Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Anxiety & Paranoia

Distrustful, suspicious, frightened and uninformed can be complex factors when treating an injured worker.

The patient spends his days with pain and anxiety as his only companion. Without the emotional and intellectual resources to resolve his physical, financial, marital and future occupational fears, he processes each office visit as a disappointment.

He tells a friend or relative that he is in pain. The response he receives is similar to `what kind of doctor is this? Who sent you there? He doesn_t care about you. He just wants you to go back to work. Etc_

The patient_s memory becomes selective. He believes he has been told he has a surgical condition (where none exists) or that there are specific diagnostic findings (when all have been negative).

Months pass, and he is unimproved. He is de-conditioned, napping during the day, overeating, socially isolated and intellectually deprived. His anxiety becomes complicated by depressive thoughts and increasing doubt that anyone has his best interests in mind.

If he does not discuss these perceptions, beliefs and fears, they become expressed by an increase in physical symptoms, increased reliance upon narcotics and decreased compliance with physical therapy and motivation to mobilize.

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