Mental and Physical Health

Sleep hygiene

Sleep is one of the most important "times" in our lives that we can give to our body. An irreplaceable time of regeneration for our psyche and for our body. Basic principles of sleep hygiene, divided into three stages: preparation for sleep, sleep itself and waking up. All recommendations are based on modern medical and psychiatric knowledge to promote healthy and restorative sleep.

Consistent sleep schedule: Go to bed and get up at consistent times each day, including weekends. Maintaining regularity helps regulate your internal biological clock.
Avoid stimulants before bed: At least 4-6 hours before bed, avoid caffeine (coffee, tea, energy drinks) and nicotine, which have stimulating properties.
Avoid alcohol in the evening: Although alcohol may initially induce drowsiness, it interferes with the quality of sleep, especially in the second half of the night.
Avoid large meals and liquids: Eating heavy meals just before bedtime can cause discomfort, while drinking large amounts of liquids can lead to frequent awakenings to use the restroom.
Relaxing routine: Use relaxation techniques before bedtime, such as a warm bath, meditation, reading a book or practicing deep breathing. These activities help quiet the mind and body.
Avoid bright screens: At least one hour before bedtime, limit exposure to blue light from screens (smartphones, tablets, computers). This light inhibits the production of melatonin, the hormone responsible for sleepiness. If you must use electronics, use blue light filters.
Appropriate ambient temperature: Keep your bedroom temperature at 18-20°C. Too high or too low a temperature can interfere with sleep.
Reduce noise and light: Make sure your bedroom is quiet and adequately darkened. You can use earplugs or an eye mask if necessary.

Comfortable sleep environment: choose a comfortable mattress and pillows, tailored to your preferences. An inappropriate mattress can lead to back pain and compromised sleep quality.
Limit activity in bed: The bed should be used only for sleep and sexual activity. Avoid working, eating or watching TV in bed so that the brain associates the place only with sleep.
Avoid daytime naps: If you have difficulty falling asleep in the evening, limit naps, especially those lasting longer than 20-30 minutes or taking place in the late afternoon.
Using relaxation techniques: If you can't fall asleep within 20-30 minutes, get out of bed, go to another room and do a relaxing activity until you feel sleepy. Lying in bed, being anxious, can reinforce sleep problems.
Avoid looking at the clock: If you frequently wake up during the night, avoid checking the time, as this can cause stress and difficulty getting back to sleep.

Fixed wake-up time: Establish a consistent time to get up each day, even if you slept less than usual at night. This helps regulate your circadian rhythm.
Natural light: As soon as possible after waking up, go outside or open the curtains to expose yourself to natural daylight. Light helps inhibit melatonin production and signals the body to begin daytime activity.
Physical activity: Regular exercise, preferably outdoors and during the first part of the day, promotes better sleep quality. Avoid intense exercise just before bedtime.
Avoid morning naps: Try not to go back to bed for short naps after waking up. These can disrupt your sleep rhythm and make it harder to fall asleep the next night.

Following the above rules will help improve the quality of your sleep, make it easier to fall asleep, and ensure that you feel better during the day. These changes may also benefit your mood, energy level and overall mental condition.

If you follow the above rules and still have problems with sleep (including falling asleep, staying asleep, or difficulty waking up) be sure to consult your doctor. Don't wait it out! Sleep-related disorders very quickly impair somatic and psychological functioning. Sleep problems may also require scheduling longer-term psychological help, i.e. attending courses or participating in psychological therapy.

Dealing with pain

Acute pain is usually short-lived and results from trauma, surgery or the specifics of a chronic disease. Of course, it always requires a response. First, diagnosis of its causes based on medical knowledge. It is therefore necessary to consult a relevant specialist, a qualified health professional. At the same time, however, some measures based on psychological knowledge can be taken. The purpose of psychological measures is to reduce the intensity of pain and manage the emotional response to it. Among short-term (intervention) and long-term (therapeutic) psychological measures, there are several suggestions.

Relaxation techniques
- Diaphragmatic Breathing: Slow, deep breathing that engages the diaphragm can help lower tension levels.
- Muscle relaxation: Progressive muscle relaxation (relaxing and tensing muscle groups) reduces tension in the body.
Distraction (distraction)
- Focusing on something else (e.g., reading, listening to music, talking) can help reduce the subjective sensation of pain.
- Visualization techniques: Imagining peaceful, relaxing places or situations.
Acceptance
- Instead of fighting the pain, accepting it as part of the momentary experience helps reduce anxiety. A "this will pass" attitude allows you to focus on getting through the difficult moment.
Mindfulness
- Focusing on the present moment without judging the pain can help you better cope with the intensity of the pain. Focusing on breathing or sounds in the environment are popular methods.
Social support
- Talking to loved ones or getting emotional support from others can help reduce the feeling of pain.

