Mental Health by Dr Linda Kwakkenbos
Summary
TLDRThe speaker, a psychologist and behavioral researcher, discusses mental health in the context of chronic rare diseases, focusing on Scleroderma and similar conditions. She highlights the importance of holistic healthcare, explaining the biopsychosocial model and how mental health impacts patients' quality of life. The presentation emphasizes positive mental health, resilience, and the concept of positive psychology. Through interactive exercises, she encourages participants to reflect on their mental health and explore ways to improve it, offering practical tools like mindfulness and peer support. The session concludes with advice on how to enhance well-being through small, actionable steps.
Takeaways
- 😀 The speaker is an assistant professor focusing on Scleroderma, a rare autoimmune disease, and highlights that principles in psychology for chronic rare diseases can be applied to other diseases.
- 💡 Mental health is discussed in a positive way, not just focusing on challenges but also on psychological resilience and the capacity to adapt to life's difficulties.
- 🧠 Health is redefined from the medical model (absence of disease) to 'positive health,' which emphasizes the ability to adapt and self-manage despite challenges.
- 📊 Resilience is key in managing chronic diseases and mental health, defined as the ability to adapt successfully to difficult life experiences, and it can be cultivated and practiced.
- 🌱 Mental health is more than the absence of illness; it's about enhancing life enjoyment and dealing with challenges. It involves thinking, feeling, and acting in ways that promote well-being.
- ⚖️ The traffic light analogy is used to explain mental health, with green for well-being, orange for mental health issues, and red for mental illness.
- 🔄 Positive psychology focuses on building well-being and resilience, while traditional psychology focuses on reducing symptoms. Both are important and often use similar techniques.
- 🧩 People with rare diseases like Sjögren's often experience a significantly decreased quality of life, with depression and anxiety being more prevalent compared to the general population.
- 👥 Peer support and communication with healthcare providers are important components of managing both physical and mental health, especially for people with chronic diseases.
- 📝 The speaker introduces a reflective exercise where participants rate their control over their condition, encouraging small, actionable steps to improve mental health and resilience over time.
Q & A
What is the primary focus of Linda's research?
-Linda's research primarily focuses on Scleroderma, a rare autoimmune disease. However, she mentions that some principles in psychology related to chronic diseases can be applied to other conditions, like Sjögren's syndrome.
What is the biopsychosocial model of health that Linda discusses?
-The biopsychosocial model of health considers a person as more than just their biological condition. It includes their psychological health, social challenges, and the broader context in which they live, promoting holistic healthcare.
How does Linda define resilience in the context of chronic illness?
-Resilience is defined as the process and outcome of successfully adapting to difficult life experiences, such as being diagnosed with a chronic illness. It involves mental, emotional, and behavioral flexibility and adjusting to both external and internal demands.
What is Linda's view on health in relation to people with chronic diseases?
-Linda challenges the traditional view that health is merely the absence of disease. She supports the concept of 'positive health,' which is the ability to adapt and manage physical, social, and emotional challenges, even in the presence of chronic conditions.
What is positive psychology, and how does it differ from traditional psychology?
-Positive psychology focuses on enhancing well-being and helping individuals flourish, even if they are not facing significant mental health challenges. Traditional psychology often addresses what is wrong and aims to reduce symptoms. Positive psychology aims to improve an individual's overall quality of life.
Why does Linda emphasize building resilience?
-Linda emphasizes building resilience because it helps individuals with chronic conditions adapt and improve their mental health. Resilience can be cultivated through various strategies, leading to better coping mechanisms and a higher quality of life.
What exercise does Linda propose during her presentation to help participants reflect on their mental health?
-Linda proposes an exercise where participants rate their current life situation on a scale from 0 to 10, where 0 means their condition completely controls their life, and 10 means they can live their life without being affected by their condition. Participants are then asked to reflect on why they chose that number.
What challenges do people with chronic conditions like Sjögren's face in terms of mental health?
-People with chronic conditions like Sjögren's often face mental health challenges such as depression and anxiety. These issues are more prevalent among those with chronic diseases compared to the general population, and they can significantly affect quality of life.
