It is estimated that up to 7 percent of the general population suffers from clinical depression. That figure rises dramatically for people with renal disease—nearly 25 percent of people on dialysis experience deep sadness and hopelessness that continues over several months. The good news is that with medication and therapy, most people who suffer serious bouts of depression do recover and feel better about themselves and life.
“Clinical depression can affect people’s lives in many ways, including their health and medical treatments,” says Michael Cannella, M.D., psychiatrist and attending physician at SBMC.“There are normal emotional reactions to life events,” he explains. “It makes perfect sense for someone to feel sad if they are facing chronic illness. But, it doesn’t make sense for someone to feel worthless because of their medical options.”
Sound mental health and stability are important factors when assessing a person’s ability to adjust to life with a transplanted kidney and evaluating his or her level of commitment to comply with the demanding post-operative requirements for maintaining a transplanted organ.The Saint Barnabas Health Care System (SBHCS) Renal and Pancreas Transplant Centers rely on Dr. Cannella and an experienced team of social workers to identify and coordinate the treatment of any mental or behavioral health issues that may prevent transplantation, such as clinical depression, drug or alcohol abuse, and current or prior psychiatric illness.
Some individuals may be requested to complete individual or group therapy sessions as a prerequisite to transplantation. “Patients are re-evaluated at the conclusion of their therapy and many receive clearance for transplant surgery,” says Dr. Cannella. “There is a great deal of hope for people who are dealing with mental health issues before and after transplantation.”
In addition to evaluating the potential transplant candidates’ psychological status, psychiatric consultation is available following transplantation when necessary. Occasionally, kidney recipients experience mood swings, anxiety or behavioral changes that can develop abruptly or progressively as a side effect of the anti-rejection medication. “With treatment, these symptoms can be controlled and over time the body builds up a tolerance to the medication, and the patient’s moods and behavior normalize,” says Dr. Cannella.
Families can also benefit from meeting with a psychiatrist when the balance of the marital or family relationship is upset after a loved one receives an organ transplant. “It is typical for each family member to have a well defined role,” explains Dr. Cannella.“The transplant may change one member’s role and upset the family dynamic, thus putting stress on the relationship.”
Health care professionals and family members caring for chronically ill people who are having an extraordinarily difficult time coping should consider clinical depression or other psychological issues and seek appropriate help, says Dr. Cannella.“There are more treatment options than ever before and great optimism for recovery.”
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