A COUNSELOR’S BLOG FOR OPTIMAL FUNCTIONING

If an individual has a medically or psychologically determined disability, she would most likely qualify for vocational rehabilitation services from her state office. 

Vocational rehabilitation services provided range from medical services to sheltered employment, employability skills training, job placement assistance, on-the-job training, and vocational or academic training, etc.  Once an individual has completed the application process (a lengthy one unfortunately) and has qualified for services, a vocational rehabilitation counselor will help write a rehabilitation plan. The particular services provided depend on individual needs and help the client achieve an optimal level of functioning.   

Usually this program is the Department of Vocational Rehabilitation (DVR) in many states or within the Department of Education.  The program is available to all legal residents of the United States.  To find the office in your community, contact your state Department of Vocational Rehabilitation or Department of Education. 

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The field of rehabilitation recognizes that people who become physically disabled go through two emotional stages, denial and mourning, before adjusting to their disability. Negative aspects of these stages, such as dependence and hostility, are viewed as logical outcomes within a society such as ours that perpetuates an ideology of normality.  Although denial and mourning are natural responses to a disabling event, sometimes the denial (thinking one will get well in time or is able to physically do more than in actuality) and mourning (sadness and depression), take longer to overcome and impede the rehabilitation process and eventual reintegration into society. 

If you have prolonged difficulties with these negative aspects, let your doctor know.  Most major hospitals have support groups of individuals experiencing similar difficulties.  If not, perhaps a referral to a mental health professional might help.

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Chronic pain is defined as pain that lasts longer than 3 months. Some experts define it as lasting longer than 6 months. Chronic pain is different than acute pain in that it is not easy to find the cause. Diagnosis can reveal no injury in the body at all, and yet the patient can be experiencing very debilitating pain.

One way that chronic pain begins is from an injury. Scientists have found that repeated pain from an acute injury changes the way the brain lets you know you have pain. Even after the injury has healed, pain messages replay over and over again. Chronic pain may worsen in response to environmental and/or psychological factors such as depression and addiction. Chronic pain may also be related to a number of different medical conditions including (but not limited to) diabetes, arthritis, migraines, fibromyalgia, cancer, shingles, sciatica, besides injury or trauma.

There are a variety of treatment options for chronic pain. The goal of pain management is to provide symptom relief and improve an individual’s level of functioning in daily activities. A number of types of medications have been used in the management of chronic pain, including acetaminophen, ibuprofen, aspirin, COX-2 inhibitors, antimigraine medications, sedatives, opioids, and antidepressants. Many people have become addicted to narcotic pain medication. Nonmedicinal treatments for chronic pain can include exercise, physical therapy, counseling, electrical stimulation, biofeedback, acupuncture, hypnosis, chiropractic medicine, and other treatments.

For more information contact the American Pain Society.

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When a person has an addiction plus depression, doctors say they have a “dual diagnosis.” The term is a reminder for physicians, nurses, and other medical professionals that this patient has extra challenges on the road to recovery.  Symptoms of addiction and depression can be very similar. When depression is directly connected to the drug or alcohol abuse, and isn’t present independently, it’s considered a consequence of the addiction.

The combination of addiction and depression can make it harder to recover. When a person feels sad, hopeless, or exhausted, battling an addiction is a special challenge that may be difficult to face. But knowing about the link between addiction and depression, and seeking treatment to address both issues, can help make recovery possible.

Often, some people who are several weeks, if not months, into their recovery, still exhibit symptoms of sadness, hopelessness, and exhaustion.  This might not be due to “not working” the recovery program hard enough or not having “faith” in a higher power, but, rather, to the presence of depression and the need for special treatment.  For more information contact your state’s Mental Health Association.   

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