What does Linda say about the relationship between physical activity and mental health?
-Linda highlights that adopting a healthy lifestyle, including exercising and moving more, is beneficial not just for physical health but also for mental health. Even small activities like a brisk walk can positively impact mental well-being.
What strategies does Linda suggest for improving mental health in people with chronic diseases?
-Linda suggests a variety of strategies, including mindfulness-based stress reduction, peer support, adopting a healthy lifestyle, and engaging with healthcare providers about mental health. She also recommends focusing on positive psychology practices to enhance resilience and well-being.
Outlines
🧠 Introduction to Mental Health and Scleroderma
The speaker, Linda, introduces herself as an assistant professor from the Netherlands, specializing in psychology with a focus on rare autoimmune diseases, particularly Scleroderma. She discusses the importance of understanding mental health in the context of chronic diseases and highlights the biopsychosocial model of care, which takes into account not just physical health but also psychological and social factors. The goal is to share insights on how mental health is vital for managing diseases like Sjögren's and how resilience and adaptability play key roles in the well-being of patients.
🌿 Resilience and Cultivating Mental Health
Linda defines resilience as the process of adapting successfully to life's challenges, including chronic illness. She explains that resilience can be both an innate trait and something that can be developed through practice. The speaker emphasizes the broader concept of mental health, not just focusing on mental health issues like depression and anxiety, but also on how individuals can enhance their well-being through emotional, mental, and behavioral flexibility. This positive approach to mental health highlights the importance of building resilience and improving quality of life.
🔍 Tools for Mental Health Improvement in Chronic Diseases
Linda shares strategies for addressing mental health challenges, especially in the context of chronic and rare diseases like Sjögren's. She advocates for using existing mental health tools available to the general public, such as mindfulness-based stress reduction, as a starting point. This can be supplemented by disease-specific strategies to manage the unique challenges faced by people with rare conditions. Linda stresses the importance of taking immediate action with accessible tools rather than waiting for specific interventions to be developed over many years.
💡 An Exercise in Mental Health Reflection
Linda introduces an interactive exercise designed to help participants reflect on how their condition affects their daily lives. She asks the audience to rate how much their condition controls their life on a scale from 0 to 10, where 0 means complete control and 10 means no control. This exercise encourages individuals to assess their own experiences and discuss with others why their chosen number isn’t a 0 or a 10. Through this reflection, participants gain insights into their own coping mechanisms and areas where they may need to improve their mental health.
🚶♀️ Taking Small Steps to Improve Mental Health
In the final part of her talk, Linda encourages participants to think about small, concrete steps they can take to improve their mental health. She introduces the 'miracle question,' which prompts people to imagine what their life would look like if their problem no longer existed, and to identify steps to move toward that ideal. The focus is on incremental progress, such as moving from a score of 4 to 4.5, by changing behaviors, thoughts, or feelings. Linda emphasizes the importance of both individual effort and support from loved ones in this journey.
Mindmap
Keywords
💡Mental Health
💡Resilience
💡Biopsychosocial Model
💡Positive Health
💡Sjögren’s Syndrome
💡Chronic Disease
💡Positive Psychology
💡Quality of Life
💡Mindfulness-Based Stress Reduction (MBSR)
💡Self-Management
Highlights
Introduction of Linda Quos, an assistant professor from the Netherlands, focusing on Scleroderma, a rare autoimmune disease.
Emphasis on applying psychological principles from chronic rare diseases like Scleroderma to other diseases such as Sjogren's syndrome.
Mental health is discussed from a positive perspective, highlighting the importance of addressing both mental health issues and building resilience.
Introduction of the biopsychosocial model of health, which considers the psychological and social aspects, not just the biological challenges.
Discussion of the shift from the traditional medical model of health, which defines health as the absence of disease, to a more positive health definition focused on adaptability and self-management.
Introduction of the concept of resilience as the ability to adapt successfully to challenges like chronic diseases, emphasizing that resilience can be built and cultivated.