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Cognitive-behavioral therapy (CBT)
- Working on beliefs: Identify negative thoughts about pain ("I can't do anything through pain") and replace them with more constructive thoughts ("I can control certain aspects of my pain").
- Behavior change: CBT helps develop healthy habits that reduce pain, such as regular physical activity and avoiding excessive rest.
Physical activity and movement
- Low-impact exercises such as yoga, Pilates and walking help maintain mobility and reduce pain by improving circulation and strengthening muscles.
- Start with small steps: Gradually increasing activity helps avoid worsening symptoms and reinforces a sense of control.
Acceptance and commitment therapy (ACT)
- Acceptance of pain: Individuals learn to tolerate pain while engaging in activities that are meaningful to them.
- Focus on values: Instead of fighting the pain, focus on what is important in life (e.g., relationships, work, hobbies) despite the pain.
Mindfulness Training
- Regular practice of mindfulness helps develop acceptance of pain, reduces the subjective sensation of pain and helps cope with the emotional stress associated with pain.
- Focusing on the breath: Breathing exercises and mindfulness of the body can help reduce the sensation of pain.
Stress management
- Meditation techniques: Regular meditation lowers stress levels, which can reduce pain perception.
- Biofeedback: monitoring and controlling the body's physiological functions, such as heart rate and muscle tension, can lead to better pain control.
Social support and group therapy
- Participating in support groups with people who have had similar experiences can help reduce feelings of isolation.
- Psychological support from loved ones or a therapist can significantly improve pain management.
Planning and structuring the day
- Creating schedules and planning tasks to avoid overtaxing the body and anticipating rest breaks helps better manage energy and avoid aggravating pain.
Therapeutic techniques based on art and expression of emotions
- Art therapy, journal writing, painting or other forms of emotional expression can help manage the emotional burden of chronic pain.

Some of the mentioned ways of psychological support for pain management can be implemented on one's own, supporting oneself with materials available on the Internet. However, they should always be reviewed with a health care professional (whether actions taken on your own will not adversely affect the treatment process), as well as a clinical psychology specialist or a therapist who works with pain. However, some of the techniques given require scheduling longer-term psychological assistance, i.e. attending courses or participating in psychological therapy.

Dealing with negative emotions - towards positive emotions

Description: Cognitive-behavioral therapy helps understand how thoughts affect emotions and behavior. Changing thinking can reduce negative emotions.

Ways to cope:

Identify negative thoughts: When you feel anxiety, sadness or frustration, write down the thoughts that accompany these emotions. Realizing that certain thoughts may be irrational or exaggerated is the first step to change.
Rephrase thoughts: replace negative thoughts with more realistic and positive ones. E.g., instead of thinking "I will never be healthy," think "I am doing everything I can to improve my health."
Gratitude exercise: Every day, write down 3 things you are grateful for. This can change your perspective and focus your attention on the positive aspects of life.

Description: Stress and negative emotions can aggravate somatic complaints, and relaxation techniques help reduce stress levels.

Ways to cope:

Deep breathing: Focus on slow, deep breathing, inhaling through the nose, exhaling through the mouth. Breathe deeply for a few minutes to calm your body and mind.
Progressive muscle relaxation: Tense and relax successive groups of muscles, starting from the feet and going up to the head. This technique helps reduce tension in the body and relax mentally.
Mindfulness meditation (mindfulness): Focusing on the present moment and what you are feeling, without judgment. Regular practice of mindfulness helps reduce negative emotions through acceptance and reduction of emotional over-reactivity.

Description: Acceptance and Commitment Therapy helps you to accept difficult emotions and situations instead of fighting them, and then focus on actions in line with your values.

Ways to cope:

Acceptance of difficult emotions: Instead of trying to avoid or suppress negative emotions, try to accept them. Realize that emotions are a natural reaction to difficult situations, such as illness.
Identify values: Focus on activities that are important to you and in line with your values, even if you feel bad. For example, cherishing your relationship with your family or taking care of your health despite pain.
Acting despite difficult emotions: Even if you feel sadness or anger, taking action can help you overcome negative emotions. For example, meeting friends, going for a walk or engaging in a hobby can reduce negative emotions.

Description: Regular physical activity, even on a limited basis, has a positive effect on mood, reduces stress levels and improves overall well-being.

Ways to cope:

Exercise tailored to your condition: Even light exercise, such as walking, yoga, stretching or breathing exercises, can improve mood and reduce anxiety.
Exercise therapy: enlisting the help of a physical therapist to develop a safe exercise plan can help improve physical health, which contributes to better mental well-being.
Outdoor movement: Spending time outdoors, even on a limited basis, has a relaxing effect and improves mood.

Description: leaning on others and using support networks can help reduce negative emotions.

Ways to cope:

Talk to loved ones: Share your concerns, frustrations and emotions with family, friends or your partner. Expressing your feelings helps relieve your mind and reduce tension.
Support groups: Joining support groups for people with similar health problems can help you feel understood and receive valuable advice from those with experience.
Psychological therapy: Meetings with a psychotherapist can help you deal with emotions that are difficult to process on your own, especially in the face of chronic illness.

Description: Reframing is about changing the way we perceive negative situations to see the positive in them.

