Sometimes those who are referred to us with physical limitations have psychological limitations that are just as significant.
While we are no strangers to dealing with mental health conditions, we also know that it’s important to stay in our ‘own lane’! This means referring to the specialists when we start seeing red flags that someone is at risk of, or is struggling with, a mental health condition.
We know that physical health and mental health are deeply interconnected, so it’s not unusual to see people whose physical limitations have prompted a deterioration in their emotional and/or mental capacity. Not only are they unable to do the things they used to be able to do (including work and other activities of daily life), but often they also can’t do the recreational activities that would usually ‘fill their cup’ and provide meaning to them.
So what are the clues we should be looking out for to prompt a further intervention? We brought it to the team in a recent team meeting. Here’s what they had to say!
5 Clues that it’s Time to Engage the Psych
- If they are showing signs that they aren’t coping with the change.
They may verbally express that they are feeling emotionally unstable, tearful, stressed / anxious or down, as a result of their condition. They may also start acting out of character or behaving differently. Sleeping and eating may become disrupted.
There’s a name for this – ‘adjustment disorder’ – defined as: “An emotional or behavioral reaction to a stressful event or change in a person’s life” (1).
Having a disease diagnosis or a major injury can be a life-altering event, throwing their world upside down and leaving them to pick up the pieces. People have often gone from busy, physical, active lives, and get completely knocked off their feet by an injury or disease diagnosis. It’s a lot to take in! When we suspect that their response to the event is more significant than would be expected, bringing a psychologist into the team is the best port of call.
- When they are still grieving their loss of function.
People often do need to go through a grieving process! It’s the same 5 stages of grief as they would with other losses: denial (I can’t believe this has happened to me), anger (it’s my boss’s fault), bargaining (if only XYZ could have happened instead), depression (it has happened and now everything feels hopeless), and finally acceptance (it has happened and now I need to move on with my life).
If someone is stuck in one of the phases, having a psychologist involved can help them move through to the stage of acceptance and finally on with life.
- When their mindset and thought patterns interfere with their progress.
This one can present in a lot of different ways…
- When they speak only about their pain / injury / illness, and not about their progress. Humans have a bias towards negativity, but when the negatives are all that they can see, this can create sticking points in their rehabilitation. How can you move forward if you are always looking back?
- When they have self limiting beliefs. Sometimes, people create their own glass ceiling through their own beliefs about what they are capable of. Longstanding thought patterns can be difficult to change. Psychologists can help people to become aware of the ways in which their own thought patterns are holding them back.
- When they expect to be ‘fixed’ and aren’t prepared to help fix themselves. We all know that there is no silver bullet in rehab! Exercise in particular is something that you need to be an active participant in… If expectation and reality don’t line up, we’ve got a problem.
- When the incident causing their injury was traumatic, and we notice symptoms of post-traumatic stress disorder (PTSD).
This can present as avoidance behaviours (i.e. avoiding returning to driving after being in a car accident, or being fearful of walking down the street after an abuse incident), nightmares or flashbacks, severe anxiety, or negative changes in thinking. PTSD is definitely a condition that requires input from a mental health professional.
- If we believe that there are external social factors that are holding them back from achieving more in their rehabilitation.
This may be related to a lack of social support from friends or family, toxic environments, relationship breakdowns, or domestic abuse (physical and / or emotional). These things fall outside of our scope of practice to advise on, but they do need addressing if we consider the holistic bio-psycho-social model.
There are many times when we need to lean on our psychologist friends for support with a tricky case. They can lean on us too! Check out our previous article, Three Ways Exercise Physiologists And Psychologists Can Collaborate. And to see the collaboration in action – Working Together To Optimise Mental Health Outcomes.
References:
Author: Yolanda van Vugt
Clinical Exercise Physiologist and Content Creator at Specialised Health
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