Understanding Anger of CKD Patients

Dr Surinder Sodhi
For those dealing with Chronic Kidney Disease and Dialysis, anger and frustration are pretty common because patients can be resentful of being ill, stressed about losing control of their lives, irked due to dietary changes (unable to enjoy their favorite foods), restless about long Dialysis Treatment times, annoyed due to lack of employment, vexed over less income, exasperated from medication side effects, and more.
While some outsiders may recommend that patients suppress their feelings of frustration and say, “You should be happy to be alive,” or “You look great! What are you complaining about?” It is clear that they just do not get it. In fact, anger is a normal emotion and there are a number of health benefits that arise when Chronic Kidney Disease and Dialysis patients harness and express their anger. Hence, those with Chronic Kidney Disease shouldn’t bottle it up. Yet, how can patients express themselves without alienating loved ones or offending others?
Dr SK Bali HoD Deptt of Nephrology SSH Jammu states that suppressing anger can worsen pain and put stress on an individual’s Cardiovascular (Heart) systems (leading cause of death in the Chronic Kidney Disease Community). Pushing anger down has also been tied to anxiety, depression, and low self-esteem. In contrast, the benefits of acknowledging and harnessing angry energy may make Chronic Kidney Disease patients feel more optimistic and confident, lower stress on the heart, limit anxiety, and help to better manage pain.
Studies have further noted that addressing anger as it arises, instead of fighting against expressing frustration and letting it all come out in one explosive fight, has been found to benefit interpersonal relationships (relating to relationships or communication between people). On the other hand, if anger is regularly directed at a patient’s family members or spouse then it can strain relationships. The following tips can be used by patients to better manage the anger and frustration associated with Chronic Kidney Disease, Kidney Failure, and Dialysis in order to improve health as well as quality of life:
By realizing that you are in control of your health and you are the most powerful person on your Healthcare Team, you may help limit frustration, feel a regained sense of control, and release tension – avoiding anger.
“When you want to express anger or any negative emotion, one way to do so is to start with what we call the ‘discomfort caveat.’” Let other people know explicitly that you are experiencing intense emotions and because of this, it is more difficult than usual for you to communicate clearly. Apologize in advance, not for your emotions or your actions, but for the potential lack of clarity in how you convey what you’re about to say.
If you catch yourself becoming frustrated, then pause for a moment, count to ten (10), and don’t forget to breathe! If you have difficulty realizing when you are getting angry, look for signs like muscles tensing, face getting hot, hands shaking, breath shortening, and voice rising. Once, you are a bit calmer, you can then clearly express your frustration. Expressing your anger can help it diminish.
Picture the consequences if you lose control for both you and the person with whom you’re angry (e.g. I’ll feel worse; I’ll be embarrassed later; I’ll hurt my loved one’s feelings). If there is something that you want them to know, deliver it in a serious, but non-confrontational manner. You can preface your statement with, “I do not want to be offensive, but…” or “It really frustrates me when…”
Ask yourself what you’re really angry about. What need do you have that isn’t being met? Are you acting out of a knee-jerk desire for self-protection? Are you really angry at the current situation, or are you still bothered by something that happened days ago? We usually feel safer taking out our anger on people close to us, but it’s important not to misdirect feelings. Instead, focus on identifying your needs. Work to figure out how these needs can be met in a healthy way. If this requires another person’s involvement, then talk to that person about it — but only after you’ve calmed down and when you both have the time to hear each other out.
Ask yourself how you can cool off, and then take the time to do it. Classic cool-down activities include taking a walk, showering, listening to relaxing music, hitting a pillow, journaling, calling a friend, working out, meditating, or doing a few yoga poses. It’s okay if it takes a few hours or even days to cool off. What’s important is that you return to the situation with a level head and the ability to communicate your needs and negotiate conflicts in a calm manner. Whenever it’s time to have a conversation, use “I” statements (“I felt hurt by your words” instead of “You always hurt me”) and listen to the other person’s feelings to minimize the chances of triggering another round of fighting.
Appreciate yourself for managing your anger. It’s hard work, and it’s quite likely that we won’t get it right every time. But a little positive reinforcement,a long bubble bath can encourage you to keep handling anger like an All-Star!
Loved ones and Caretakers of Chronic Kidney Disease and Dialysis patients should try to bear with the patient by understanding that anger and frustration is a part of Kidney Failure. If you are a patient, help your loved ones better understand what you are going through, by sharing with them this article.
(The author  is  faculty in Nephrology SSH, Jammu)