The three factors impacting a Crohn's patient's coping abilities are physical control, psychological traps, and chemical deficiencies. And, as a caregiver to a Crohn's patient, I have seen them operating first hand.
Physical Control Issues of a Crohn’s Patient
A physical component of Crohn’s is excessive diarrhea and gas, which can be embarrassing in public. The coping mechanism for my wife, at least in the early stages, was humor. For instance, shortly after her diagnosis, we traveled to London England on a theatre tour. The experience turned out to be a series of bitter sweets. While some of the plays were memorable – Sleuth with Michael Cane, and The Old Boys with Sir Michael Redgrave – others were terrible; and while the people were hospitable, the weather was dreadful and the food sparse and tasteless (the meat on a roast beef sandwich was so thin you could barely taste it, and a tomato sandwich consisted of tomatoes crushed and spread on bread). Most troubling, however, were the two drizzles: the diarrhea that my wife was constantly plagued with, and the rain; the combination made her miserable much of the time.
We had many a laugh, however, at some of the predicaments we found ourselves in. For instance, on one occasion, we met a mother and her daughter in a shop on Oxford Street. After a short conversation, the mother invited us to lunch at their place the next day, and gave us directions. They lived near Harrow on the Hill, so after lunch they took us to see the sites of the town where Winston Churchill had spent some of his school years. At one of the churches, there was a graveyard that contained the tomb of Lord Byron, and as we were walking around the graveyard, and had moved inside the church, it suddenly became evident that my wife wasn’t with us. Suddenly she appeared and grabbed me by the arm. “Well, we had better be getting back to the hotel. It was nice to have met you,” she announced, in a somewhat stiff manner. “I forgot we’re meeting with Mickey and Naomi for supper. We’ve got to go.”
I sensed that something was wrong and obtained directions to the train station but when we were well out of hearing range, I turned to her and asked, “What was that all about?”
“I had to go to the washroom,” she replied, somewhat shaken from the experience.
“Oh oh... where did you go?”
“In the graveyard behind a tombstone,” she replied with a smirk.
“You went behind a tombstone? Anyone we know?” I inquired, with a grin.
“Yes, Lord Byron,” she replied with a snicker.
After that my wife began carrying a change of clothes with her, started familiarizing herself with her surroundings, including the location of bathrooms, and became more aware of her body’s reaction to certain foods.
Psychological Traps for a Crohn’s Patient
Living with Crohn’s brings emotional stress and humor doesn’t always help. My wife was bound and determined to live as normal a life as possible with the disease and did for 20 years. But for younger people dealing with the disease, there is a significantly increased risk for depression and anxiety, according to research done at the Mayo Clinic.
In an article entitled "Crohn’s Disease Puts Young People at Higher Risk for Depression," by elementsbehavioralhealth.com, Edward Loftus Jr., M.D. of the Mayo Clinic was quoted as saying that studies have shown that “individuals younger than 18 with a diagnosis of Crohn’s disease were more than twice as likely to have a diagnosis of depressive disorder than those young patients not suffering from Crohn’s.”
He went on to say that “depression was also found to be 70 percent more common in these young patients,” but, fortunately, “those suffering from Crohn’s were not more likely to suffer from bipolar disorder, substance abuse or eating disorders. You bring in a chronic disease, and if that goes on, especially untreated or inadequately treated for a long enough time, that can affect their whole psyche,” he said. “They’re worried about, ‘Where is the bathroom, I have to get up in the middle of class, everyone will see me going to the bathroom’ — you can imagine a whole set of concerns and angst about that.”
According to Dr. Loftus, however, “studies in adults have shown that successful treatment of Crohn’s disease leads to a reduction in depressive symptoms, giving hope for those young people dealing with these complications.”
But there are also other aspects of Crohn’s disease that are not often discussed. Poor self-image, physical pain, and fear often hamper sufferers’ sex lives. In addition, medication such as prednisone that is taken to treat the disorder also has negative side effects.
Of course, if the emotional stresses of the disease create psychological issues it is important to seek professional help. Some can deal with the pain of Crohn’s, and some cannot. For instance, according to Dr. W.R. Cassidy in his unpublished book for his patients, Trapped in the Web of Life, “pain is that unpleasant disturbing emotion which we identify with tissue damage and distress. Pain is a conscious and personalized experience, only describable and understood fully by the individual with pain. In other words, whether the pain is present and how severe it is, is a judgment usually only the pain sufferer can make…”
Chemical Deficiency Issues of a Crohn’s Patient
Crohn’s impairs digestion and absorption, and a vicious cycle of nutritional decline can easily perpetuate itself. A very high percentage of Crohn's sufferers are malnourished. As it relates to the mind, diarrhea promotes depletion of water-soluble vitamins that contain, what Paul Meier, M.D., in Blue Genes, considers the three essential amino acids for mental health – tryptohan, phenylalanine, and tyrosine- and essential minerals like zinc and magnesium.
Healthyfellow.com reported on a study out of Australia in January of 2009 that examined the role that dietary magnesium may or may not play in the incidence of anxiety and depression. In order to answer this question, researchers studied a group of over 5,700 men and women.
The men and women were asked to fill out detailed food questionnaires and were required to take a special test that quantified their levels of anxiety and depression.
With that data at hand, the researchers looked for any association between magnesium intake and the degree and frequency of anxiety and depression. Here’s what they discovered: Regardless of age or gender, those participants who consumed the most magnesium suffered from the lowest risk of depression. A simple blood test can check for this.
Sources:
Meier, Paul. Blue Genes. Tyndale House Publishers, Inc. Carol Stream, Illinois. 2005
Dr. W.R. Cassidy. Trapped in the Web of Life. Unpublished. 2008
elementsbehavioralhealth.com
Disclaimer: The information contained in this article is for educational purposes only and should not be used for diagnosis or to guide treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact a doctor for advice.
James Gibson - James Gibson is a retired teacher and small business owner. He is a published writer and has a wide spectrum of interests.
Join the Conversation