Should MD’s do ‘biopsychosocial’ biopsies?

A recent Washington Post article by Michael W. Kahn, began:

“The patient was a college student newly admitted to our inpatient psychiatric unit. Her boyfriend had dumped her by text and then ghosted her. She got tipsy, swallowed a handful of pills and sent several “goodbye” messages on social media. Panicked friends called 911, and campus police picked her up in front of shocked roommates. After a stop in our emergency room, she was admitted to our locked unit. A psychiatry resident (doctor-in-training) whom I was supervising took a thorough history, and then reported back to me about the patient’s symptoms, medical history, physical exam and laboratory findings…”…”“So what was the breakup about?” I asked him. This was an unexpected question. The resident stammered a bit, looked uncomfortable and replied, “I thought that was too personal to ask about…”

The Post article cites a study, published in the American Journal of Medicine, by the same author, which suggest doctors be willing to be invasive in a new way. The author suggests physicians are comfortable with mechanically invasive procedures but are not as well versed in the emotional realm of their patients. He suggests that emotion is a significant component of health, wellbeing and overall health.

Interestingly, most medical doctors are not trained in counseling or therapy and are not as well versed in navigating these areas clinically. I wonder if this kind of training might go a long way in changing the stigma of mental health as well as allow patients and their MD’s to better relate.

This may another example of inclusion bring us closer to a more accurate understanding of the individual. With the integration of physiological and emotional functioning we get a more accurate understanding of the individual. When making a mental health diagnosis we want to rule out any physiological explanations for the presentation before making a mental health diagnosis. Equally, when making a physiologically based diagnosis it is encouraged to consider the patients current emotion and mental health functioning into account.

I really like the steps of the Biopsychosocial biopsy. They involve the doctor asking the patient to “tell me more about it” in 4 areas. This type of open ended exploration can be very powerful and allow greater exploration which tends to relate to greater understanding, albeit a more complex understanding.

Feeling younger can help protect against stress and health decline!

In a recently published study published in Psychology and Aging researchers from the German Centre of Gerontology looked at data from 5,039 participants age 40 and older. They considered peoples’ perceived stress and their functional health. They also collected subjective age by asking “how old do you feel?”

The research found that participants who reported more stress had a increased risk for rapid decline in functional health over three years and the connection between stress and functional health increased as individuals were older.

Of note, subjective age seemed to provider a degree of protection. For those who felt younger than their actual age, the link between stress and declines in functional health were weaker.

Conclusions from this suggest that interventions that help people feel younger may result in reduced negative impact from stress and may improve health among older adults. On a larger social level, as we are able to counter negative age stereotypes and promote positivity around age could help people feel younger.

The research was not able to suggest an ideal gap between chronological age and subjective age. Further research is needed to clarify this point. This study references past findings that suggest it’s helpful to to feel younger up to a point but that benefits decrease as the gap between subjective and chronological age increases.

The lead author, Markus Wettstein, PhD, University of Heidelberg, said “Feeling younger to some extent might be adaptive for functional health outcomes, whereas ‘feeling too young’ might be less adaptive or even maladaptive.”

Davenport Psychology provides therapy and counseling services to gracefully aging adults in Sarasota and Venice FL. Call 941-321-1971 today if you want to talk about stress management or feelings younger.