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20
Sep 22

The biopsychosocial approach to Fibromyalgia treatment

As a young adult, I was a certified massage therapist and eastern bodyworker. Many of my clients experienced widespread and chronic pain of unknown etiology. After diagnostic tests appeared within normal limits, many of their doctors, to legitimize their symptoms, would diagnose them with Fibromyalgia. Fibromyalgia is an elusive diagnosis with no directly identifiable cause and no cure (Tezcan & Alkar, 2022). However, the biopsychosocial model can offer a comprehensive viewpoint to treat and relieve symptoms of the syndrome.

Fibromyalgia causes sensitivity, widespread and chronic pain, sleep disorders, fatigue, and a decrease in overall quality of life, among countless other symptoms. The symptoms of this disease are experienced differently from one person to the next (Tezcan & Alkar, 2022). Marie A., a fibromyalgia sufferer, likens the pain to a slapped sunburn, while Chanel M. explains that the condition is physically and mentally draining (Smith, 2020). Surprisingly, 2% of the U.S. population suffers from Fibromyalgia (Centers for Disease Control and Prevention, n.d.)! This statistic does not include the many people suffering who do not seek treatment or do not have access to healthcare.

Fibromyalgia challenges the traditional biomedical model because it is not a condition that can be easily found and fixed (Gruman, 2016). Instead, a biopsychosocial approach is employed to treat this syndrome. The biopsychosocial model considers the whole person from a biological, psychological, and social perspective and promotes a multi-disciplinary approach to treatment (Gruman, 2016).

In a meta-analysis, Tezcan & Alkar (2022) sought to explain the psychological/social components of the disease and interventions for Fibromyalgia patients. Some physiological factors affect psychological factors and subsequent moods. For example, when sleep quality deteriorates, as is common in Fibromyalgia patients, pain perception is heightened, which triggers negative affect. This interchange between somatic and psychological symptoms is why treatment efforts are most beneficial when examining all components of a person’s well-being.

However, Fibromyalgia is difficult to treat. Each patient is assessed individually and with the expertise of clinicians from many different disciplines to guide treatment. The most bothersome symptoms are usually the focus of treatment. Patients who fear pain more intensely were more likely to suffer from increased pain perception, negative affect, and disability. Therefore, many interventions target cognitive-behavioral processes to reduce anxiety (Tezcan & Alkar, 2022).

Much success in symptom reduction has been through psychological means. Research shows that high self-efficacy, self-compassion, and positive coping strategies were associated with higher functionality and predicted pain perception (Tezcan & Alkar, 2022). To achieve higher levels of self-efficacy, Cognitive-Behavioral Therapy (as of September 2022) is the most studied and effective intervention. In conjunction with Cognitive-Behavioral Therapy, several strategies exist to improve symptoms. Mindful Self-Compassion, Compassion-Focused Therapy, Compassion Cultivation Training, Acceptance and Commitment Therapy, Emotional Regulation, Biofeedback, Mindfulness, improving interpersonal relationships, and physical activity are some of the methods used (Tezcan & Alkar, 2022).

According to the biopsychosocial model, Fibromyalgia symptoms are equally responsible for and treated by physiological and psychological/social factors. Thus, the only framework to properly evaluate patients is the biopsychosocial model. When a multi-disciplinary approach is embraced, with biological, psychological, and social factors supported, clinicians can be confident that they are providing suitable care to Fibromyalgia patients.

References

Centers for Disease Control and Prevention. (n.d.) Fibromyalgia. CDC. https://www.cdc.gov/arthritis/types/fibromyalgia.htm#:~:text=Fibromyalgia%20affects%20about%204%20million,be%20effectively%20treated%20and%20managed.

Gruman, J. A., Schneider, F. W., & Coutts, L. M. (Eds.). (2016). Applied social psychology : Understanding and addressing social and practical problems. SAGE Publications, Incorporated.

Smith, L. (2020). 7 People with Fibromyalgia Describe What It Feels Like. GoodRxHealth. https://www.goodrx.com/conditions/fibromyalgia/what-fibromyalgia-feels-like.

