How do adults (18-55) with mild depression describe their energy expenditure as it relates to participation in activities of daily life?
My review of the literature came up with no results that specifically focused on energy expenditure in relation to mental health and activities of daily life. The majority of articles focusing on energy conservation had to do with multiple sclerosis (Blikman, et. al, 2013), cancer (Mitchell, et. al, 2014), or other physical difficulties. Other articles focused on older adults and limitations in activities of daily life in the aging process, which occasionally addressed depression (Arbesman & Mosley, 2012). Others address activity limitations and depression with chronic conditions, but do not specifically focus on mental health. While I may have missed some articles in my non-exhaustive literature search, it’s clear that this is a very specific area that has had minimal attention.
Occupational therapists and many other health professionals have knowledge and experience in dealing with energy conservation, but it’s typically based on physical needs, not mental. Mental health occupational therapists clearly recognize that people with depression have limitations in ADLs, and that even an activity as benign and simple as pouring a bowl of cereal can seem exhausting. While they certainly address these issues, I don’t know if the therapists or clients are considering this or calling this a form of energy conservation. It would be interesting to see if adults with depression describe their energy expenditure for such tasks as physical or mental, or even perceive the limitation as an energy expenditure issue in the first place.
I think the occupational therapy field would benefit from a more evidence-based approach to managing energy conservation in younger adults with mental health challenges (I chose depression but I’d also be equally interested in anxiety). If there were an assessment that was linked to the COPM, it would allow the therapist and client to get the unique viewpoint of what activities take up the most energy expenditure for that particular client (emphasis on uniqueness), and give them goals for intervention. A support group and/or energy conservation program could also be appropriate for this population.
Occupational therapy is rarely seen in most major healthcare mental health settings these days, but mental energy conservation programs for ADLs could be a new way to promote OT in mental health, and a way to help more people handle their day to day ADL participation with more awareness, compassion, and knowledge, which may in turn reduce their limitations and allow increased participation.
Arbesman, M., & Mosley, L. J. (2012). Systematic review of occupation- and activity-based health management and maintenance interventions for community-dwelling older adults. American Journal of Occupational Therapy, 66, 277–283. http://dx:doi.org/10.
Blikman, L. J., Huisstede, B. M., Kooijmans, H., Stam, H. J., Bussmann, J. B., & van Meeteren, J. (2013). Effectiveness of Energy Conservation Treatment in Reducing Fatigue in Multiple Sclerosis: A Systematic Review and Meta-Analysis. Archives Of Physical Medicine & Rehabilitation, 94(7), 1360-1376. doi:10.1016/j.apmr.2013.01.
Mitchell, S. A., Hoffman, A. J., Clark, J. C., DeGennaro, R. M., Poirier, P., Robinson, C. B., & Weisbrod, B. L. (2014). Putting Evidence Into Practice: An Update of Evidence-Based Interventions for Cancer-Related Fatigue During and Following Treatment. Clinical Journal Of Oncology Nursing, 1838-58. doi:10.1188/14.CJON.S3.38-58
As occupational therapists, we are so lucky to have training that allows us to to help any person of any age and with any issue, by addressing the factors that are hindering their ability to participate as fully as possible in their own life! OTs learn to analyze the spectrum of possibility and then help the supposed impossibles become possible.
Here are some of the areas we work in:
OT & Schools (children in any grade who need services for their particular issue…sensory, handwriting, fine motor, visual motor, regulation, tolerance, executive functioning…)
OT & Mental Health (of any age after mental health challenges become apparent, helping with independent living, tolerance, regulation…)
OT & Pediatrics (children of any age and any diagnosis)
OT & Acute Care (immediate care after acute issue)
OT & Inpatient rehabilitation (regaining function in a facility after hospital stay for any issue…)
OT & Outpatient (helping huge variety of issues)
OT & Vocational Rehab (for first time, back to work, or finding new work…)
OT & Driving (getting on or back on the road, safety…)
OT & Hands (trigger finger, lateral epicondylitis, accidents, burns…)
OT & Feeding (children and adults with special needs)
OT & Neurology (strokes and multiple sclerosis…..)
OT & Orthopedics (hip and knee and much more…)
OT & Chronic Disease (diabetes, lung diseases, pain syndromes…)
OT & Military (amputations, PTSD and much more…)
OT & Trauma (burns, pain management, catastrophic injuries…)
OT & Health and Wellness (joint protection, ergonomics, energy conservation, self-care, empowerment, fall prevention…)
I cracked up at the screen shot below. It was a Reddit.com thread about methods to get up in the morning. Redditors are notoriously snarky. I loved the bolded box below. The man’s suggestion was to "place your alarm over a pit of lava filled with lava dwelling snakes who like to jump to get their prey." Yes, that would certainly wake a person up. OTs can work with sleep hygiene although most of us don’t take it quite that far. 🙂
PS: I recommend going to Reddit and checking the "Ask Reddit" section because they have some pretty incredible topics, some of which may be helpful to occupational therapists.