Mental health is framed as a capacity to enjoy life and manage challenges, not just the absence of mental illness.
Introduction of a traffic light model of mental health, with green representing flourishing, orange for mental health issues, and red for mental illness.
Positive psychology is discussed as a movement to not only reduce symptoms but to enhance well-being and resilience, even when individuals are doing relatively well.
Key finding: People with primary Sjogren's syndrome have significantly decreased health-related quality of life, similar to other chronic inflammatory diseases like rheumatoid arthritis and lupus.
The prevalence of depression and anxiety is approximately three times higher in people with Sjogren's syndrome compared to the general population.
Challenge: Conducting well-designed, large-sample studies for rare diseases like Sjogren's is difficult, but there is a need for targeted interventions to improve quality of life.
Linda proposes a framework for mental healthcare tools, starting with general mental health strategies like mindfulness-based stress reduction and progressively addressing challenges related to chronic and rare diseases.
Interactive exercise: Attendees are asked to rate how much their condition controls their life on a scale from 0 to 10, leading to discussions on how different perspectives impact mental well-being.
Recommendation: Attendees are encouraged to take small, concrete steps to improve mental health, aiming for gradual progress rather than drastic changes.
Final takeaway: Tools such as mindfulness, peer support, and guided relaxation techniques can help improve mental health and resilience in those living with chronic diseases like Sjogren's.
Transcripts
I'm very grateful that we can have uh
now uh Linda
quos also from the Netherlands and she
is a uh professor of the assistant
professor of the University of n the
rbout and she was to told something
about mental health yes thank you thank
you very for the very nice introduction
and also for having me and for all the
insights that I have gathered already on
showrun because as you can see uh here
on the bottom line under my name my work
mainly focused around Scleroderma which
is another rare autoimmune disease which
some of you may know um but I think that
like saurin said some of the general
principles that we use in Psychology um
in um in chronic diseases especially
chronic rare diseases can be transferred
to other diseases such as sug so uh I'm
learning a lot but I hope that I can
also give you some insight in mental
health and psychology
I am a psychologist by training and a
behavioral researcher and I was very
happy to find saurin because he is in
the same boat with me um in uh in that
respect and I'm going to speak about
mental health about mental health in a
positive way and about a little bit
about mental health
issues um and just a disclaimer in
addition to telling you about mental
health I also have a small exercise
because I know that about 5% of what I
will tell you you will remember after
this presentation but but about 75 to
90% of what you experience you will be
remembering after this presentation so
uh be aware uh there's no test but it's
a small exercise that I will walk you
through I do not have any
disclosures um when you walk into the
doctor's office or as a doctor clinician
when the patient Works walks into your
uh office what do you see do you see a
patient a sugr patient or do you see a
person who has sugrin but also has a lot
of other things in addition to this bi
biological challenge it's also a person
with um uh psychological challenges uh
but also psychological Health Social
Challenges and health uh who lives in a
certain context I see that the um uh the
corners of the and the colors is not
really visible uh um but these are like
little circles that all constitute the
person with a certain
disease the bioc psychosocial model of
health and holistic Healthcare and I
think they go hand handin hand and if
you look at EUR this um they also made
priority of holistic care and holistic
Healthcare and you may be surprised that
when I'm at UL or at ACR or another
rheumatology conference that I'm one of
the few psychologists actually who is
present there whereas for you as
organizations this is such an important
topic um not to say that all of the
medical research and uh advances are not
important but this is another important
part of healthare for people with
children so when thinking about health
and mental health how would you actually
Define health and I'm giving you a
moment to think about it yourself if you
think about health what is health to
you anyone who would like to
share what does Health mean that I that
I can do what I want yeah that you can
do what you want yeah yeah thank you
same for you yeah good quality of life a
good quality of life yeah yeah
nice from morning till night wow yeah
thank you thanks for sharing that yeah
and actually for the longest period of
time the healthc care system has been
focusing on the medical model of Health
until approximately 1977 the medical
model of Health where Health was the
absence of disease so that means that
when you have a disease or when you have
sug for instance you will not never be
healthy again I tend to disagree and
luckily many with us because there's
