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The Mental Toll of Living With Chronic Illness

If you have one or more chronic illnesses, you may be getting medical help for your physical symptoms, but what about the emotional toll it takes on you? 

Maybe the illness you have means you must carefully monitor what you eat, and maybe you don’t know how you’ll feel from day to day—and so you find yourself missing yet another baseball game of your daughter’s or another concert of your son’s. Perhaps you need more sleep than a typical person your age (maybe a lot more) and your medical bills can make you feel downright anxious.

And maybe, when you visit your doctor, all he or she wants to discuss are your physical symptoms. Yes, that’s important, but coping with chronic illness also requires strategies that help to keep your spirits up and keep you engaged with friends and family. And, this post will offer suggestions to help you do just that.

Types of Chronic Illness

First, it’s important to note how there are numerous chronic illnesses, each with its own challenges. From arthritis to asthma, and from diabetes to heart disease, and from interstitial cystitis to ulcerative colitis and more, each is defined as a chronic illness because they all have certain characteristics in common.

According to
MedicineNet.com, a chronic disease is one that lasts for “3 months or more, by the definition of the U.S. National Center for Health Statistics. Chronic diseases generally cannot be prevented by vaccines or cured by medication, nor do they just disappear.”

The most common forms of chronic disease in America and other developed countries include (in alphabetical order, not in order of how often they exist):

  • arthritis
  • cardiovascular disease, including heart attacks and strokes
  • cancer, with breast cancer and colon cancer specifically noted in the list
  • diabetes
  • epilepsy and seizures
  • obesity
  • oral health problems

Next, we’ll look at the ways in which chronic illness can take a toll on you, emotionally. There’s an incredibly insightful article on this topic at Ausmed.com, one that shares how pain that’s chronic creates a “fluctuating and unstable progression that leads to the individuals feeling uncertain about the future.”

And, this feeling of uncertainty can add significantly to the challenges being experienced.

That isn’t to say, by any means, that the frustration felt by people coping with chronic illness is “all in their heads” or that, if they simply changed their attitudes, all would be much better. That’s demeaning and an inaccurate oversimplification of what happens to someone dealing with one or more of these conditions. The article goes on to say that chronic pain can actually change the nervous system and not in a good way. The results of these changes can, in fact, create a whole new “disease entity” for people affected by chronic pain.

Ways that chronic pain and illness can take a mental toll include how it affects their “relationships with others, employment, and ability to participate in their normal activities.” They can worry about being judged and have increased levels of shame and guilt, which can spiral into anxiety and/or depression.

Chronic Pain and Depression

A strong connection exists between chronic pain and depression, and can cause people to experience even greater pain symptoms. Being treated for depression, then, can often help people to manage their pain symptoms.

The
Mayo Clinic shares that you might need to be treated separately for each (meaning, for your chronic condition and for any depression you’re experiencing)—but, in some cases, one treatment helps with both.

For example, some antidepressant medications can help with both because they target certain chemicals in the brain that are involved in both conditions. It can also help to get psychological counseling; meaning, for some people, it can help with both conditions to talk to a compassionate therapist.

Effectively addressing stress can also help with chronic pain and depression alike, with the following ideas suggested:

  • physical activity
  • exercise
  • meditation
  • journaling
  • learning coping skills

If you were taken by surprise by the mention of journaling, you might want to read Journaling Power: How to Create the Happy, Healthy Life You Want to Live by Mari L. McCarthy. This book shares McCarthy’s own story, including how she is now off all medications for multiple sclerosis, something she attributes to therapeutic journaling. She shares research studies if you want to explore this idea further and she includes journaling exercises to try; she is also very careful to say that you need to work with your medical team if you want to stop or even reduce your medications.

Returning to ideas about chronic illness and depression shared by the Mayo Clinic, they also state that pain rehabilitation programs can also help significantly, because they typically use a team approach that addresses mental wellbeing. Their final suggestion in the article is to get help sooner, rather than later.

You can find even more suggestions at the
National Institute of Mental Health site.

Chronic Illness and Anxiety

Studies have found that, if you have a chronic illness, you’re more likely to also develop symptoms of anxiety. In fact, people with chronic pain are three times as likely to become anxious than people without that pain. Everyone is different, of course; as Psycom.net puts it, “Some are more easily able to adapt to the changes in their lives. Others may feel overwhelmed with anxiety and struggle to cope.”

Here, we’ll quote the symptoms they list that can exist when someone has both chronic illness and anxiety symptoms:

  • excessively worrying about physical health
  • trouble sleeping due to worry
  • having nightmares about physical health
  • experiencing panic attacks about prognosis
  • difficulty discussing physical condition
  • avoiding treatments that cause anxiety
  • avoiding social interactions
  • having intrusive thoughts about dying
  • becoming irritable about physical health

Recommendations from the site include to challenge your negative thinking, by not ignoring what’s going on that’s positive. They recommend relaxation techniques, including yoga, mindfulness meditation, and breathing/focusing practices.

