Depression following chronic illness diagnosis a hidden danger

THE National Health and Morbidity Survey (NHMS) 2022 has revealed a concerning trend of increasing suicidal thoughts and attempted suicides among Malaysian teenagers in the past five years.

The prevalence of suicidal thoughts increased from 10 per cent in 2017 to 13.1 per cent among teenagers aged 13 to 17 years in Malaysia last year.

Similarly, the rate of attempted suicides among Malaysian teenagers rose from 6.9 per cent in 2017 to 9.5 per cent in 2022.

Depression following a chronic illness diagnosis

While the increase in suicidal thoughts and attempts among Malaysian teenagers is alarming, there is another issue that is often overlooked: depression following a chronic illness diagnosis.

This is a phase that often goes unnoticed, as not everyone is fully aware of its impact.

For those grappling with chronic health conditions, the period post-diagnosis can be exceptionally challenging.

Without the necessary care and support, it can plunge individuals into the depths of depression, posing a serious threat to their well-being and, in some cases, their lives.

Understanding the emotional stages of chronic illness

Psychiatrist and fellow in Consultation Liaison Psychiatry Dr Nurul Nadia Ismail said it is important to understand the emotional stages that individuals with chronic diseases experience.

She refers to the Kübler-Ross grief model, which outlines five stages: denial or shock, anger, bargaining, depression, and acceptance.

This is what individuals commonly go through when dealing with loss or life-altering situations.

"The initial stage often involves denial or shock, where patients may struggle to accept their diagnosis.

"Research has shown that a significant percentage of patients, up to 20 per cent, may experience this first stage of grief.

However, the majority of them manage to comprehend their condition and the prognosis with time and appropriate support from various agencies, especially family, friends, and healthcare professionals," Dr Nurul said.

She added that it is also important to understand the role of healthcare professionals in effectively communicating a chronic illness diagnosis.

"Doctors play a crucial part in preparing patients for this challenging journey and providing the necessary guidance and support," she said.

She also highlighted Leventhal's model of illness cognition, which highlights the influence of a patient's illness perception.

"For example, individuals with a family history of diabetes may have a different perspective on their condition compared to those without such a background.

"Understanding these perceptions can significantly impact how patients cope with their illnesses," she said.

Need for emotional support

Dr Nurul stressed the need for emotional support and the role it plays in a patient's acceptance and adaptation to chronic illnesses.

"Various therapeutic approaches, such as Mindfulness-Based Cognitive Therapy (MBCT) and Interpersonal Therapy (IPT), have shown positive effects in improving patients' emotional well-being and overall quality of life," she said.

Risk of self-harm and suicide

Dr Nurul also warned about the alarming issue of patients who, overwhelmed by their chronic conditions, may contemplate self-harm or even suicide.

"Such cases are relatively rare. However, it is important for healthcare professionals and family members to be vigilant for signs of extreme distress and promptly seek professional help when necessary," she added.