The diagnosis of heart failure can have a significant psychological impact, which can manifest itself in particular by:
- Avoidance behavior.
- Fear.
- Processing problems.
- Social limitation and isolation (decreased social contacts).
- Physical limitation (no longer daring to make efforts).
- Anxiety and
- Sleeping disorders.
- Decreased libido and sexual problems.
Patients with Type D (“distressed”) personality are particularly at risk.
These psychological manifestations can:
- Impair the patient 's quality of life.
- Compromise patient self-care and compliance. This can be further exacerbated by impaired cognitive function, poor comprehension of information, or low literacy.
It is therefore very important to quickly detect the affected or at-risk patient and, if necessary, to refer them to appropriate psychological help.
In the case of cardiomyopathies caused by drug addiction (alcohol, cocaine, etc.), targeted referral to detoxification treatment is indicated.
In addition, smoking cessation guidance through a tobaccologist is an essential part of optimizing lifestyle in heart failure.
In conversation with the patient:
- Confirm the presence of physical complaints.
- Normalizing processing and difficulties with it :
- Don't minimize.
- Don't laugh it off or make fun of it.
- Also remain who you are as a person, as a doctor.
- Assess whether or not a treatment is appropriate.
- Explain how processing and coping can be difficult.
- Lower the threshold.
- Assessment of adequate or inadequate processing.
- Check the willingness to undergo therapy.
- Offer therapy or support if signs of psychological difficulties appear.
- Cooperation.
- Processing.
- Psychoeduction.
- Structuring.
- Regulation of emotions.
A psychologist can specifically support in:
- The process of adaptation and learning to manage the disease (adaptation, coping).
- Learn anxiety and stress management techniques.
- Adjust lifestyle (in particular by quitting smoking and drug addiction (alcohol, drugs)).
- Managing relational and sexual tensions through couple conversations in particular.
Some patients continue to struggle with persistent feelings of depression or anxiety, which may require a referral to a psychiatrist. A psychiatrist can prescribe medication or other treatment if necessary.
Note: The psychiatrist should take into account the risk of hyponatremia linked to certain antidepressants such as selective serotonin reuptake inhibitors (SSRIs). Sodium levels should therefore be monitored during treatment with an SSRI.
