Typically red blood cells contain an iron-rich protein, haemoglobin, that carries oxygen. People with Sickle Cell Disease inherit genes with instructions, or codes, for abnormal haemoglobin. This abnormal haemoglobin makes these red blood cells - sickle or crescent-like making them rigid and sticky, causing obstruction in normal blood flow and, at times, occluding complete blood supply to organs leading to sickle cell crisis, which commonly presents with acute pain frequently managed with the help of opioids. Dr Saswinder Kaur, Senior Resident, Department of Psychiatry, Amrita Hospital, Faridabad, explains the situation may begin within the first year of life and continue throughout life.
People With SCD
People with SCD must remain vigilant throughout their life, which can be emotionally and physically draining. They may also have trouble coping with pain, fatigue, frequent medical visits and hospitalizations. The limitations imposed on children because of susceptibility to infection can lead to social isolation in early childhood, causing low self-esteem and making it difficult for them to learn adequate social skills predisposing these children to develop mood and anxiety disorders in adulthood. They may become dependent on opioids, predisposing them to develop opioid-induced mood disorders. It is difficult for people living with SCD to have an everyday life. Depression is common in people with SCD. Rates of depression are similar to those found in other serious chronic illnesses, ranging from 18% to 44%.
Causes Of SCD
Potential causes are chronicity of the disease, the unpredictability of crises, chronic pain, and the overwhelming nature of medical complications, including anaemia, fatigue, growth retardation, leg ulcers, renal failure, strokes, and substantially reduced life expectancy. As with depression, anxiety has also been shown to predict more pain. In various studies, depression and anxiety have been linked to more daily pain and poorer physical and mental quality of life. It is recommended that along with pain management, people with SCD should undergo screening for depressive and anxiety disorders during their regular health check-ups.
Recognize and avoid triggers predisposing to the crisis, like dehydration, over-exertion, cold exposure, alcohol and smoking.
Regular moderate-intensity exercise can provide adequate blood flow and release endorphins, improving mood and anxiety symptoms.
Talking to friends, family and treating medical team: Talking about their feelings and concerns may help them prepare a personalised treatment plan for the individual and provide moral support to improve their quality of life.
Seek help from mental health professionals like Psychiatrists, Psychologists and Psychiatric social workers (PSW) if needed. Psychiatrists and psychologists can recognise early warning signs of anxiety and depression and guide accordingly. PSW can help with the financial burden and arrange social support groups. They help families by creating awareness about national policies which can help such families in terms of need.
Regular yoga and meditation
Socialisation
Healthy eating habits
In The End
Make people living with SCD aware that one should take life one day at a time, although it's difficult because no one knows or can predict the future. We only know the present moment in which we are living, so take advantage of this moment and live the life you desire without fears, guilt and regrets. It is easier said than done, but at least we can always try, no matter how often we fail. And help is always there when one decides to take help.
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