Ways to cope:

Instead of "I can't do it" - "I will find a way to do it": Reframe negative thoughts into a more constructive approach. Instead of focusing on the limitations of the disease, try looking for opportunities.
Searching for lessons: When faced with difficult situations, you can think about what you can learn from them. For example, an illness can teach patience, perseverance, or force you to change your priorities in life.
Practice optimism: Practice imagining positive scenarios for the future, focusing on what can go well instead of what can go wrong.

Description: Participating in creative activities such as painting, writing, and making music can help express and process emotions.

Ways to cope:

Painting or drawing: expressing emotions through art can help you understand your own feelings and work through them.
Keeping a journal: Regularly writing down your thoughts and emotions helps you process difficult experiences and express what is difficult to say out loud.
Music and dance: Participating in forms of artistic expression, such as listening to music, singing or dancing, can affect mood and allow emotions to be released.

Description: Visualization is a technique in which a person imagines positive images, situations or places to bring about a state of calm and positive emotions.

Ways to cope:

Imagine a place of peace: Close your eyes and imagine a place where you feel safe and peaceful (e.g., beach, forest, mountains). Focus on the details: the sounds, the smells, the feelings this place evokes.
Visualize success: Imagine yourself coping with challenges, such as overcoming symptoms of illness or achieving goals that are important to you. Visualization can give you the strength to keep going.

Reducing stress and anxiety: These techniques can help reduce tension, anxiety and emotional overwhelm.
Improved quality of life: Changing one's perspective and introducing more positive emotions can significantly improve one's overall well-being and quality of life.
Greater mental resilience: Regular use of emotion management techniques can improve the ability to cope with the difficulties of chronic illness.

Some of the ways mentioned can be implemented on one's own, including with the support of materials available on the Internet. However, they should always be verified with a health care professional (whether actions taken on your own will not adversely affect the treatment process), as well as a clinical psychology specialist or certified therapist. Some of the techniques given, however, require scheduling longer-term psychological assistance, i.e. attending courses or participating in psychological therapy.

Effective stress management

Acute stress is a brief, intense reaction to sudden challenges or situations. Coping methods should work quickly to reduce tension immediately.

Breathing techniques
- Deep breathing (diaphragmatic breathing): Concentrate on deep, slow breaths, breathing mainly through the diaphragm (the abdomen rises, not the chest). This helps calm the body and mind quickly.
- Method 4-7-8: Inhale through your nose for 4 seconds, hold your breath for 7 seconds, then exhale through your mouth for 8 seconds. Repeat several times.
The "grounding" technique (grounding)
- Direct your attention to your surroundings to take your mind off the flurry of stressful thoughts. Take advantage of the "5-4-3-2-1 technique."
  - 5 things you see
  - 4 things you feel by touch
  - 3 things you hear
  - 2 things you smell
  - 1 thing you can taste.
Progressive muscle relaxation
- Tense and relax the different muscle groups in the body, starting with the feet and ending with the head. This technique allows you to release accumulated tension in the body and reduce stress.
Physical exercise
- Short, intense physical exertion (e.g., running on the spot, jumping, brisk walking) can help quickly discharge adrenaline and cortisol, the stress hormones, and restore a sense of calm.
Quick visualization
- Imagine a peaceful, relaxing place, such as a beach, forest or mountains. Visualize the details of this place, focusing on smells, sounds and tactile sensations. This will help reduce tension quickly.
Mindful pause
- Stop for a moment, close your eyes, take a few deep breaths and concentrate on the present moment. A brief "dip" into the present helps interrupt negative thoughts.

Chronic stress is a prolonged, often less intense, but ongoing tension associated with life's challenges. The ways to deal with it are more long-term and require regular application.

Regular physical exercise
- Aerobics, yoga, tai chi: These exercises not only improve physical fitness, but also promote stress regulation and emotional balance.
- Walking outdoors: Regular walks, especially in nature, reduce tension and promote relaxation.
Relaxation techniques
- Mindfulness meditation (mindfulness): Practicing mindfulness on a daily basis helps to increase awareness of the present moment and reduce a flurry of stressful thoughts. Do short sessions of meditation (5-10 minutes) each day.
- Progressive Muscle Relaxation: In long-term practice, it helps release tension on an ongoing basis, especially before bedtime.
Planning and organizing your time
- Creating a daily schedule: Organizing your schedule on a regular basis, prioritizing tasks and delegating responsibilities reduces feelings of overwhelm. Avoid excessive multitasking.
- Pomodoro technique: Divide work into short intervals (25 minutes) and then take a short break (5 minutes). This helps you stay focused and reduces work-related stress.
Social support
- Talking to loved ones: Sharing your feelings with loved ones on a regular basis helps ease emotions and gain support. Having stable social relationships is an important factor in reducing stress.
- Support groups: Participation in support groups, where difficult experiences can be shared with people in a similar situation (e.g., people with chronic illnesses), helps in coping with chronic stress.
Changing the mindset
- Cognitive-behavioral therapy (CBT): Learning to identify and change negative thought patterns that contribute to stress. By regularly working on thoughts, you can reduce their impact on your emotions.
- Reframing (transforming perspective): Transforming difficult situations into more positive or at least neutral ones by changing one's perspective on the problem. E.g., instead of thinking "I will never recover," one can think "I have difficulties, but I can overcome them step by step."
Hobbies and relaxing activities
- Creative hobbies: Activities such as painting, playing an instrument, journal writing or knitting help to take your mind off your daily problems and reduce stress.
- Sensory relaxation: Regular use of aromatherapy, relaxing baths or massages promotes physical and mental relaxation.
Sleep management
- Sleep hygiene: Set regular bedtimes, create a routine for evening relaxation, and avoid screens before bed. Prolonged lack of adequate sleep can exacerbate stress, so taking care of the quality of your sleep is key.
Practice gratitude
- Gratitude Journal: Every day, write down three things you are grateful for. Focusing on the positive aspects of life reduces feelings of stress and improves mood.