also something called positive health
and maral Huber also from the
Netherlands by the way she came up with
an other definition of health and she
said health is the ability to adapt and
to self-manage in the face of social
physical and emotional challenges and
I'm teaching my third-year psychology
students this because they still while
we all talk about like the
biopsychosocial model they still have
this like internal idea like if someone
is ill you cannot be healthy right but
there's many things of positive Health
uh Health adaptation and self-management
that you could still build and some of
this is related to the concept of
resilience and resilience basically is
defined as the process and outcome of
successfully adapting to difficult or
challenging life experienes such as
getting a diagnosis with sugar
especially through mental emotional and
behavioral flexibility and adjustment to
external and internal demands wow that's
quite a mouthful but what basically the
idea is is that you can build resilience
like we all have a certain level of
resilience already based on our uh life
challenges that we've already had our uh
youth um our um personality traits Etc
but you can also cultivate and practice
resilience improving your mental health
or cultivating your mental health and I
think this is a really important
component of what I would like to
discuss today in uh in this
presentation so I've given you a
definition of resilience I've given you
a definition of Health but what actually
is mental health and often if we talk
about mental health we think about
challenges mental health challenges
mental health issues depression anxiety
Etc but it's much broader it's a much
broader concept looking again not at the
disease side of it but at the health
side of it so Mental Health is the
capacity of every individual to feel
think and act in ways that enhance their
ability to enjoy life and deal with
challenges so again very positively
connotated um uh positive sense of
emotional and spiritual well-being uh in
someone's
context so thinking about this a little
bit more you could come up with this
kind of like I it's like traffic light
colors I don't know if you can see it
but like the green on top mental health
you have the capacity to think feel and
act in ways that uh enhance your ability
to enjoy life deal with your challenges
and it doesn't mean that there are no
challenges it basically means that you
suffer your losses and you pull yourself
back up again so that is mental health
on the complete below spectrum is mental
illness depression anxiety uh conditions
that really affect your thinking feeling
uh your mood and behavior and then
somewhere in between is where I would
think um many people with a chronic
disorder sometimes um uh are situated
the mental health issues it's not what
we call in Psychology Psychopathology
it's not mental health uh Mental Illness
but you have diminished capacities that
interfere with your enjoyment of life um
and that interfere with your ability to
rebound or recover from losses or
challenges so that's the orange part of
this uh uh traffic
light still with me yep
good just a check and then if you think
about psychology there's also this
movement from the traditional
psychological approaches that basically
speak about something is not going well
something is wrong and you're trying to
reduce the symptoms and prevent it from
getting worse so basically something is
going wrong and you're making it normal
again very important I'm not saying that
one is more important than the other but
there's also a newer tradition on
positive psychology and that means
you're already doing quite well but you
can still improve you can improve your
well-being you can flourish you can uh
um uh um strengthen your character and
build even more resilience and um uh
they kind of like go hand inand and the
techniques that we're using in
Psychology may be quite similar actually
um in both Traditions but it's really a
bit of a mindset and a change in
thinking about health and also our
Mental Health
I did put one slide with some Su uh uh
information um and uh only one slide
because I think that um uh this uh um
these two points are important or
actually the three points that are
listed here are important first of all
we're not talking about quality of life
here because it's not important in
people's uh life and people with primary
Sugar's life we actually see that people
with primary sugar have significantly
decreased health related quality of life
and it's actually simp similar if you
compare on the different aspects of
quality of life to other chronic
inflammatory diseases such as rheumatoid
arthritis or
lupus the prevalence if we talk about
mental illness the prevalence of
depression and anxiety are approximately
three times higher in people with Su
than in the general population so this
is a really important topic to keep in
mind in our research programs but also
in our care for people with uh with
Su actually I found this nice quote and
I put it here is that um because this
quality of life is diminished it
suggests that targeted intervention
should be carried out to improve health
related quality of life I agree but it's
very hard to do that in a rare disease
um and future well-designed and well-
conducted studies with larger sample
