The Mental Health Impacts of Chronic Illness

If you live with a chronic illness like migraine, diabetes, or heart disease, then life is already hard enough as it is. The physical symptoms of your disease may affect your day-to-day life in a very real way. But what’s not as commonly discussed is the way these chronic illnesses have significant mental health implications as well.

We know that physical health and mental health are inextricably tied. Research shows chronic illness impacts our mental health in both direct and indirect ways. If you’re getting treatment, it’s important to address both aspects (physical and mental health symptoms) because one affects the other.

Living with chronic illness and mental health difficulties can be challenging, but there are ways to manage both so you can live a full and meaningful life.

How are chronic illness and mental health related?

It’s well-documented that people who live with chronic illness are much more likely to also live with a mental health problem like depression or anxiety.

For example^[1]:

• People with diabetes are 2 to 3 times more likely to have depression than people without diabetes.
• Over 50% of patients with Parkinson’s disease and up to 30% of cancer patients have depression (compared with around 4 to 8% of the general population).
• Around 30% of people who have had a heart attack experience anxiety symptoms afterward.
• 3 out of 4 people with severe COPD also experience depression and/or anxiety symptoms.
  The World Health Survey found those diagnosed with 2 or more chronic illnesses are 7 times more likely to have depression.

But more and more, we’re learning the reverse is also true. Strong evidence shows people who have depression are more likely to later develop chronic diseases like heart disease, stroke, and Alzheimer’s disease^[2].

This could be because depression and other mental health problems make it more difficult to take care of yourself. It could also mean people who have less healthcare access are more likely to develop both depression and these chronic diseases.

When you live with a chronic physical illness and a mental illness, the symptoms of both tend to be worse. This means it’s critical to address both areas of your well-being because the two are deeply intertwined.

How can chronic illness lead to mental illness?

We’re still studying the exact mechanics of how chronic illness and mental illness are related. But we’ve come to understand there are both direct and indirect paths through which chronic illness can lead to mental illness.

For example, neurological diseases like Parkinson’s disease and multiple sclerosis are known to cause changes in the nervous system and brain structure. Some research now suggests those changes could lead these patients to develop depression as well. Both depression and schizophrenia can impact your body’s resistance to insulin, which can put you at higher risk for diabetes.

But one of the most common ways in which chronic illness leads to depression (and other mental health concerns) is through the insidious ways in which chronic disease can affect your life and day-to-day functioning. Many people who have chronic illnesses are in a lot of pain; this and other symptoms can keep them from living life in the way they want to.

If you live with a chronic illness, you might find it’s more challenging than it used to be to keep up with your hobbies and your relationships. You may have had to adjust your lifestyle and diet or find you get fatigued more easily. All of this can disrupt your personal, professional, and relational life.

Chronic illnesses can also cause you to reflect more than usual on your own mortality. You might experience a fear of death or worry excessively about what will happen to your family if your health takes a turn for the worse. These worries can quickly turn into anxiety.

When you’re newly diagnosed with a chronic illness, it’s easy to start feeling overwhelmed. Chronic illness can’t be cured, and thinking about a future with this condition may be disheartening. It’s completely reasonable that people often develop symptoms of depression and anxiety when faced with these challenges.

Lastly, some medications used to treat certain chronic conditions can have side effects on mental health. For example, prednisone, an anti-inflammatory drug often used to treat lupus, rheumatoid arthritis, and other chronic illnesses, can affect your serotonin levels and cause symptoms of depression.

The importance of treatment

It can’t be stressed enough that the presence of depression and other mental health problems can make the symptoms of chronic illness much worse.

For example, people with depression are more likely to rate their pain higher than people without depression. People who have both diabetes and depression show poorer glycemic control, higher obesity rates, and more diabetes-related organ complications than diabetics who don’t have depression^[3].

This is partly because people who live with both a chronic health condition and a mental illness like depression can have a hard time practicing self-care. It’s understandable; life is hard enough with just one of these conditions, and when faced with both, it can feel nearly impossible to stick to habits like exercising, connecting with friends, spending time in nature, and more. It may even be hard to keep up with medical appointments or remember to take medication regularly. Unfortunately, this can make both depression (and other mental health concerns) and chronic illness worse.

It’s critical, therefore, to address the symptoms of both the mental health condition as well as the chronic illness. But, too often, we treat mental health symptoms as secondary to the physical disease. Not even half of diabetic people with depression get the mental health support they need^[4].

If you’ve been diagnosed with a chronic illness, your physician may or may not refer you to mental health support. But if you start experiencing the symptoms of depression, anxiety, or another mental health condition, it’s important to seek out help for yourself.

When should I ask for mental health support?

Almost everyone who’s newly diagnosed with a chronic illness feels down to some extent. It can be hard to differentiate what’s a “normal” reaction and what’s a sign of a deeper mental health issue.

First of all, there is no right or wrong way to feel when you’ve been diagnosed with a chronic illness – there is no “normal.” Different people react to these health changes in different ways. How you feel depends on many factors, including how much the illness affects your life and how much support you have.

With that said it can be helpful to watch out for the signs and symptoms of depression and anxiety so you can reach out for professional support when you need it.

You may be experiencing depression or anxiety if:

• You have persistent feelings of sadness or hopelessness.
• Daily activities and interests no longer bring joy or pleasure.
• Your sleep patterns have changed significantly (too little or too much sleep).
• You feel constantly fatigued or lack energy.
• You’ve experienced appetite changes, which may have led to significant weight loss or gain.
• You have a hard time concentrating or making decisions in your daily life.
• You feel worthlessness or excessive guilt.
• You have recurring thoughts about death or suicide.
• You have overwhelming feelings of worry or fear that affect your daily functioning.
• You constantly feel restless or on edge.
• These symptoms have started to affect your relationships or work life.

If you’re experiencing any of these symptoms, asking a mental health specialist could be beneficial. But even if you aren’t struggling, it’s often a good idea to look for mental health support right when you’re diagnosed. Working with a mental health professional during these difficult life changes can help provide support for resulting challenges.

Holistic mental health support at The Center A Place of HOPE

At The Center • A Place of HOPE, we deeply understand your physical and mental health are woven together. Treating mental illness isn’t just about looking at symptoms; it’s about helping you heal from within.

Our unique Whole Person Care approach ensures your treatment will address not only the physical and emotional/mental but also the intellectual, relational, and spiritual elements of your life. Your treatment team will include diverse professionals like mental health therapists, medical professionals, nutritionists, and fitness trainers. We’ll help you heal on every level and manage symptoms of both chronic physical disease as well as mental illness.

Contact us today to learn more about how we can help you and your family.

1 – https://adaa.org/understanding-anxiety/chronic-illness-disease-anxiety-depression
2 – https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health
3 – https://diabetesjournals.org/care/article/27/9/2154/22613/Relationship-of-Depression-and-Diabetes-Self-Care#ref-9
4 – https://publichealth.jhu.edu/2021/the-intersection-of-mental-health-and-chronic-disease