Acute stress requires quick relaxation techniques such as deep breathing, physical exercise and grounding to immediately reduce tension.
Chronic stress requires long-term strategies such as meditation, exercise, social support and cognitive-behavioral therapy to effectively deal with the ongoing stress.

Commitment to therapeutic compliance

Patient education
- Simple and clear explanations: Doctors should clearly explain to patients why each element of therapy is important, what the consequences of nonadherence may be, and what benefits they can gain by following the recommendations.
  Example: A patient with diabetes may be better able to follow a diet if he or she understands how it affects glucose levels and reduces the risk of complications.
Facilitating access to information
- Written instructions and educational materials: Patients can receive brochures or have access to health apps that facilitate understanding and remind them of recommendations. Example: A blood pressure self-monitoring diary for patients with hypertension to track progress and report results to a doctor.
Monitoring of treatment
- Technology to support medication reminders: Mobile apps, SMS reminders, smart drug packaging that sends alerts when a medication needs to be taken.
  Example: An app that reminds a patient to take medication at a certain time
Managing side effects
- Adjusting treatment: In the case of bothersome side effects, the doctor may modify drug dosages or change formulations so that the patient can continue therapy.
  Example: A patient with rheumatoid arthritis may change his pain medication to one that is better tolerated to reduce negative side effects, such as drowsiness.
Emotional and psychological support
- Psychological therapy: Psychological support, such as in the form of cognitive behavioral therapy, can help patients struggle with depression, anxiety or low motivation.
  Example: A patient with chronic pain uses therapy to better cope with feelings of helplessness and to motivate himself to use pain treatment.
Simpler treatment regimens
- Facilitate dosing regimens: Reduce the number of daily doses (if possible) by using extended-release drugs or combining several drugs into one package.
  Example: A patient with hypertension can receive a medication in one dose per day instead of three, making it easier to remember medications.
Social support
- Increase family support or support groups: Encouraging patients to involve family in the treatment process. Support to join support groups for people with the same disease.
  Example: A patient with diabetes who attends support group meetings can better manage his diet and follow dietary recommendations.
Improving communication with the doctor
- Regular follow-up visits: Meetings with the doctor allow progress to be assessed, questions to be answered, and possible changes to therapy to be made. The patient gains a sense that treatment is being monitored.
  Example: A patient with chronic obstructive pulmonary disease (COPD) meets regularly with a pulmonologist to adjust inhaler doses and reduce shortness of breath.
Stress and emotion management
- Relaxation techniques: Teaching patients stress management techniques, such as meditation or breathing, can improve their ability to comply.
  Example: A patient with heart disease uses relaxation techniques to cope with anxiety related to the disease and avoid skipping medication doses.
Financial and organizational support
- Financial assistance: Arrange support for access to cheaper medications, reimbursement or social programs that can ease the financial burden on patients.
  Example: An asthma patient who receives support to purchase inhalers through reimbursement is more likely to use medications regularly.
Introducing a routine
- Daily routine: Establish regular times to take medications and follow instructions, such as taking them with meals.
- Example: A patient with epilepsy takes his medications at the same time every day during breakfast, which helps him comply.

Key issues related to treatment nonadherence can be addressed through education, emotional support, technological support, and social and financial support. These interventions increase patient engagement and help in the long-term management of chronic diseases.

In a situation where the patient himself, those close to him, orient themselves that there is a chronic or recurrent difficulty in adhering to therapeutic recommendations, it is necessary to immediately reach out for help from a specialist in this field. These include specialists in clinical psychology, health psychologists, or psychotherapists but who specialize (have experience or work) with chronically ill people.

No therapy, no doctor or medical procedure is as valuable in the treatment process as the knowledge, motivation and involvement of the patient himself! Without the patient's conscious involvement in the treatment process, any efforts by health care professionals are half-effective.

Supporting cognitive processes (e.g., memory)

Supporting cognitive processes, such as memory, attention, perception and thinking, in somatically ill people is crucial, as physical illnesses can affect brain function. In such cases, there may be diminished ability to concentrate, difficulty recalling information or slowed thought processes. Below are specific techniques and advice to support these processes.

