Mental health implications in the treatment of physical illnesses

The connection between mental and physical health was made at the latest Grand Rounds presentation as Psychology Intern, Christine Mackay shared her insights from working with a multidisciplinary team.  The team treated individuals living with Hepatitis C and found that there was a clear role for psychology as part of the multidisciplinary team.

Giving some background on Hepatitis C and its treatment, MacKay shared that this is a blood born virus, transmitted through direct blood contact usually associated to drug paraphernalia, transmissions or from unprotected sexual activity and can have many variants.

“The progression of this illness is slow and the treatment responds better when the virus is caught early,” shared MacKay. ”The treatment regime can be complex and challenging,” she adds.

Lasting between 12 and 48 weeks, depending on the variant as well as how the individual responds to treatment and their overall health, the treatment is demanding. Including weekly injections and four to five pills per day for up to 48 weeks, the treatment schedule often means travelling.  This cumbersome process itself can affect the mental health of the individuals living with Hepatitis C.

The stress caused by the process of receiving treatment is also complicated by the mental health and psychosocial side effects of the medication used in treatment.  These can result in depressive symptoms such as low moods, difficulty concentrating, insomnia, and irritability.

“There is often comorbidity found in individuals with Hepatitis C for mental health disorders and substance use,” says Mackay.  “They also often deal with stigma associated with how they contracted the disease and this often leads to a potential risk for depression,” she adds.

The psychologists on the multidisciplinary team are therefore very important in helping to treat these symptoms and often use cognitive behaviour therapy (CBT) to increase a sense of control over these feelings and decrease anxiety.

The psychologists are also able to monitor the patient from a psychosocial and mental health perspective both before and during the treatment phase.  “Pretreatment examination helps determine if an individual is ready for treatment and the expected side effects.  We also need to monitor very closely during the treatment to offer ongoing psychological support and help monitor for suicide risk,” explains Mackay.

This multidisciplinary approach treats the individual in a holistic way and can be applied to many other physical illnesses, which may have an impact on mental health.

“While the treatment of Hepatitis C is challenging, it can be successful and the multidisciplinary approach helps with this success,” adds MacKay.