Wednesday, June 29, 2005

Mental health report..... 

After I spent part of a third day revising my report on daily activities, I decided I should follow up with an update on how I'm coping mentally. The results of neuropsyche exam I had in October are something I need to provide to Social Security to show evidence of my cognitive dysfunction, but I'm really worried about their psychological evaluation as it provided a distorted view of my mental status. In my opinion, the main problem inherent in "personality" profiles is that these are yes/no questions that do not allow for a physical origin for such behaviors as sleeping more than usual, spending less time with friends, doing fewer things that you enjoy, etc. I had to answer in the affirmative on these questions, so it appeared that I was depressed when the real reason was that I'm too sick to do as much as I'd like. But when I was asked if I was happy, I answered in the affirmative because I feel that it's true. That was interpreted as me being in denial. And when I answered in the affirmative to questions such as whether I considered myself to be less healthy than most people and whether I was concerned about my physical functioning, that was interpreted as somatization disorder! Problem is, if my long-term disability company gets a hold of this report, they will decide that my illness is mental rather than physical and deny coverage. The only way I can think to provide a more realistic view of my mental status is to provide my thoughts on this to my psychologist and see if she can write a letter or something with her professional opinion. I mean, if I do have mental problems, so be it, but I don't want them to be distorted into something they're not because that could jeopardize further treatment and/or benefits. So the following is what I will give to my psychologist on Thursday:

Thoughts on my Psychological Functioning as of June 2005

I have made a conscious effort to maintain a positive outlook and to avoid over-reacting to stressors in my life. This is because I found that staying physically tense when stressed aggravated my already existing pain and fatigue. I can no longer spare the energy for frivolous worry or anger out of proportion to a given situation. This has enabled me to cope with the worsening of my physical health. This may appear to an observer that I am in denial of my shortcomings or perhaps am even inappropriately cheerful. I do realize that I have shortcomings, but I prefer not to dwell on them if they are not something I can improve. My cheerfulness is a coping mechanism as it produces modest pain relief. I also view this as a healthy psychological outlook.

I am frequently told that I must be depressed because I have fibromyalgia. I have experienced depressive episodes, but they were too brief to fit the definition for clinical depression until recently. Since I have gone on medical leave from my job in February, I have experienced periods of sadness and self-esteem issues more consistent with clinical depression. I believe most individuals would experience a coping crisis if faced with no longer being capable of sustaining themselves financially. However, this depression is a direct result of chronic illness, not a cause of my disability. I have in response to this coping crisis sought appropriate psychological counseling.

It has been suggested that I may be preoccupied with my physical health. This may indeed be so as it is impossible to ignore. The sum total of my ailments affect my sleep, my digestion, my mobility, my ability to express myself, my activity level, my pain tolerance, my muscle and joint function, my socialization skills, my ability to follow instructions, my energy levels, my independence, my ability to eat and swallow, my bowel habits, my memory, my tolerance of heat/cold, my hearing, my circulation, my teeth, my strength, my ability to use a computer, my sex life and even my breathing. I do tune out many of my physical symptoms but cannot deny that my physical health significantly hampers my ability to function.

My family relationships are not strong, but neither were they before I became ill, so little has changed. I do have a relative by marriage who has been especially unsupportive since I became ill, but that is probably common in families where someone has a chronic illness. My friendships themselves have changed little, but I cannot spend as much time with them in person as I used to due to physical illness. However, within the past few months, I have attended a local science fiction convention, gone to lunch and have gone to movies with friends as well as attending the baby and bridal showers and birthday parties of relatives, so not everything revolves around my health. I have not lost any close friendships due to illness, and my husband is extremely supportive of me, so overall I am not terribly bothered by the lack of familial support. At this time I do not believe any family members are interested in changing their relationship with me. If any of them expressed an interest in counseling to improve our relationship, I would be willing to do that.

Early on when I first became ill, it was suggested to me that I could be somatizing at least part of my physical illness. I took this into consideration and began to ignore all my physical symptoms in the hope that in time they would either lessen or go away entirely. I even attempted hypnosis to see if my physical symptoms would disappear in the absence of conscious control over my functioning. Hypnosis was unsuccessful as was the ignoring of my symptoms for a period of three months. I do not believe I suffer from somatization disorder as I am already aware of the link between physical reaction to stress and elevation of pain and fatigue and do my best to not dwell on stress.

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