Dr. David B. Adams – Psychological Blog

Psychology of Illness, Pain, Anxiety and Depression

Ignoring Depression

An injured worker has damaged her right knee. A year later, she complains of tingling and burning in her hands and feet. Although not injury-related, the new symptoms need not be “psychological.”

Is she middle-aged and obese? Has she had a general physical exam? What is the general health status of the family?

My experience has been that many injured workers had horrible health habits and virtually no health care prior to injury.

They lived lives of multiple risk factors. They had abused their bodies through poor diet, use of alcohol, nicotine and caffeine and lack of exercise. They rarely saw their primary care physician if they had one at all.

They go into an injury with undiagnosed hypertension and diabetes, elevated cholesterol, uncorrected age-related visual changes, and following injury, these maladaptive health habits actually increase.

When these patients are referred to me, they tell me that since their shoulder injury they cannot read small print…since their back injury, they have chest pain…or since their neck injury they are always thirsty and frequently urinating.

I am certain that what is indicated is a visit to their family doctor to determine their general health status and the true cause of these symptoms.

It is important to the patient that those complaints, due to non-injury health problems, be separated from those which are injury-consequent. It may be extremely critical differential-diagnosis for the patient.

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