Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Depressed on the Job

At what point does a patient become prepared_or a doctor prepare a patient_for chronic problems. Some degree of pain remains with many injuries, and this neeeds to be presented to the patient.

There are two problems here and two types of pain:

a. There is the sensory/physical pain from a trauma which in many cases never fully resolves. Few if any talk to the patient about the possibility. It is often said that this takes away hope. In reality, what takes away hope is the patient being led to believe that this next surgery or next series of injections or next medication will resolve all remaining pain. When this does not occur, the patient is often devastated and feels he/she has nowhere to turn.

b. The psychological/emotional pain that arises from severe scarring, paralysis or loss of limb is typically not addressed until the patient appears so depressed that _something must be done._ The patients in this case will state _I have felt this way for over a year, and no one wanted to do anything about it._

In both cases, the patient must be prepared (by others) for some degree of permanency (chronicity) of their injury. It simply will never completely resolve.

A patient once told me that he would commit suicide (due to back pain) as soon as his settlement was received (for his family) since no one could live with this pain.

That was 12 years ago. He coped quite well after administrative closure and understanding/accepting that life with pain is more than possible.

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