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When facing a severe or slow-healing wound, it’s understandable to focus only on surgeries, bandages, and medications. However, physical healing and psychological well-being are intertwined.
That’s why MedStar Health’s Wound Healing Institute, in collaboration with the Department of Psychiatry, have had me join the team as their dedicated psychiatrist so patients have streamlined access to the care they need. The Institute coordinates more than 30,000 patient visits each year, bringing together a team of medical specialists focusing on advanced healing and limb-loss prevention.
Living with a chronic medical illness brings a heavy emotional and mental toll. Patients who have a chronic wound face a complex path to healing because they’re often managing multiple health challenges at the same time, such as diabetes or blood flow complications.
Dealing with a long-term wound means distinct challenges that can disrupt your quality of life, such as:
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Coping with a visible, daily reminder of your illness
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Limitations to independent mobility and your ability to perform daily activities
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Managing the stress of having several chronic illnesses simultaneously
Psychological support should be a standard part of physical recovery. By addressing your emotional health, we can provide a more compassionate, holistic path to recovery.
How the mind affects the body.
Multiple studies have shown that your emotional state impacts physical health, including your body’s ability to repair tissue.
For example, data shows untreated depression is associated with poorer wound healing outcomes. When severe depression or anxiety saps your motivation, keeping up with necessary daily treatments can feel impossible.
Emotional distress can negatively impact physical healing by:
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Draining the energy you need to clean wounds properly and change bandages
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Making it more difficult to find the strength and motivation to leave the house and travel to medical appointments
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Causing a dangerous sense of hopelessness, when you might feel there’s no point in trying to follow your doctor’s advice
My practice focuses on diagnosing and managing the types of chronic stress, anxiety, and mood disorders that can derail physical recovery.
By actively treating the mental health challenges that come with wound healing, we do more than improve your mood. We help you unlock the mental energy you need to care for your body, leading directly to improvements in your physical health and wound recovery.
Our embedded approach to care.
To ensure convenient access to behavioral support, we integrated mental health care directly into our wound clinic. I spend about 70% of my time as the embedded psychiatrist in the wound center, creating a direct link that allows us to treat the whole person.
When I was a trainee, I noticed that wound care specialists often reached out for our help with highly complex, medically ill patients. While the wound team was great at recognizing when their patients needed help, they didn’t have the time or expertise to help them manage heavy mental health burdens alongside complex physical procedures.
Today, the integrated approach we developed is a unique care model that offers our patients the benefits of a collaborative, patient-centered environment. These include:
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Collaborating with the inpatient team to evaluate and provide ongoing support to hospitalized patients with wounds
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Maintaining a continuous relationship with patients across hospitalizations and clinic visits
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Reserving outpatient clinic appointments so I can see patients who visit the wound clinic in the same space where they get wound care
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Collaborating closely with wound physicians and nurses who can flag concerns to fast-track direct referrals to me without long wait times
Related: Read “How Team Care Helps Patients Treat, Prevent, and Recover from Non-healing Wounds.”
Practical mindset shifts and coping tools.
Our first evaluation reviews your current symptoms, history of mental health treatment, family situation, and home life to understand who you are as a whole person.
Agreeing to a psychiatric evaluation does not mean you are required to take medication. While mental health medications can be very effective for many individuals struggling with depression or other mental health concerns, my main goal is to establish a baseline of how you are doing, normalize talking about emotional health, and work together to develop a treatment plan.
We weave evidence-based strategies like cognitive behavioral therapy (CBT) and relaxation training into comfortable, conversational visits that focus on practical skills you can use at home, such as:
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Diaphragmatic breathing: We practice this specific style of belly breathing together, and I explain the neurobiology behind the exercise so you can learn how deep breaths can help turn off your body’s fight-or-flight stress response
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Progressive muscle relaxation: We teach you how to release physical tension from your muscles, which can help lower the baseline of chronic pain and anxiety
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Other resources: We connect you to the tools developed by the expert pain psychology team at MedStar National Rehabilitation Hospital, such as guided meditations and relaxing audio recordings
For many individuals struggling with physical and psychiatric symptoms, receiving a formal mental health diagnosis can be a meaningful first part of treatment. Putting a name on what you’re experiencing can help you understand how many people share your struggles and realize that “toughness” doesn’t have much to do with it.
I also work to reassure you that experiencing deep grief after a major life change, such as an amputation, is a completely normal human response. It’s not an automatic red flag. In fact, it’s often an indication of your brain naturally processing an intense situation.
Related: Read “Live Confidently: How Adaptive Sports Empowers People with Disabilities.”
How caregivers can spot the signs.
While stress is normal during recovery, caregivers often can sense when a loved one’s distress turns into something more serious. There’s no harm in requesting a one-time psychiatric evaluation just to check. Sometimes, I’m able to reassure families that their loved one’s emotional reactions are completely normal for their situation.
Consider reaching out to a mental health professional or the wound care team if you notice warning signs, such as:
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Emotional struggles that cause an unusual spike in arguments or tension with family members
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Low mood that prevents them from working or completing household tasks
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Sudden loss of interest in hobbies and finding no joy in activities they used to love
Working together, we can provide strategies and tools to help your loved one navigate the emotional challenges they’re facing and improve their quality of life.
Related: Read “Clean, Dry, and Covered: Essential Wound Care at Home and When to Seek Help.”
Finding a compassionate path forward.
Rebuilding your life after a chronic wound diagnosis can be an ongoing process of physical and mental healing. No one feels perfect when leaving the hospital. Asking for help is a sign of strength, not weakness.
If you or a loved one is struggling with the impact of a chronic wound, you don’t have to carry the burden alone. Talk with a primary care doctor who can help you evaluate treatment options and refer you to a specialist.