Techniques for supporting short-term and long-term memory:

Mnemonic exercises: The use of memorization techniques, such as acronyms, rhymes, and picture associations, helps to better consolidate information.
- Example: When memorizing a list of words, imagine an image associated with each word.
Taking notes and keeping a diary: Regular recording of important information and daily events supports both working and long-term memory.
- Tip: Keep a notebook of the day's important tasks or a journal of emotions to more easily recall events and thoughts.
Repetition of material: Systematic repetition of the content we want to remember helps to better consolidate it in long-term memory.
- Example: After learning new material, repeat it on the same day and then a few days later.
Split into smaller parts: Dividing the material into smaller sections makes it easier to remember.
- Tip: Instead of trying to memorize the entire list, divide it into smaller groups (e.g., 3-4 items at a time).
Visualization: Creating mental images related to the information we want to remember.
- Example: Imagine the face of the person whose name you want to remember in a certain setting.

Techniques to strengthen concentration and attention:

Mindfulness training: Regular mindfulness practice helps develop the ability to focus on the present moment, which aids attention.
- Exercise: Focus on your breathing for a few minutes, trying to ignore any distracting thoughts.
Pomodoro technique: This method involves dividing work time into 25-minute sessions with short breaks in between. This promotes concentration and reduces cognitive fatigue.
- Example: Set the timer for 25 minutes of operation and then take a 5-minute break.
Elimination of distractors: Limiting external stimuli, such as noise, conversations or unnecessary objects in sight.
- Tip: Work in a quiet, orderly place, away from distractions such as a TV or phone.
Prioritization: Working on one task at a time.
- Tip: Create lists of tasks and prioritize the order in which they should be done, starting with the most important ones.
Physical activity: Regular exercise improves blood circulation and oxygenation of the brain, which promotes better concentration.
- Tip: Short walks or stretching exercises can improve your ability to focus.

Ways to promote perception (the ability to receive sensory stimuli):

Multisensory training: Exercises that engage more than one sense, such as listening, looking and touching at the same time.
- Example: When learning new information, read it aloud while looking at pictures and touching objects related to the topic.
Perceptual exercises: Exercises that involve identifying objects with eyes closed or recognizing various sounds. Help develop the ability to process sensory information.
- Exercise: Listen to ambient sounds and try to identify each one without looking.
Careful attention to detail: Training to consciously pay attention to small details in the environment.
- Exercise: Observe the image for 30 seconds, then try to describe every detail you remember.
Improving the quality of incentives: Adequate lighting, better color contrasts or improved sound quality (such as the use of hearing aids) can support perception.
- Tip: Make sure the space you are in is properly lit and organized.

Techniques to support critical thinking and decision-making processes:

Logic exercises and puzzles: Regularly solving crossword puzzles, sudoku, logic puzzles stimulates thought processes and develops the ability to think logically.
- Example: Solving a crossword or math puzzle every day.
Breaking problems into smaller pieces: A step-by-step analysis of the problem, breaking it down into smaller steps for solution.
- Example: If you have a complex task, divide it into several smaller steps, and treat each step as a separate challenge.
Brainstorming technique: Exploring multiple solutions and ideas before deciding on the best one.
- Tip: Write down all ideas, even those that don't seem to make much sense, to trigger the creative thinking process.
Visualize solutions: Imagining different scenarios and potential outcomes helps in decision-making.
- Exercise: Before making a decision, imagine various possible endings and evaluate which one is most likely.
Lateral thinking training: Trying to solve problems in unusual ways, looking for new perspectives.
- Exercise: Try solving everyday problems using methods you wouldn't normally choose to force your brain to work in new patterns.

Each of these techniques can be modified depending on the person's condition and abilities. Regular exercise and implementation of cognitive strategies helps improve and maintain cognitive function, which has a positive impact on overall quality of life. Use available paper publications (e.g. crossword puzzles, mindfulness books - painting pictures) but also numerous apps that in the form of fun (cyclical participation in puzzle games or improving reaction speed) can improve cognitive functioning.

Use of social support

Social support is crucial for people experiencing chronic somatic illness. It can take many forms, from practical help to emotional support. Here are the types of social support and the specific ways people with chronic somatic illnesses use it.

Description: Offering understanding, empathy, caring and a sense that someone is available at difficult times.

Uses:

Conversations with loved ones: Regular conversations with family, friends or loved ones can help you express difficult emotions and get mental support.
Individual therapy: Consultation with a psychologist or therapist can help you cope with negative emotions or stress related to the disease.
Support groups: Attending support group meetings for people with similar health experiences can provide a sense of understanding and belonging.

Description: Help to gain knowledge about the disease, treatment, available resources and ways to cope.

Uses:

Consultations with doctors and specialists: Regular meetings with doctors, physiotherapists or nutritionists can help you gain up-to-date knowledge about treatment and how to manage your symptoms.
Seeking information online: using reliable sources of information, such as health organization websites, blogs of specialists or educational platforms.
Online groups: Join discussion groups, forums or social media where you can exchange knowledge and experiences with other patients.

Description: Physical assistance in daily activities such as shopping, cleaning, transportation or cooking.

