The human brain is made up of over 80 billion different nerve cells that are each connected to up to 1 quadrillion (1,000 trillion) other nerve cells. The Human Brain in Numbers: A Linearly Scaled-up Primate Brain - PMC (nih.gov)) https://www.sciencedaily.com/r.... In fact, a piece of brain tissue the size of a grain of sand contains 100,000 neurons and each of these neurons shares information with other neurons at a rate of up to 268 mph (11 Fun Facts About Your Brain | Northwestern Medicine). Not surprisingly, then, science writers such as Sandra Ackerman have called the brain “the most complex thing we have yet discovered in our universe.” (Foreword - Discovering the Brain - NCBI Bookshelf (nih.gov))
This complexity, however, also means changes to the brain can dramatically impact how a person functions – from their movement to their communication to the ways in which they experience emotions. This is why Reunion not only works with best-in-class therapists but with neuropsychologists and rehabilitation psychologists to optimize patient recovery. For many of our patients, these psychological interventions are a fundamental part of rehabilitative treatment and can significantly improve their quality of life.
This month, Reunion joins the National Alliance of Mental Illness’ “More Than Enough” campaign to honor these patients and remind them that they are “inherently worthy of life, love and healing” regardless of “where they are in their journeys” and “what they are or aren’t able to do.” (NAMI’s #MoreThanEnough Campaign Unites, Empowers Mental Health Community During 2023 Mental Health A | NAMI: National Alliance on Mental Illness). In our commitment to living out this mission daily, we’re exploring why mental health care is important in rehabilitation and how Reunion can help.
How Mental Health Affects Rehabilitation
Before entering an inpatient rehabilitation (or IRH), most patients expect that they will need time adjusting to their new environment. IRH patients must adapt to many lifestyle changes at once, learning to sleep in new beds, eat at new dining room tables, complete challenging new therapy exercises, and manage potential side effects from new medications. But while many patients adapt to the new environment within the first few days of treatment, some patients may begin to experience mental health symptoms during treatment.
Postoperative Anxiety and Depression
According to researchers, certain surgeries put patients at a greater risk of postoperative depression and anxiety. These procedures include total knee replacements (https://www.arthroplastyjourna...(21)00349-1/fulltext), hip replacements (Preoperative Patient Factors and Postoperative Complications as Risk Factors for New-Onset Depression Following Total Hip Arthroplasty - The Journal of Arthroplasty (arthroplastyjournal.org), and surgeries for debilitating medical conditions, such as osteoarthritis Patterns of Depressive Symptoms Before and After Surgery for Osteoarthritis: A Descriptive Study - PMC (nih.gov)). Patients may begin to experience these symptoms in an acute care hospital, in inpatient rehabilitation, or in their communities after they’ve met their inpatient goals and begun outpatient care. Risk factors for postoperative anxiety in adults - Caumo - 2001 - Anaesthesia - Wiley Online Library
There are many factors that may lead those in recovery to develop postoperative depression and anxiety, including having depression or anxiety before surgery, the physical and emotional stress of surgery, reactions to anesthesia and pain medications, anxiety over the pace of recovery or over a potential loss of independence, and complications following surgery.
While symptoms vary among patients, many patients with postoperative depression experience difficulty sleeping or eating, overeating, irritability, anxiety and/or panic attacks, hopelessness, and a persistently low mood. Many patients with postoperative anxiety experience sleep difficulties, heart palpitations, nausea, shortness of breath, and excessive worry.
Fortunately, most people learn to manage postoperative depression and anxiety through sleep, exercise, and the support of friends and family. Reunion also provides families with resources for recovery, including therapy referrals, medication, and access to support groups.
Neurological Trauma and Mental Health
For patients with certain neurological conditions, treatment can be more complicated. In one study of patients with moderate to severe traumatic brain injuries, for example, over 75% of participants were diagnosed with a psychiatric disorder, often during the first year after treatment. While many TBI patients are diagnosed with depression and PTSD, sometimes as a result of the circumstances that led to their injury. Some TBI patients who have sustained frontal lobe damage may also experience mood swings or struggle to regulate their emotions. A prospective examination of Axis I psychiatric disorders in the first 5 years following moderate to severe traumatic brain injury | Psychological Medicine | Cambridge Core. For these patients, mental healthcare can not only help them adjust to the stress of the recovery process, but it can help them manage their emotions.
Many patients healing from strokes are also diagnosed with depression and anxiety as a result of the recovery process. Depending on how a stroke damages neurons in their brain, survivors of stroke may also experience problems with impulsivity, hostility, and irritability. Anger, a Result and Cause of Stroke: A Narrative Review (j-stroke.org)
Like patients with TBIs, longer term mental health care can help these patients manage their emotions and behaviors.
Patients with TBIs and strokes primarily benefit from cognitive behavioral therapy (or CBT). In CBT, patients learn to identify thought patterns that impact their behavior and develop skills and strategies to change them. Psychologists also provide neuropsychological assessments to evaluate the needs of these individuals and strategize with the therapy team to determine how their mental health may impact their work in physical, occupational, and/or speech therapy exercises. Additionally, Reunion team members and/or consultants may meet with the patient’s family to provide psychoeducation, share resources for ongoing mental healthcare, discuss options for medication, and offer access to support groups.
While patients with many different conditions may seek mental healthcare at Reunion, we work hard to ensure they never feel alone in the recovery process. That’s why we prioritize individualized care in not only the physical, communication, and occupational aspects of recovery, but an individual’s emotional experience of that process. To learn how Reunion can give you the resources you need to heal your body and mind, check out our patient services page Inpatient Rehabilitation Facility (IRF) Services (reunionrehabhospital.com) or contact us about setting up a visit at a hospital near you today Contact Us | Reunion Rehabilitation Hospitals (reunionrehabhospital.com)
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