sizes may be required I also agree but
again it's really hard to do that in a
rare disease so I also start thinking
about like what can we learn from what
is already available in terms of
interventions rather than wait for 10 20
years to things to be developed because
in my opinion if you think about Mental
Health Care tools you can start with
tools that basically are available to
anyone in the general public mindfulness
Bas stress reduction for instance then
on top of that there are challenges that
you have to deal with if you are F
coping with a chronic disease any
chronic disease can be diabetes can be
sugar can be Scleroderma rheumatoid
arthritis then on top of that there's
the challenges of living with a rare
disease like Su or Scleroderma and and
then on top of that are disease specific
uh uh issues that may be targeted if you
start with the top and I'm not saying
that that isn't a good approach you're
actually a long way out of making tools
available for people with
shrs um I'm am very dedicated to to
building that and to building that
framework and to see where there's
adaptations necessary but also think
that we shouldn't wait for so many years
to give you some tools and some examples
of what you can do to improve mental
health so that is the next part of my
presentation and the exercise is coming
up so just a
reminder so tips and resources lifestyle
I actually put quite some uh slides on
lifestyle and then I saw that tomorrow
there's a colleague of mine who's going
to speak a lot about lifestyle lifestyle
medicine adopt a healthy lifestyle may
sound like an Open Door um but actually
exercising moving more sitting less uh
is very good for not only our physical
health but also for all our Mental
Health
even a small like brisk walk like every
movement counts peer support um and I
think just by being here together and
like all of your organizations you're
taking very good care of uh that part
already um it's helping for emotional
support inform informational support
like letting people know and navigating
the health system as well as tangible
support just um practically you can help
each each other
out talk with your healthcare provider
about mental uh uh Health uh there are
some tips in this link that I put here
um but also the Dutch have a very nice
uh um conversation card that you could
actually download and bring uh to your
Healthcare appointment uh and uh find
information and support from trustworthy
sources so these are very generic tips
that uh uh that you could
use okay so now for this small exercise
and um I already said that uh this is um
um an exercise from the positive
psychology to make you like kind of like
feel how a different outlook on your
condition may affect your mental health
and uh your view on uh uh on daily life
so I would like to ask you if whether
you have sugar another condition or if
you don't have any uh um condition think
about any problem that may interfere
with your life so rate yourself on a
zero to 10 skill you have a very nice
notepad you can write it down or you can
just remember it where zero is is my
condition totally controls my life and
makes it impossible for me to live my
life all at at all in the way that I
want to and 10 is very positive I can
live my life the way I want to and my
condition does not affect that so take a
moment to think about it where on this
skill would you
be good got it yeah
okay so now the next step is to think
about about why is it the grade that you
chose and why is it not a 10 unless
someone had a 10
but so why is it a grade that you chose
and why is it not a
10
ready
yeah why is the grade that you chose and
not a zero
got
it okay so here is actually a bit of
time for uh discussion I'm I'm doing
well for time right so um let's take two
minutes to discuss the difference in
experience with your neighbor so the
difference between comparing the number
with a zero and comparing the number
with a 10 so two minutes to discuss and
then I would like to hear back what you
found out
borrow this one
my
all
right all
right let's um let's move
on there are a lot of
um there are a lot of nice
discussions I'm are you done yeah yeah
so thanks um thanks for all the nice uh
discussions also in the back can we
um yes
yeah okay so I um I'm actually I'm
actually interested to hear some of your
experiences is there anyone who would
like to tell me like how does it make
you feel how was it to do this exercise
yes thank you
uh with it's difficult yes it's
difficult first of all to understand the
meaning and you need to be honest with
yourself to understand how the others
react and how the others uh um affect
your
feelings um we were discussing with the
girls here and we say that it's hard for
the others to understand how the
patients with SH disease
feel H because we have to put some
limits on our daily lives and the others
cannot understand even
though as much as they want to
understand you they can't even our
partners who live with us in a daily
basis and at night and they feel and
they understand how we feel and how hard
we try sometimes to go through the day
um even though our partners there are
times that they can't um a lot of people
think or feel that we exaggerate on our
feelings or maybe we are Bor to do
something or we are not interested and
