Historically society refers to chronic illnesses as a physical health issue all to itself, leaving mental health completely out of the picture. This is an outdated approach that puts all people at a disadvantage. It’s time that society finally understands the true connection between your chronic illness and mental health.
Chronic Illness & Mental Health Statistics
Approximately 36.6% of people living with a chronic illness are diagnosed with a mental illness (BMC Public Health, 2019).
An estimated one-third of people diagnosed with a serious, life-changing chronic illness or disease will experience symptoms of depression, one of the most common forms of mental illness. In fact, depression caused by a chronic illness can worsen your condition if not properly treated for it (Cleveland Clinic, 2021).
People living with a mental illness are more likely to experience physical health symptoms that can lead to preventable chronic conditions (Mental Health Foundation, 2022).
But why? And how can you get ahead of this to support both your mental and physical health?
Here are several ways that your chronic illness and mental health are related.
Chronic Illness and Depression
Have you ever noticed moments of feeling sad, down and in a dark place? This is a common experience that anyone can experience in their lifetime, but it’s more likely to happen when living with a chronic condition. In fact, there is plenty of research that states people living with one or more chronic illnesses are at a higher risk of living with a mental health condition, including depression.
Research from Johns Hopkins School of Public Health also indicates that “so much of managing multiple conditions requires self-care on the part of the person, and depression can make caring for oneself difficult.” Medical professionals have found that effective treatment of depression reduces depressive symptoms, improves daily functioning, and slows down disease progression.
That being said, it’s vital for the wellbeing of you and your loved ones to understand what depression looks like so that you can proactively maintain a balance of optimal mental and physical health along the way.
What is Depression?
Here are some signs of depression that can lead to a diagnosis:
- Changes in eating habits (increased or decreased appetite)
- Change in sleeping habits (sleeping too much, not sleeping enough, difficulty getting to sleep, interrupted sleep)
- Less motivation to do things you enjoy doing
- Crying more often
- Persistent or prolonged feelings of sadness
- Difficulty concentrating
- Feeling hopeless
- Isolating or withdrawing yourself from other people more often
- Thoughts of harming yourself or ending your life
- Thoughts that others would be better off without you (and that you are a burden on others)
How To Tell the Difference Between Depression and My Chronic Illness?
Medical professionals have confirmed that it “can be difficult to diagnose depression” within the medically ill community because it’s not as simple as looking at a list of criteria. There are also gaps in how some medical providers assess and treat mental health conditions with their clients, making it more likely for providers to miss or overlook the signs of depression.
Some of the symptoms of clinical depression look similar to chronic health symptoms and your responses to caring for it. In order to make a correct diagnosis of depression, it’s important to take a closer look at how your mood is impacting your life.
Many of the mental health symptoms listed above are natural changes that occur as a result of having your specific chronic condition. For example, you’re more likely to spend time away from others to manage your condition or recover from a chronic illness flare up. And although you may want to participate in activities you previously enjoyed, your chronic illness can make it much more difficult for you to carry them out or enjoy doing them at all.
Sometimes your chronic illness changes your eating and sleeping habits, energy levels and heightens feelings of pain. These changes make it more difficult to feel hopeful and manage your daily responsibilities (i.e., hygiene tasks, working/attending school, household chores, following health plan, parenting, attending to personal relationships, etc.).
Simply put, having these problems does not guarantee that you are living with depression. So let’s take it a step further.
How to Know the Difference Between Your Chronic Illness and Depression
- Do all the changes happening in your life with a chronic illness bring you to prolonged feelings of sadness?
- Does your condition and what it takes to manage it make you feel less motivated and want to give up on caring for yourself (i.e., taking your medication, attending medical appointments, following hygiene practices)?
- Have you stopped following your medical treatment plan or carry it out less often?
- Do you feel that it’s best to spend more time alone because you feel you are an inconvenience to others?
- Are you considering ending your life or harming yourself as a result of the stress you feel with your chronic condition?
If you answered “yes” to any of these questions, speaking with a Chronic Illness Therapist, Health Psychologist or your doctor is an important next step to getting mental health support. Confirming that you are living with depression helps you to manage your health condition effectively (i.e., follow through with treatment recommendations, maintain hygiene practices, participate in activities that give you hope).
Here are some tips to keep your mood steady on the challenging days to get you started.
Chronic Conditions and Anxiety
Chronic conditions often bring on many unknowns that make it difficult for you to approach your life. Common anxiety provoking situations include worrying how you’ll feel later, having a hard time making plans, feeling worried about how others will respond when talking about your condition (or avoiding discussing it altogether), panicking and thinking worst case scenarios before upcoming medical appointments and other aspects of your life.
You’re not alone here. These concerns make you human.
However, if not careful, unmanaged anxiety can make it harder to manage your condition, leading to worse mental and physical health outcomes long term.
