Being diagnosed with a chronic illness can completely turn one’s world on its head. We all have goals and aspirations in life, believing that if we apply ourselves, we can attain them. Never do we factor into our perceived life story that a chronic illness could impact those goals and dreams, even destroying them. We aren’t prepared for altering our daily life to accommodate the necessities or demands of a serious health condition, sometimes opting to stick our head in the sand in firm denial of this new reality.
The psychological effects of chronic illness can be profound. In fact, it is common to mourn the loss of good health. Grieving for the physical health once taken for granted is just as real as grieving for any other significant loss. Loss is a loss, and it needs to be mourned. The emotional fallout, which can include depression or anxiety, can further exacerbate the deterioration of a person with a chronic illness. Diagnosing and treating the co-occurring mental health disorders is an essential element in the overall healthcare treatment protocol.
The Psychological Effects of Chronic Illness
Coming to grips with the reality of a chronic health condition is challenging and distressing, as the new normal is unwelcome—like an intruder who has invaded your home and trashed it. No one relishes the idea of managing a serious or chronic illness, with concerns surpassing themselves and including how the diagnosis will impact family members. Because of the life-altering effects of a medical diagnosis like congestive heart failure, cancer, diabetes, rheumatoid arthritis, lupus or any other serious medical condition that will be ongoing in nature, co-occurring mental health disorders can develop.
In fact, according to the National Institute of Mental Health, those individuals facing chronic illnesses have higher rates of depression than the public at large and have enhanced symptoms of each. A 2015 study published in Health Psychology Research featured 204 patients with chronic illness, including hypertension, diabetes, coronary artery disease, and other serious diseases. It was found that anxiety disorder affected 57% of the patients and depressive disorder affected 40% of the patients.
Depression and Chronic Illness
Chronic illness exacts a heavy emotional toll on an individual. Emotions such as fear, anger, grief, and frustration can become manifested, no longer able to be shaken off. When this happens, a depressive disorder has likely developed, only adding to the daily misery. No one wants to feel like they are a burden to their loved ones, so this can be one of the triggers for the depression taking root. The individual begins to think of him or herself as a burden or liability but is dependent on family members to a large extent.
The symptoms of the illness, such a chronic pain or debilitating fatigue, can contribute to feelings of despair. Management of pain and discomfort is essential in arresting spiraling depression. Depression should be recognized and treated as part of the comprehensive medical treatment plan. Symptoms include persistent low mood, irritability, feelings of emptiness and despair, and thoughts of suicide should be acknowledged by the health professional as a co-occurring depressive disorder.
Anxiety and Chronic Illness
Anxiety disorders, such as generalized anxiety disorder, panic disorder, and phobias often accompany a diagnosis of chronic disease. Patients begin to experience excessive fear and anxiety related to their sense of helplessness to change the outcome of the illness. Irrational fear and anxiety can cause lead to panic attacks or specific phobias, as well as avoidance behaviors.
The prevalence of anxiety in patients with chronic obstructive pulmonary disease (COPD) is 85% higher than in the general population, with up to 55% of patients experiencing anxiety symptoms. Patient outcomes are worse for COPD patients with anxiety, correlating with a significantly lower quality of life, according to an article published in the Cleveland Clinic Journal of Medicine. As with depression, patients with chronic illness and co-occurring anxiety disorder must be treated for both physical and mood disorders.
Treating the Psychological Effects of Chronic Illness
Initially, the health practitioner will be the first point of contact for obtaining treatment for a co-occurring mood disorder. Early screening and detection of the anxiety or depression symptoms are often made by the primary care provider. There are screening tools, such as questionnaires, that can assist the health provider in identifying the somatic disorder. These might include:
- Primary Care Evaluation of Mental Disorders (PRIME-MD)
- PHQ-2 and PHQ-9
- Generalized Anxiety Disorder 7-item scale (GAD-7)
- Beck Depression Inventory (BDI)
- The Beck Anxiety Inventory (BAI)
- Specific assessment tests to the particular illness
Receiving appropriate intervention and treatment as early as possible can result in a much better outcome for both diagnoses. In many cases, antidepressants are well tolerated by patients with chronic medical conditions and can ease symptoms. In addition to pharmacologic treatment, behavioral therapy is also beneficial. Cognitive behavioral therapy (CBT) helps patients address negative thinking patterns that contribute to mood disorder and replace them with positive mental messaging. CBT is sometimes combined with physical rehab programs that integrate movement and exercise for patients whose medical condition is stable enough for participation.
Holistic Therapies that Help Treat the Psychological Effects of Chronic Illness
Another helpful treatment intervention for patients suffering from both chronic illness and mood disorder are holistic activities. These types of activities, such as deep breathing techniques, sequential muscle relaxation, hypnotherapy, mindfulness exercises, and guided imagery can help reduce stress and promote relaxation. This results in a better overall treatment outcome for both the medical and psychological conditions.
This text was provided by Marissa Katrin Maldonado.
Marissa Katrin Maldonado has been working in the behavioral health care industry for over 12 years. She is the founder of The Treatment Specialist, a national online resource and helpline for adults, teens, and families seeking treatment options and depression rehab, anxiety, addictions, and most other mental health conditions. Dedicated to guiding individuals to the help they seek, Marissa believes that with the right support and guidance, those struggling will have the opportunity to turn their lives around and enjoy a healthy and happy life. She is a proud mother and wife and enjoys long-distance running, traveling, and music.