they don't understand that it's our
limits for the day we can't go
through um more than we do because if we
do um we will have
consequences thank you yeah yeah thank
you thank you for sharing that so it's
also very important and I think uh you
you pointed it out to communicate with
the people around us and to help them
understand what you're going through
yeah thank you were there any insights
from this exercise that someone would
like to share how is it to compare it
with a Zero versus a 10 where you are
right now yeah
um I felt like when I compared myself to
a zero I was thinking of all the things
that are positive and that I am capable
of doing um that get me to the number I
felt I was at um versus When comparing
myself to ATT 10 I'm thinking about what
are all the things I can't do so
thinking more negatively about you know
how it how it impacts me in a negative
way so one was more positive I felt than
the other
thank you thanks three minutes okay I
have uh I'm I'm doing well for time were
there any other experiences or is it
like General agreement I just leave this
here because otherwise I look like I'm
singing a song which I am not I will not
bother you with that yeah so on the one
side if you look at the uh zero it makes
you feel quite positive but all the
things that you can do and the 10 about
the things that you find struggle with
of doing or what we say in like more
positive psychology focus on the flowers
not on the weeds that are in your garden
but then like it's easier said than done
right so how do you actually do that
first by hopefully remembering this this
exercise and sometimes looking at what
the zero would be but also how do you
take steps what if
your initial number was for instance a
four or the number of your um Pier was a
four and you would actually like to
improve and move towards that then how
would you do that um it's actually a
first step to think about like if I
would move from a four to a four and a
half and imagine think about like that's
a really small step which also makes it
more
attainable what would I need to change
in my behavior what would I need to
change in my feelings and what would I
need to change in my thoughts so how can
I go from a four to a four and a half
and it's a very difficult question and I
know that I'm challenging you with these
with these questions but it also helps
you make the step from a four to a four
and a half and the changes that you
would like to make in your life towards
a more positive mental health very
concrete and actionable so things that
you can actually do small things that
you can do in the next week or the weeks
after to improve your mental uh Health
going from four to a four and a half
maybe to a five to a five and a half
Etc also think about like what it means
for yourself but also what it means for
your surroundings so um it's not just uh
uh you but also your family Partners
Etc another thing that you could do to
think about like how can I move up on
that scale um if you would want to is
like the miracle question and a miracle
question basically is if your problem
would not exist anymore what would your
life look like so what would you do how
would you feel what would you think so
that is your 10 maybe and what actions
can you take yourself or with support of
others to help go up high that point or
one point so small steps moving from
where you were towards the 10 uh looking
at what you can still do so why it's not
a zero but also what you would like to
attain and this is actually um very
classical exercise that is helpful for
those who are in like the orange Zone
with like me some mental health issues
but also in the green zone because in
the green zone doesn't mean that you're
necessarily at a 10 there may be room to
grow and to flourish and to improve your
well-being then there's some tips and
resources for mental health issues um uh
for if you're in the red and I think
it's really important to mention that uh
there's disease specific but also many
generic programs and interventions that
could be available in your local setting
uh such as mindful mindfulness based
stress reduction that you could follow
they may not be specific to sugr but in
my um experience people like who give
trainings are very open to adapting if
needed to your personal needs um that's
not only for people with SU but there's
many other people who have like back
problems or other reasons they cannot
follow the the classic traditional
program so be open to speak about that
there's things you could do in terms of
relaxation guided breathing guided
imagery and I've put two links up here
and this the slides will be uh shared I
I know that you can uh look at and get a
refer to to a mental health professional
if needed don't um uh walk around with
your problems for too long ask for help
try to uh accept that sometimes you're
in the red you want to go back to the
orange or the green and you may need a
bit of help to get
there so thank you very much for
participating and I hope that this gave
you some insight in what psychology
could uh could mean and contributes to
improving quality of life and thank you
again for the organization for having me
thank you
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The Biopsychosocial Model
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