for depression in cancer, depression may impact the course of the disease and a person's ability to participate in treatment. At times it is taken for granted that cancer will induce depression, that depression is a normal part of dealing with cancer, or that depression cannot be alleviated for a person suffering from cancer. But these assumptions are false. Depression can be treated and should be treated even when a person is undergoing complicated regimens for cancer or other illnesses. Therefore, people undergoing cancer treatment who develop depression, as well as people in treatment for depression who subsequently develop cancer, should make sure to tell any physician they visit about the full range of medications they are taking. Specific types of psychotherapy, or "talk" therapy, also can relieve depression.
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