Signs You’re Feeling Anxious with a Chronic Condition
- Avoiding discussions or activities that remind you of your chronic illness
- Becoming more short-tempered and irritable with people
- Experiencing racing thoughts that are hard to shut off
- Headaches or increased body tension
- Stomach pain or discomforts (i.e., cramps, bloating, constipation, diarrhea)
- Sleep habit changes (difficulty getting to sleep/winding down, sleeping more to cope with feelings)
- Fidgeting or difficulty sitting still more than usual
- Thoughts focused on future situations, having a hard time being present in the moment
The worries you live with regarding your chronic illness can become so overwhelming that it seems best to avoid dealing with it or act like it’s not really affecting you. However, the most effective way to overcome your anxiety is to face the issue head on. Otherwise, unresolved anxiety promotes more production of stress hormones in the body, putting you at higher risk for other mental and physical health problems.
Many Chronic Illnesses and Treatments Alter Biochemistry
Now that we’ve established that your chronic illness can bring on mental health conditions like depression and anxiety, let’s consider what happens when your body chemistry changes, too.
Chronic illnesses can bring on involuntary biological changes, making it more difficult for you to feel a sense of control with your body. Can you imagine dealing with one or more of these changes and trying to maintain a sense of calm?
On top of that, it’s hard to feel like yourself when important life functions and activities aren’t possible with these changes.
I recommend speaking with your medical professional about your symptoms, confirming if any changes have occurred biologically that could use medical intervention. It’s best to have blood work completed as an initial part of your mental health journey, because many health conditions mirror mental illnesses. This communication helps your doctor and mental health professional collaborate and provide the most effective treatment for both your chronic illness and mental health.
Chronic Pain Increases Risk of Mental Illness
Chronic pain occurs when the pain is present for 3 months or longer. The U.S. Pain Foundation declares that approximately 21% (51.6 million) of Americans live with chronic pain. People who live with chronic pain are at more risk of experiencing mental illness, including suicidal thoughts. And a major challenge of living with chronic pain is that it’s not all visible.
Many people with chronic pain find themselves dealing with it alone, trying to mask or cover it up to coexist with the rest of society. The pressure that comes with acting “okay” or “normal” while managing your chronic pain makes you feel more lonely, depressed and less likely to feel supported.
Chronic pain significantly impacts how one functions in life, noting changes in sleep quality, concentration, energy levels, and the ability to carry out self-care tasks and life responsibilities. To add to that frustration, it can be extremely difficult when you are having to rely on medication and a host of other treatments to make it through each day.
This is the difficult and mentally exhausting journey that many people have to explore in life with chronic pain.
The Chronic Pain Cycle and Decreases Mental Health
Living with chronic pain is often associated with higher levels of anxiety because one often worries about when the pain will return, how bad it will be and how it will impact your day. The Chronic Pain Cycle shows how it shifts your attention to the pain, increases your anxiety and pain levels, and makes it more difficult to feel a sense of calm or relief over time. As you learn to live with your chronic pain, learning to lower your anxiety levels will help to decrease personal suffering and the intensity of the pain.
Here are some ways to cope with chronic pain and change the cycle:
- Recognize the triggers that promote your pain (i.e., people, places, things, situations, stress levels).
- Work through pain triggers with your therapist to reduce stress
- Practice mindfulness as a way to bring anxious thoughts calmly into the present moment (slowing the panic response).
- Practice meditation daily, redirecting your nervous system’s stress response in moments of pain
- Take deep breaths to bring your heart rate down and calm muscle tension.
- Pace yourself through activities.
- Follow your medical treatment plan (i.e., medication management, exercise, therapies)
- Distraction. Sometimes allowing yourself to focus on something else helps you to mentally and emotionally regroup, transitioning back to activities of importance to you briefly afterwards.
History of Medical Trauma and Medical Decline Over Time
Medical trauma is one or a series of medical events that have occurred in your life that are extremely stressful and have an impact on you after the event has taken place. Here are some examples of medical trauma and signs you may have experienced it.
Unresolved medical trauma has an extensive impact on your mental health because it interferes with how you engage with medical services moving forward. The increased worry, sense of helplessness and feeling on guard that comes from medical trauma makes it more difficult to trust medical providers, follow your treatment plan and even attend follow-up appointments.
Oftentimes, toxic relationship dynamics with a doctor consist of one feeling dismissed, ignored, discredited and unsure of yourself. This also contributes to persistent and unresolved medical trauma over time.
The connection between your medical trauma and chronic condition is strong, as the trauma often presents itself physically through muscle tension, body aches, fatigue, stomach pain and digestive problems, difficulty concentrating and rapid heart rate. Over time unresolved trauma can lead to poor health outcomes and a diagnosis of one or more chronic illnesses, including Post-traumatic Stress Disorder.
Chronic Illness-Related Grief and Mental Health
People typically think about the death of a loved one first when they hear the word “grief.” But in the case of living with a chronic health condition, you experience chronic illness grief through a range of losses, life changes and strains on relationships as a result of your health condition. This combination takes a toll on your mental health.
