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making_art

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Psychology Works Fact Sheet: End Of Life
Canadian Psychological Association.
2015

Psychological distress and coping with advanced illness.


When someone becomes seriously ill, it usually starts an intense process of medical testing and therapy with treatments that may involve some degree of pain and stress. Understandably, each phase of a major illness has a psychological impact. For example, the medical testing may be a time of real worry as one prepares for the possibility that the illness is very dangerous. After diagnosis, there may be a period of shock, as well as anxiety and fear. Active treatments may bring about troubling side effects, perhaps with no certainty of a cure.

Throughout these periods, declining physical function, changes in family and social roles, increasing dependence on the health care system, as well as the threat of death, are all sources of psychological stress. People use a range of coping strategies during these stressful times. In fact, coping styles may range from trying to avoid reminders of the illness through to thinking about it all the time.

Over the long term, however, people who adopt more active coping strategies, such as seeking support from others, constructive problem solving, and finding positive meaning, tend to show the best adjustment. Most people who are told they have an advanced illness will experience periods of anxiety, sadness and grief, and anticipation of loss and death. These can all be considered part of a normal adjustment process, albeit a difficult one.

For many medically ill people, however, these emotions can become quite overwhelming and develop into difficulties in their own right. For example, it has been estimated that about 25% of people with advanced cancer will exhibit depression or anxiety disorders. These problems are important to recognize and treat. Not only are they distressing, but they also make it more difficult to manage physical symptoms and to face the full spectrum of concerns involved in preparing for the end of life.

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