From the Guidelines
Emotional overwhelm in patients is commonly referred to as emotional distress or emotional overload, as defined by the National Comprehensive Cancer Network Distress Management Guidelines Panel 1. This condition occurs when a person experiences intense emotions that exceed their ability to cope effectively. Patients experiencing emotional overwhelm may exhibit symptoms such as:
- Anxiety
- Panic
- Irritability
- Difficulty concentrating
- Sleep disturbances
- Physical manifestations like headaches or gastrointestinal issues Treatment typically involves a combination of psychological interventions and sometimes medication. Cognitive-behavioral therapy (CBT) is often effective, helping patients develop coping strategies and emotional regulation skills. For severe cases, medications such as SSRIs (like sertraline 50-200mg daily or escitalopram 10-20mg daily) or benzodiazepines (like lorazepam 0.5-2mg as needed, though only for short-term use due to dependency risks) may be prescribed, as suggested by the American Society of Clinical Oncology guideline adaptation 1. The underlying mechanism involves the autonomic nervous system's fight-or-flight response becoming chronically activated, leading to sustained stress hormone release that overwhelms normal emotional processing pathways. Patients benefit from learning stress management techniques such as deep breathing, progressive muscle relaxation, and mindfulness practices that can be implemented immediately when feeling overwhelmed. Additionally, the NCCN guidelines recommend psychotherapy with or without an anxiolytic or an antidepressant for the treatment of anxiety, after eliminating medical causes 1. It is essential to note that distress management is a crucial aspect of cancer care, and early identification and treatment of emotional distress can improve patients' quality of life and reduce the risk of complications, as highlighted in the American College of Chest Physicians evidence-based clinical practice guidelines 1.
From the Research
Emotional Overwhelm in Patients
- Emotional overwhelm in patients can be related to various mental health conditions, including anxiety disorders 2 and major depressive disorder 3.
- Patients experiencing emotional overwhelm may exhibit symptoms such as excessive fear, anxiety, avoidance of perceived threats, depressed mood, and loss of interest or pleasure in activities 2, 3.
- Posttraumatic stress disorder (PTSD) and anxiety-related conditions can also contribute to emotional overwhelm, with symptoms including intrusive experiences, avoidance, mood, and arousal symptoms 4.
- Hospitalization can negatively affect patients' emotional well-being, exacerbating feelings of depression and anxiety 5.
- Mental health nurses may experience emotional labour, which can impact their ability to care for patients effectively and may lead to emotional exhaustion and burnout 6.
Key Factors Contributing to Emotional Overwhelm
- Genetic factors, environmental factors, and their epigenetic relations can influence the risk of anxiety disorders 2.
- Trauma and stressor-related disorders, such as PTSD, can contribute to emotional overwhelm 4.
- Hospitalization factors, including admission, length of stay, and readmission, can impact patients' emotional reactions and well-being 5.
- The role of healthcare providers and patient characteristics can also influence hospitalization experiences and emotional outcomes 5.