Uses:

Help from family and friends: Relatives can help organize the day, provide transportation to the doctor, prepare meals or run daily errands.
Outside care services: Use of assistants, health caregivers or volunteers who can support patients in daily tasks.
Assistive technologies: Using technology to make everyday life easier, such as apps for time management and medication reminders, and smart devices for health monitoring.

Description: Financial or material assistance, such as covering medical expenses, providing medicines, supporting access to medical supplies.

Uses:

Social security benefits and allowances: Benefit from state financial support programs, such as rehabilitation benefits, pensions and drug reimbursement programs.
Support from charitable organizations: Many organizations offer material or financial assistance to sick people, such as funds for treatment.
Family assistance: Relatives can help cover the cost of treatment, medication or rehabilitation.

Description: Using the resources of institutions, foundations, associations that offer various forms of support for chronic patients.

Uses:

Rehabilitation programs: Participation in special rehabilitation programs run by hospitals or health organizations.
Foundations and associations: Join foundations dedicated to supporting people with certain diseases that offer training, therapies or emotional support.
Volunteer care: Take advantage of programs where volunteers visit patients, help them with daily activities and provide companionship.

Description: Help in the search for the meaning of life, spiritual balance and inner peace, which can be especially important in the face of chronic illness.

Uses:

Conversations with clergy: Contact with chaplains, clergy, priests or other spiritual guides can help you understand the emotional and spiritual aspects of your illness.
Spiritual groups: Participate in prayer, meditation or spiritual groups that offer support during difficult times.

Increase sense of belonging: People who are ill can often feel isolated. Social support provides a sense that they are not alone in their experience.
Reduced stress and anxiety: Knowing that there are people you can count on reduces the sense of stress associated with the disease.
Better quality of life: Support in daily activities and access to knowledge and resources contribute to better functioning and well-being.
Increased motivation: People who receive emotional and practical support may be more motivated to take care of themselves and engage in treatment.

Taking advantage of various forms of social support helps somatically ill people better cope with daily challenges, improving their mental and physical well-being. However, it is important to remember that it is meant to foster the healing process and not to distract from or replace it. This means seeking forms of support that will help subjectively and objectively in taking care of one's own health.

Dealing with negative thoughts - towards positive thoughts

One of the main reasons for the appearance of negative thoughts is cognitive distortions. Cognitive distortions are abnormal thinking patterns that lead to negative emotions and behaviors. Among people experiencing health disorders ( including chronic illnesses), these distortions can be exacerbated due to chronic stress, pain or anxiety associated with illness.

Description: a person imagines the worst possible scenario in any situation, predicting that the health situation will worsen, even if there is no evidence of this.

Ways to cope:

Shifting perspective technique: Ask yourself, "What is the worst that could really happen? What are the other possible scenarios?" This helps you look at the situation more realistically.
Gradual taming of fear: Instead of avoiding thinking about fears, spend a few minutes a day consciously "taming" fears to reduce their intensity.
Abbreviated image of success: Instead of thinking the worst, imagine overcoming difficulties and dealing with health challenges.

Description: Perceiving situations in extreme terms. E.g., "If I am not completely healthy, my life has no meaning."

Ways to cope:

Becoming aware of gray: Try to notice the shades of gray between the extremes. Ask yourself, "Is there really only one possible outcome? What are the other options in between?"
Introduce scaling: Rate the problem on a scale of 1 to 10, which can help you see the gradability of the situation and ease your emotions.
Search for evidence: Check for evidence that supports your "all-or-nothing" beliefs, and look for more balanced information.

Description: Blaming yourself for events that are beyond your control. E.g., "It's my fault I got sick."

Ways to cope:

Responsibility analysis: Consider what factors beyond your control affected the situation. List the things that were beyond your control.
Change of perspective: Ask yourself, "Would I say this to someone else who is in a similar situation?" This allows you to look at yourself with more empathy and objectivity.
Seek support: Talk to others to get a more balanced view of the situation. Often others can help you see that you are not responsible for everything that happens.

Description: a person assumes he knows what will happen and predicts negative events, without evidence. E.g., "I will certainly never recover."

Ways to cope:

Evidence for confirmation: Ask yourself, "What evidence do I have that this will happen?" Focus on facts, not conjecture.
Alternative planning: Instead of focusing on what negative things might happen, create an action plan that covers various possibilities, including positive scenarios.
Step-by-step breakdown technique: Focus on short-term goals instead of making predictions about the distant future. This allows you to focus on smaller, more controlled actions.

Description: a person belittles his or her accomplishments, successes or positive experiences, focusing only on the negative aspects. E.g., "It's no big deal that I got through the day, nothing is going to get better anyway."

Ways to cope:

Achievement list: Write down small successes or positive events every day, even if they seem insignificant. This practice helps you see that the positive aspects exist.
Celebrating small victories: Consciously celebrating even small accomplishments, such as a better day of health or overcoming daily difficulties.
Change of perspective: Ask yourself, "How would an outsider evaluate this?" Often others see our successes more clearly than we do ourselves.

Description: Focusing only on the negative aspects of a situation, ignoring everything positive.