Tezcan, R. E. K., & Alkar, Ö. Y. (2022). Psychological Factors Associated with Fibromyalgia and the Areas of Psychological Intervention. Psikiyatride Guncel Yaklasimlar, 14(2), 221-234. https://doi-org.ezaccess.libraries.psu.edu/10.18863/pgy.972163.

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09
Feb 22

Social Media Influences on Health

The biopsychosocial model is a combination of biological, psychological, and social factors of health and illness. This approach allows mental health professionals to acknowledge other factors that are important in explaining illness. In this blog, I will focus on the social variables within the biopsychosocial model. The social influence of others can have both positive and negative effects on our health (Gruman et al., 2017, p.194). Let’s dive into the negative effects social media has on our overall well-being.

Many advertisements distort body image and portray unrealistic ideals of beauty. Models photographed on billboards, in magazines, and television advertisements look flawless. They have the perfect smile, unblemished skin, ample cleavage, defined abs, a skinny waist, no cellulite, hairless bodies, and are covered in makeup. Most viewers, including myself, neglect to realize that we are being misled by images that are retouched and photoshopped to give them the perfect, ideal look.

The way women and men are portrayed in the media has been an ongoing, controversial issue. High beauty standards and the constant pressure of meeting society’s expectations leads to severe, harmful consequences and lifechanging decisions. We compare ourselves to models and begin to nitpick every flaw on our body. This destroys our self-confidence, body image, and causes us to feel bad about ourselves. Women feel the only way to be accepted in society and be considered beautiful is by conforming to these high, nearly impossible expectations. Most individuals get frustrated when they don’t see results immediately after exercising. Therefore, they switch to easier, quicker methods such as starvation, surgery, dieting pills, botox, lip injections, and implants. Not only can this be costly, but it is also physically, mentally, and emotionally unhealthy. The pressure of conforming to body image standards can cause eating disorders, stress, low-self-esteem, and depression.

Since social media plays a significant role in shaping our attitudes about our health, it can be used in a positive manner to promote health (Gruman et al., 2017, p.195). Fortunately, over the past decade or so, companies, artists, and influencers have promoted positive body image and self-love through social media campaigns. An example of this is The Full Body Project by Leonard Nimoy which challenges societal beauty standards by photographing nude overweight women. Plus-size models have emerged into spotlight and have been using their voice to advocate body image and inspire women of every shape to feel confident in their own skin. The overall goal of these campaigns and global movements is to empower women of all ages, shapes, and sizes, improve their self-esteem, and give them the confidence to be themselves. Although we are on the way to redefining beauty standards, they still exist.

Reference

Gruman, J.A., Schneider, F.W., & Coutts, L.A. (2017). Applied Social Psychology:

        Understanding and Addressing Social and Practical Problems. Thousand Oaks,

CA: Sage.

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24
Sep 20

Mental Health, Are We Treating the Whole?

It is no secret that mental health conditions are on the rise, impacting 1 in 5 adults according to the American Psychiatric Association. Since COVID 19 the situation has gotten worse. According to a report published in August 2020 by the Centers for Disease Control and Prevention (CDC), “U.S. adults reported considerably elevated adverse mental health conditions associated with COVID-19. Younger adults, racial/ethnic minorities, essential workers, and unpaid adult caregivers reported having experienced disproportionately worse mental health outcomes, increased substance use, and elevated suicidal ideation.” But what can we do to help those dealing with these issues?

 

In the past, when it came to mental health conditions, medical professionals were solely focused on understanding and treating the biological functions thought to be causing the illness. This approach called the biomedical model approach, viewed mental health conditions as being diseases of the brain, and sought to treat them solely by the use of medications. However, as suggested in Applied Social Psychology: Understanding and Addressing Social and Practical Problems this might not necessarily be the best approach.

 

It is believed that mental health conditions are affected by more than just biological factors. Psychological traits and social circumstances are also contributing factors and thus why the biopsychosocial model approach is now often implemented by medical professionals today. The biopsychosocial model approach, as its name suggests, believes that the best way to determine and treat illness is by a combination of not only biological factors but also psychological and social factors as well. When addressing issues of mental health, we need to look at the whole picture and treat not only the biochemical imbalances in the brain but also the psychological traits and social circumstances contributing to the mental health condition(s). Some of those psychological and social influences can include, childhood psychological trauma such as emotional, physical, or sexual abuse, suffering a loss at a young age such as the loss of a parent or sibling, gender identity, social class, and race and ethnicity.

