Why would a doctor ask about spiritual practices? (Part 2 of 5)

Guest blogger, Laurie A. Tone, LMFT, LPC, MHSP, served six years as Siloam Family Health Center’s behavioral health consultant. Today, she continues a series of blogs on the body-mind-spirit connectedness.

Laurie writes…

In part one, I wrote about how patients’ spiritual life impacts their physical well-being.  Now consider the following case:

Sam (not his real name) is a 56-year-old male who presented in the clinic with a chief complaint of diffuse body pain. He also reported for the past two months he felt fatigued, had poor sleep Check Engine light - 1-2013and poor concentration, low energy, poor appetite with a weight-loss of about 10 pounds in the last month, and just had an overall lack of desire for life. He also reported feelings of excessive guilt over things he had done. On further investigation, Sam reported that he had been stealing from his employer over the last three months. His family needed the money to pay the rent or they would have been evicted.  No one suspected him because he had worked for the company for many years and is good friends with the boss.

Since he began stealing Sam hadn’t slept or eaten well. At the time of the medical visit his symptoms were worsening and he began worrying that he might have bone cancer. His father had died of bone cancer a few years ago. Sam thought God was punishing him for stealing. After putting off his medical visit for weeks, mostly because of fear, Sam decided to seek medical care.

He had thorough visits with his medical provider. All his medical exams were negative, lab results within normal range and they found no evidence of any disease processes.

What do you think Sam’s diagnosis is?

a)      bone cancer

b)      depression

c)       thyroid disorder

d)      muscular dystrophy

If you guessed depression you are right. Sam was suffering from major depression brought on largely from the stress of guilt. His spiritual beliefs were in conflict with his actions resulting in distress. His ruminating guilt disrupted his sleep to such a degree, that after several months of insomnia, it led to a depressive episode. But interestingly enough, it wasn’t the other symptoms of depression that brought Sam into the clinic – it was the physical pain.

Pain, which is a common symptom of depression, is often like a “check engine light” indicating something is wrong under the hood. In Sam’s case there was indeed something going wrong “under the hood.” The good news for Sam is that by addressing the spiritual, emotional, physical and social areas of his life he was able to get the help he needed.

Sam is a good example of how we are integrated beings. It is impossible to separate out the spiritual from the physical. Stay tuned as next time we will address the connection between spirituality and emotional health.

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