| Abstract: |
(from the chapter) Psychiatrists seem to have little to say about existential distress, based on the relative dearth of psychological literature on the phenomenon of loss of meaning and its resolution at various phases of the life cycle, including the end of life. A typology of existential distress, is much needed to better understand the diverse coping responses found in the clinical settings of oncology and palliative care. In this chapter, we focus on two intertwined but distinguishable phenomena: depression and demoralization. Depression is an identifiable set of perceptions and experiences subject to screening and management. The discussion of depression is instrumental: what actions to take or not to take and what strategies to deploy or not to deploy in the interest of solving a problem that has already emerged. The discussion of demoralization is observational: what stories to hear and what morals to perceive so that the ruptured threads of the sufferer's life can be woven back together in a pattern that is coherent even if the mend is highly conspicuous. Pharmacological and psychotherapeutic treatments are combined in treating depression. Less empirical guidance is available for treating demoralization, although newer meaning-centered and dignity-conserving therapies have applicability. In this chapter, we also consider treatments of depression and demoralization in detail. (PsycINFO Database Record (c) 2013 APA, all rights reserved). |