 

Rather than taking a biomedical model approach that focuses solely on biological functioning to explain and treat an illness, we should take a biopsychosocial model approach a treat the whole person.

 

References

Mental Health 2020: A Presidential Initiative for Mental Health. (2019). Retrieved September 24, 2020, from https://www.psychiatry.org/File%20Library/Psychiatrists/Advocacy/Federal/Mental-Health-2020-A-Presidential-Initiative-for-Mental-Health.pdf

Mental Health, Substance Use, and Suicidal Ideation During the COVID-19 Pandemic – United States, June 24–30, 2020. (2020, August 13). Retrieved September 24, 2020, from https://www.cdc.gov/mmwr/volumes/69/wr/mm6932a1.htm

BJ, D. (2013). The biomedical model of mental disorder: A critical analysis of its validity, utility, and effects on psychotherapy research. Retrieved September 24, 2020, from https://pubmed.ncbi.nlm.nih.gov/23664634/

Gruman, J. A., Schneider, F. W., & Coutts, L. M. (2017). Applied social psychology: Understanding and addressing social and practical problems. Los Angeles, CA: SAGE.

Bhandari, S. (2020, June 30). Causes of Mental Illness. Retrieved September 24, 2020, from https://www.webmd.com/mental-health/mental-health-causes-mental-illness

Mechanic, D., & McAlpine, D. (2002, April 30). The Influence of Social Factors on Mental Health. Retrieved September 24, 2020, from https://onlinelibrary.wiley.com/doi/abs/10.1002/0470846410.ch17

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09
Feb 18

Social Influence Upon Health

While health is commonly thought of in physiological terms, according to the biopsychosocial model, health is actually influenced by not only biological elements, but by psychological and social factors as well (Schneider, Gruman, and Coutts, 2012).  In particular, the social implications upon health include a wide variety of factors.

Socioeconomic status, which considers financial and educational levels, has been shown to greatly impact health (Schneider et al., 2012).  Research indicates that the higher the socioeconomic status of the household or individual, the healthier the family or individual will be (Schneider et al., 2012).  It is easy to assume why this may be.  Those with less financial constraints are able to purchase adequate food, and perhaps even healthier options, or more high-end food products.  Those with higher education are typically more aware of health recommendations and risks.  Individuals with low socioeconomic status may not have access to proper medical care, or also lack in social support.  Essentially, higher socioeconomic statuses translates to more and better resources.

Those individuals we keep within our social circles also have the power to sway our health.  For example, if your spouse, best friend, or children are active and athletic, you may be influenced to also be active (Schneider et al., 2012).  Positive health influences equates to better health choices.  Additionally, solid relationships also point to better health and healthier choices as these elements support a better mood and lessened stress (Schneider et al., 2012).

On the other hand, stressful social environments can impact health negatively (Schneider et al., 2012).  Imagine an overworked manager.  Suppose he is working well over 40 hours a week, and once he gets off work, he is too tired to visit the grocery store to shop for the necessary ingredients to prepare a healthy meal.  Instead, he usually resorts to fast food, which does not always offer the healthiest options.

According to the World Health Organization, the majority of new major health concerns are tied directly to society, and basically how we operate within it (World Health Organization, 2010).  It is not fully understood just how much social factors contribute to health, just that the relationship is firm and established (World Health Organization, 2010).  Intervention strategies are currently being employed to combat social inequalities that, in part, fuel poor health among us (World Health Organization, 2010).

 

References

Schneider, Frank W., Gruman, Jamie A., & Coutts, Larry M. (2012).  Applied Social Psychology:  Understanding and Addressing Social and Practical Problems.  Second Edition.  Thousand Oaks, CA:  Sage.

World Health Organization. (2010). Equity, social determinants, and public health programmes. Retrieved from:  http://apps.who.int/iris/bitstream/10665/44289/1/9789241563970_eng.pdf.

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