It will come as no surprise to people who have lost their sense of smell that the experience causes profound changes to the way we experience life and interact with the world. A new article, and a recently published book have looked into this. This blog is a quick summary of the findings of these new resources and mark, I think, a shift toward considering us, the patients, as not just in terms of the health of our olfactory system, but as whole human beings.
The first article comes from a team in Nice, France, and was published in BMC Psychiatry. The article looked at the effect of Covid-related smell loss upon mental health, and states “Olfactory disorders in COVID-19 impact quality of life and may lead to psychological impairments.” This is new territory: most of the literature on this topic, while recognising that quality of life can change, views the issue in the context of rhinology. In other words, this article seeks to look at the problem more holistically for the affected person. It’s not just our noses that are affected. It’s everything about life. The participants were relatively small in number (56), but the testing involved was wide in scope. They not only looked at objective tests for olfaction such as the Sniffin’ Sticks test, but they also included standardised French language tests to investigate mental health and diet, including the Quality of Life and Diet Questionnaire; the Snaith-Hamilton Pleasure Scale, The State-Trait Anxiety Inventory, The Post Traumatic Stress Checklist Scale, and Hamilton Rating Scale for Depression.
Most importantly, the article concludes by emphasising the importance of the patients’ perceptions (my emphasis) in any comprehensive assessment of their condition. This is done using visual analog scales (where you are asked to move a slider along a scale to indicate some value). These are often discounted in olfactory research, on the basis that smell is so subjective, or that people might be exaggerating, or underrepresenting. The French researchers thought differently. How patients feel about their condition “plays a crucial role, which may be even more significant than the perceptual disorder itself”.
And now, a book. The recently published “How We Break: Navigating the Wear and Tear of Living” was written by Vincent Deary. I had the privilege of working with Vincent during the pandemic, trying to bring the message of individual patient’s perspectives after smell loss from Covid. Vincent is a health psychologist in Newcastle, and helps his patients understand how illness and trauma affect our bodies, how we even start to unpick this, and where to begin if we want to put ourselves together again.
The chapter in the book that jumps out at me the most is entitled Everyday Stories. He talks about the importance of making sense of our own condition. In my case, it was about making sense of my smell loss, how to talk about it, how to communicate it to my family and my doctors. The simplicity in his description of this is restorative in itself. I kept nodding as I read (I also have it as an audio book–he has a lovely voice). His message over all is that “breaking” is hard, it’s hard work, and so is recovering. It is labour. And I love that message.
If you are interested in hearing more about the book but aren’t sure if you want to buy it, we will be discussing it in the ckos Network on Tuesday, April 16th at 8pm UK/9pm EU/3pm EST. To join the event, you’ll need to be in the Network.