MedlinePlus.gov
 suggests you find a support group, preferably with people who are experiencing the same chronic condition that you are; you can often find them through hospitals and non-profit organizations. You can ask your doctor or therapist for recommendations, too.

You can also go to
 PsychologyToday.com and enter your zip code to find support groups to consider. And, if leaving home is challenging for you sometimes (or always), there are increasing numbers of online support groups that you can access from home.

And, depending upon your personality, it may be hard to allow people to support you, to provide extra help to you when times are tough. If so, it can be helpful to talk to someone about how to set boundaries that will help you to keep the privacy you want and need, while still gaining more support with your challenges.
 

Mental Health and the Workplace

Sometimes, the workplace can be pretty stressful, and that’s even more true if you have a chronic health issue to deal with. If you’re a supervisor or manager, or if you have a human resource department that would be open to hearing ideas about reducing stress at work, the Centers for Disease Control and Prevention (CDC) offers an interesting resource to help make the workplace more mental-health friendly.

Elements of this type of workplace include one where diversity is valued, where mental illnesses are as much of a priority as physical illnesses. These workplaces offer programs and have policies and practices that support work-life balance and employee health and wellness.

Managers are trained in mental health workplace issues and can identify when someone is struggling and can make referrals. Employees’ health information is kept confidential and resources are available to help.

“Successful programs,” the resource reads, “take a comprehensive approach to health.” This includes:

  • education
  • early detection/screening
  • program integration
  • changes to the workplace to encourage healthy behaviors

A goal would be to reduce workplace stress, something that’s more harmful than many people suspect, whether it happens at work or at home.

Closer Look at Chronic Stress

The American Psychological Association takes a pretty in-depth look at how chronic stress can affect you physically. Ironically, on the one hand, chronic physical illness can have a negative impact on your mental health; and, on the other hand, chronic stress can have a negative impact on your physical health.

For example, stress naturally causes people to tense up their muscles; When you’re chronically stressed, your muscles are in a “more or less constant state of guardedness.” This can cause stress-related disorders, from tension headaches and migraine headaches to shoulder and neck pain. It’s then a natural reaction to avoid using those parts of your body that hurt as much as before, and this can lead to muscle atrophy.

Stress makes us breathe harder, which can be especially harmful for people with asthma or emphysema, and acute stress can actually trigger asthma attack or hyperventilation.

Your heart rate can increase and stress hormones flood in; long-term, this can lead to heart problems and issues with blood vessels, increasing the “risk for hypertension [high blood pressure], heart attack or stroke.”

This list doesn’t even begin to touch upon the problems that can occur with endocrine, gastrointestinal, nervous and reproductive systems.

Interestingly enough, one of the best ways to calm your body and reduce the effects of ongoing stress is wonderfully simple:
intentional breathing. To practice this, take a couple of “strong, long and deep breaths” and notice what you feel, physically, when you do this. Then switch to resonant breathing, where the time spent on inhaling and exhaling, combined, is ten seconds per breath. This means you’re breathing six times a minute.

It can help to practice this while walking because “the pace of your steps can provide a regular tempo for your breath” and it becomes a natural way to breathe. Continue your resonance breathing until you feel in control of your stress. Then, as soon as you notice signs of stress, begin your intentional breathing process.

Plus, as
EverydayHealth.com notes, you can fight stress by what you eat and drink. A warm cup of tea can be soothing, with lavender and chamomile being especially relaxing. Fatty fish, such as salmon, can ease depression symptoms because of the way it boost communication among nerve cells. A handful of nuts, particularly pistachios, has been shown to help reduce anxiety.

And
WebMD.com shares, a bowl of warm oatmeal can boost serotonin levels, which is a calming brain chemical, while oranges can curb hormones associated with stress while also strengthening your immune system. As just one more example, eating crunchy raw vegetables can reduce stress by their sheer jaw action, plus they’re among the healthiest foods you can enjoy.

Self-Care When Stressed

“When we’re stressed, self-care is often the first thing to go.” (Psychology Today)

To help, make self-care a habit, something you naturally turn to when stressed. This can be as simple as aromatherapy (such as incense, candles, essential oils and so forth), which can include simply breathing in clean, fresh air. Big deep breaths of clean fresh air!

Make a fire and enjoy the flickering flames. Take a hot shower. Pet your kitten. Read. Write a poem. Read your poem out loud, even if just to yourself. Draw a picture. Do a word search or crossword puzzle. Do a word search AND a crossword puzzle.

Mediate. Pray. Light a candle and breathe. Go outside and smell the flowers.

Walk. Stretch. Be aware of all the amazing things your body is doing for you. Get a mini-water fountain and listen to the soothing sounds. Take a nap. Call a friend and just laugh together.

And, here’s the conclusion of the Psychology Today article quoted above:

“It can also mean remembering that others go through similar experiences and difficulties as we do.

“We’re not alone.


“Simply acknowledging that we’re all part of this human experience can lessen isolation and lead to a calm mind. That’s the best self-care strategy I know.”


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