Ways to cope:

Balancing thoughts: try to intentionally find positive elements in every situation. E.g., after a hard day, try to find at least one thing that went well.
Practice gratitude: Every day, write down three things you are grateful for. This technique helps break the habit of focusing only on the negatives.
Reality check: Ask yourself, "Is it true that everything was bad? Is there even one aspect that was positive?" This will help you see a more complete perspective.

Description: Assuming you know what other people think, usually in a negative way. E.g., "They definitely think I'm weak because I'm sick."

Ways to cope:

Fact-checking: Instead of assuming what others think, try to ask or understand their perspective before jumping to conclusions.
Transforming assumptions: Ask yourself, "How do I know what someone else is thinking? Isn't it just my guess?"
Seek other interpretations: Consider what other, more positive interpretations of other people's behavior might exist.

Description: Giving negative labels to oneself or others based on single events. E.g., "I'm a loser because I can't function normally because of my illness."

Ways to cope:

Replace labels with behavioral descriptions: Instead of saying "I am a failure," say "I have difficulty with this task, but I can try to improve my approach." Focus on actions rather than overall self-assessments.
Unfolding general labels: ask yourself, "Am I really like this in all aspects of life? What am I doing better at?" This helps alleviate self-criticism.
Acceptance and Commitment Therapy (ACT): Focus on accepting oneself and one's limitations, rather than constantly criticizing. Directing attention to actions in line with values.

Cognitive-behavioral therapy (CBT): This is the most effective therapy for dealing with cognitive distortions. It helps identify negative thoughts, assess their rationality and replace them with more balanced beliefs.
Record of thoughts and emotions: Keeping a thought diary can help identify patterns of distorted thinking. Regularly analyzing your own thoughts helps you see how often these distortions occur, and work to correct them.
Seeking evidence: When negative thoughts arise, ask, "What evidence do I have to support what I think? What evidence do I have against it?"
Ponder alternative interpretations: Look for other explanations of the situation. E.g., instead of thinking that someone is ignoring you, try to consider that they may be busy or have other problems.

Psychosomatic hygiene - by taking care of your psyche you take care of your health

Chronic stress causes an increase in cortisol and adrenaline levels, which can exacerbate symptoms of somatic disease (such as exacerbation of symptoms of heart disease, gastrointestinal disease or diabetes).

Ways to cope:

Mindfulness meditation (mindfulness): Regular practice of meditation lowers stress and cortisol levels, resulting in improved physical health.
Progressive relaxation: Relaxing muscles to reduce tension in the body can reduce the negative effects of stress.

Depression lowers motivation to adhere to treatment recommendations, which can lead to somatic deterioration. It can also affect the weakening of the immune system.

Ways to cope:

Cognitive-behavioral therapy (CBT): CBT helps change negative thinking patterns that can perpetuate depression and affect physical conditions.
Physical activity: even moderate exercise (e.g., walking) promotes the production of endorphins, which can improve mood and thus physical condition.

Anxiety causes over-activation of the nervous system, which can lead to exacerbation of somatic symptoms, such as headaches, stomach problems and elevated blood pressure.

Ways to cope:

Breathing training (deep breathing): Breathing techniques help regulate nervous system responses, reducing anxiety symptoms and their somatic consequences.
Visualization techniques: Imagining calm and relaxing places can help lower anxiety levels.

Chronic illness often leads to a sense of lack of control over life, which can exacerbate stress and lower somatic health.

Ways to cope:

Reframing (transforming perspective): Changing the way you think about the disease - instead of seeing it as something that completely controls your life, you can work on accepting the challenges and focusing on what the patient can control.
Small goals: Setting achievable health goals, such as regular exercise or a healthy diet, gives the patient a sense of control and supports somatic health.

Feelings of anger and frustration in the face of illness can exacerbate somatic symptoms, such as increased blood pressure, muscle pain, and impair immunity.

Ways to cope:

Anger management techniques (e.g., expressing emotions constructively): Regularly working with emotions, through therapy for example, can lower frustration levels, which will have a positive impact on physical health.
Writing a journal of emotions: Expressing emotions in a written form can help you understand and manage difficult feelings, reducing their negative impact on your body.

Long-term illnesses can lead to a decline in self-esteem, which negatively affects adherence to medical recommendations and taking healthy actions.

Ways to cope:

Supportive therapy: Regular meetings with a psychologist or therapist can help the patient rebuild self-esteem, which will improve both mental and physical health.
Positive affirmations: Repeating affirmations on a daily basis can help change a negative self-image into a more positive one, which can affect motivation for treatment.

The social isolation that often accompanies chronic illnesses can lead to feelings of loneliness and increased negative emotional states that translate into poorer somatic functioning.

Ways to cope:

Social support: Participation in support groups (online or in-person) allows patients to share their experiences, which can improve physical and mental health.
Actively build relationships: Encouraging patients to stay in touch with family and friends, even during difficult times, can reduce feelings of loneliness.

Sleep problems can exacerbate somatic symptoms such as pain, fatigue, and weakened immunity, which in turn worsens mental health.