Types of losses that one can experience with a chronic condition:
- Impaired Physical Capacity
- Activity Limitations (including basic needs and meaningful activities)
- Difficulty working or loss of ability to work
- Risk for disability, loss of quality of life
- Increased Healthcare Costs
- Decreased interactions with others
- Difficulty traveling
- Relationship Complications
- Loss of self-confidence and self-identity
The timeline in which you are to grieve your chronic condition varies. And you are likely to experience many reminders over time that bring you to an emotional state (sadness, anger, worry, confusion), sometimes feeling like it came out of nowhere.
The Stages of Chronic Illness Grief explain the range of common emotions and responses that come when living with one or more medical conditions. If you identify that you are in one or more of these stages, respond with self-compassion and understand that grief is a process. This is an opportunity to figure out where you are and how you can be supported through it.
Chronic Conditions Impact How You Coexist with Society
Chronic conditions are a community matter, as they affect you and others around you. From immediate family, to caregivers, friends, and even employers, your chronic illness touches the lives of many people (even when you try your hardest not to let it happen). With that being said, it can be difficult to figure out how to coexist with others when your chronic conditions are impacting your life.
It’s common to feel pressure to maintain the look that “everything is okay” in order to be viewed positively and supported by people in your personal and professional lives. There are often worries about losing their jobs or performing poorly, being seen as “lazy” or “incompetent,” and making excuses while interacting with people with limited understanding of your health condition.
Let’s look at some common situations that can impact your relationships.
How Your Chronic Illness and Mental Health Impacts Personal and Professional Relationships
- Canceling plans frequently or unexpectedly
- Taking time away from other people to recover from health flares or surgical procedures
- Taking time away from work (intermittently or permanently)
- Requesting work/school accommodations to support working effectively
- Coworkers may need to take on some of your workload as you recover from health complications
- Loved ones taking on the role as your caregiver
- Needing to research before making plans to ensure your health needs are met in the community (i.e., review restaurant menus, confirm ADA accessibility, note the distance needed to commute)
These experiences may feel inconvenient for you, but they are often necessary to ensure that both your mental and physical health are considered and managed with support. It’s hard needing to make these decisions, especially when you’d rather not have attention brought to you regarding your health differences. However, accepting some of these changes in your life can actually help you move forward with your illness with hope and meaning, supporting your mental health.
Ways that Your Loved Ones are Affected by Chronic Illnesses and Mental Health
Caregivers and loved ones have the responsibility of supporting you while managing their own needs. They are more likely to experience chronic mental and physical health challenges primarily because they are devoting a lot more time to caring for their loved one than themselves.
Be mindful that their stress does not mean they don’t love you or want to help; it’s just hard to navigate but is possible with support and open communication with one another.
Friends and significant others will want to continue the relationship with you as they’re used to, but this may not always be realistic as your needs and health status changes. This can put a strain on relationships, but it does not have to be permanently changed for the worse. With time, your loved ones have the responsibility to learn how your chronic illness and mental health are connected so they can honor your needs and maintain a healthy relationship.
Here are some tips to help your loved ones support you.
What Happens When Your Relationships are Unsupportive?
Now let me indicate this here… Although your chronic condition can be a source of stress for you and others in your life, it is NEVER acceptable for people in your community to blame you for any of their emotions that they experience. This is one of many signs that can make you feel unsupported in managing your mental health and chronic illness.
Positive community support and connection is linked to improved outcomes for both your mental health and chronic health conditions. So it’s important to surround yourself with encouraging and supportive people to help you manage a healthy connection with your mental and physical health.
Lack of Societal Support and Resources for Chronic Illnesses and Mental Health Conditions
Your chronic illness and mental health require a range of different resources and support to successfully manage. Unfortunately some resources and societal norms prevent people from receiving the care needed, thus increasing the likelihood of facing more health decline over time.
These unhelpful societal norms often can lead to more worries, higher stress levels and increased health symptoms without the proper support. Lack of community resources can lead someone to stay in an unhealthy work environment and not communicate their needs.
If you or a loved one are living with mental or physical health conditions, look into these resources to help get you started on your journey.
How to Treat and Manage Your Mental Health with a Chronic Illness
- Confirm if your psychological symptoms are medically related, as some chronic illnesses and mental health conditions mimic one another.
- Seek mental health treatment to directly address your mental health. A therapist with a chronic illness specialty or a Clinical Psychologist are recommended.
- Find a provider that is willing to collaborate with your therapist to make sure all of your needs are met – both mental and physical.
- Develop a medical and mental health treatment plan that is doable at home and in the community.
- Learn and practice strategies that help you cope with your feelings and daily life pressures.
- Seek support from others to feel less isolated (i.e., talk about your situation, ask for help, join a support group).
Next Steps for Managing Your Chronic Illness and Mental Health
I help individuals and families who are trying to strike the balance with their chronic illnesses and mental health. Therapy is a powerful tool that can help you continue talking about your chronic illness in a safe space. Although your health journey can be hard, therapy can make it more bearable having hard conversations and moving forward, giving you more confidence and improving your mental health.
You can schedule your first appointment with me by booking a free 15-minute consultation call.