Ways to cope:

Sleep hygiene: Creating a consistent sleep routine, avoiding caffeine and screens before bed, and relaxation techniques before going to sleep can improve sleep quality and consequently improve physical health.
Relaxation training: relaxation techniques, such as meditation before bedtime, can help you fall asleep and recover.

Mental health conditions, such as stress, depression, anxiety, low self-esteem or isolation, have a direct impact on the somatic health of chronically ill people. Ways to improve mental health, such as cognitive-behavioral therapy, relaxation techniques, physical activity, social support and attention to sleep hygiene, can improve both mental and physical health, contributing to a better quality of life and more effective coping with the disease.

Some of the ways mentioned can be implemented on one's own, including by supporting materials available on the Internet. However, they should always be verified with a healthcare professional (whether actions taken on your own will not adversely affect the treatment process), as well as a clinical psychology specialist or certified therapist. Some of the techniques given, however, require scheduling longer-term psychological help, i.e. attending courses or participating in psychological therapy.

Intimate life of kidney failure patients

Problems:

Fatigue and weakness: Even in the early stages of the disease, reduced kidney function can lead to chronic fatigue and weakness, which negatively affects libido and sexual activity.
Endocrine disorders: MS can lead to changes in hormone levels, including testosterone in men and estrogen in women, which can cause a decrease in sexual desire.
Psychological problems: Anxiety, depression, low self-esteem related to the disease can affect sexual satisfaction.
Erectile dysfunction in men: Erectile problems can occur as early as the early stages of kidney disease, as a result of impaired circulation, hormonal disorders and reduced blood flow to the genitals.

Solutions:

Regular monitoring and treatment of hormonal disorders: Early treatment of endocrine disorders with hormone therapy (such as testosterone) can improve libido and sexual function.
Psychological support: psychological therapy, sexual counseling or support from your partner can help you cope with the emotional and psychological effects of the disease.
Lifestyle changes: Regular physical activity, a healthy diet and proper stress management can improve mood and increase energy for sexual activity.

Erectile enhancement drugs: Men with erectile dysfunction may benefit from medications under medical supervision.

Problems:

Fatigue and weakness: Dialysis patients often suffer from chronic fatigue, which can significantly reduce energy levels and interest in sex.
Erectile dysfunction and reduced libido: Hormonal disorders and reduced blood flow associated with kidney failure and dialysis can lead to erectile dysfunction in men and reduced libido in both sexes.
Body concerns: Dialysis treatments can leave scars, make changes in body appearance (such as the presence of catheters or fistulas), which can cause discomfort and lowered self-esteem.
Mental and emotional problems: Dialysis can lead to depression, anxiety and stress, which negatively affects sex life.
Fertility disorders: Dialysis may impair fertility in both sexes.

Solutions:

Improving dialysis schedule: Adjusting the dialysis schedule to make the patient feel more rested can improve quality of life, including sexual activity.
Pharmacotherapy: erectile enhancement drugs, and hormonal treatment for women can improve the sex lives of dialysis patients.
Psychological support: Psychological consultations, dialysis support groups and sexual counseling can help people cope with emotional and psychological problems.
Body Appearance Acceptance: Body acceptance therapy and educating patients and partners about dialysis and its effects on the body can help restore self-confidence.

Discussions with a nephrologist: A nephrologist can adjust treatment, such as hormone supplementation, to help increase libido and improve sexual function.

Problems:

Hormonal changes after transplantation: After kidney transplantation, patients may experience hormonal changes, including fluctuations in libido, menstrual disorders in women and erectile problems in men.
Fear of transplant rejection: Concerns about the health of the transplanted kidney and the side effects of immunosuppressive drugs can cause stress and discourage sexual activity.
Side effects of medications: Immunosuppressive drugs that patients must take can cause hormonal disturbances, mood changes and fertility problems.
Psychological problems: Anxiety, depression and reduced self-esteem after transplantation can also affect sex life.

Solutions:

Optimizing hormone therapy: After transplantation, patients may need to adjust hormone levels to minimize negative effects on sex life (e.g., hormone therapy for men or women).
Emotional and psychological support: Consultation with a psychologist or therapist can help patients cope with the anxiety and stress of transplant rejection and other health concerns.
Sexual education and counseling: Talking with a nephrologist or specialist can help you understand how immunosuppressive drugs affect sexual function, and how best to manage these problems.
Reducing the dose of immunosuppressant drugs: In some cases, a nephrologist can adjust drug doses to minimize side effects without risk to the transplant.

Physiotherapy and exercise: Improving physical fitness after transplantation can increase energy levels, improve mood and restore sexual activity.

A patient with chronic renal failure can still enjoy a satisfying sex life, but this requires taking into account certain limitations and adjusting the activity to individual capabilities. It is important for the patient and his partner to be aware of potential problems. Communication, support from the partner and regular consultations with the doctor are key elements that can help improve the patient's sex life. Equally important may be the treatment of endocrine disorders, psychological support, improvement of physical condition, and individual approach to the patient in consultation with a nephrologist.