Chronic illnesses are health conditions that persist for a long period of time, often throughout a person’s life. Such illnesses generally have complex causes and lead to impairment or disability (1). The likelihood of experiencing chronic illness increases as we age.
Chronic illness can impact significantly on people’s lives; it can alter the way a person sees the world, changing how they think, feel and behave. Some may additionally experience chronic pain or mental health symptoms as a result. Chronic illness can restrict our ability to participate at school or work, affect our relationships, or make it difficult to go about other usual activities.
Generally, chronic illnesses do not resolve by themselves and can need substantial ongoing treatment. This in itself can also be a cause of stress. However, with the right treatment plan in place, which may include therapy, it’s possible to have a better quality of life.
Examples of a chronic illness
Chronic illnesses can be physical or psychological in nature. Some examples include:
- Heart disease
- Respiratory diseases
Prevalence of chronic illness
Chronic illnesses are relatively common. The Center for Disease Control and Prevention estimates that 3 in 5 Americans are living with a chronic illness of some kind. In addition, 2 in 5 adults have two or more chronic illnesses (2).
Research suggests that the effects of chronic illness vary by gender. For example, one study reported that females have a higher rate of hospitalization than males for asthma. Males have a higher hospitalization rate for chronic obstructive pulmonary disease, diabetes, and chronic kidney disease, in terms of mortality rate (3).
It appears that there is a relationship between chronic illness and mental health problems. People who are experiencing chronic illness may be at increased risk of mental health challenges. However, there is also evidence to suggest that mental health problems such as stress or depression are associated with an increased risk of chronic illness (4).
Common challenges experienced by people with chronic illnesses
Chronic illness can affect us in so many different ways, physically, psychologically and socially. Some examples of the challenges faced by people with a chronic illness include:
- Adjusting to symptoms
- Adjusting to a loss of function as a result of illness (for example, no longer being able to work)
- Coping with treatment, physically, psychologically and financially
- Feeling helpless or losing control
- Uncertainty about the future
- Trying to maintain relationships and mental wellbeing
Mental health and chronic illness
Living with chronic illness can be distressing. It impacts on a person’s relationships and ability to go about their usual daily activities. Some people experience intense emotions, many of which are normal and reduce over time. Others may experience mental health challenges. Common experiences include:
- Anxiety or worry: You may worry about your health or the future, or find that your anxiety interferes with your daily activities.
- Sadness or depression: The ongoing nature of chronic illness can be distressing and prevent you from doing the things you want. This can lead to feeling sad, hopeless, or depressed.
- Grief: A sense of loss or grief is a common experience in response to receiving a diagnosis of a chronic illness.
- Fear: A common reaction to chronic illness is fear, particularly for people who are facing a life-threatening illness (5).
- Stress: Having a chronic illness can be stressful. Stress can, in turn, affect recovery and exacerbate mental health symptoms.
- Guilt or shame: It’s not uncommon for people with diabetes, for example, to struggle with feelings of guilt or shame (5).
- Anger or frustration: Chronic illness can stop us from doing the things we need to and impact on our quality of life, leading to feelings of anger. Many people struggle with feeling that their situation is unjust or unfair.
- Difficulty sleeping: Feeling pain, discomfort or stress can interfere with regular sleeping patterns. This, in turn, can exacerbate mental health symptoms and pain.
- Substance use problems: Some people use alcohol, other drugs, or prescription medications to help manage pain or cope. This can be unhelpful or lead to problems with addictions. This is a complex area, as the treatment of chronic illnesses often involves medication.
- Relationship challenges: Chronic illness, and the way it affects how people think and act can place strain on our relationships.
What to do if you’re experiencing a chronic illness
The treatment of chronic illness often involves a team of practitioners from different health professions addressing a combination of physical, psychological and social factors. Treatment often includes education, psychological therapy and medical interventions. Consult with your health care provider about a combination of these options:
- Therapy. There is strong evidence showing that therapy can help people to feel better and have a better quality of life. Look for a therapist who can help you understand your challenges and find strategies to manage pain, learn coping strategies, and address unhelpful thought patterns, emotions or behaviors. See more tips below on types of therapy and selecting a therapist.
- Check-ups: Chronic illnesses usually require ongoing treatment and medical attention. It’s important to have regular check-ups with your primary care doctor. Attend specialist appointments for ongoing assessment and treatment.
- Lifestyle changes: Pay attention to your diet, avoid smoking, drugs and alcohol, try to get sleep and rest, and exercise regularly. These lifestyle behaviors are risk factors for developing chronic illness (2).
- Complementary therapies: There is some evidence to suggest that acupuncture and massage can reduce pain, which is something that people with chronic illnesses often struggle with.
- Plan your day: Set goals, but make sure you pace yourself. Schedule in time for activities that you enjoy, like a relaxation exercise or a massage, for example.
- Talk to others: Talking to family and friends about chronic illness can help you to feel understood. Make sure you maintain these social connections, as friends and family are important sources of support.
- Hotlines: If you’re having thoughts of suicide or need immediate support, you can always call the National Suicide Prevention Hotline at 1-800-273-8255. You can call Pain BC’s Pain Support Line at 1-844-880-7246.
- Learn about the illness and treatment: Read or ask questions of professionals to better understand chronic illness and treatments. This can help reduce any feelings of being helpless and restores a sense of control.
Chronic illness: Therapy types to consider
Therapy can be an important part of a treatment plan for chronic illnesses; it addresses the psychological consequences of what is often considered to be a purely physical or medical problem. There are many effective types of therapy that can help improve your mood and quality of life. Common approaches include:
- Cognitive Behavioral Therapy (CBT): CBT helps people become aware of and change unhelpful thinking patterns and behaviors.
- Mindfulness Practices: Mindfulness approaches, including Mindfulness-Based Stress Reduction (MBSR), help people to be aware of thoughts and sensations without automatically reacting to them as problematic.
- Acceptance and Commitment Therapy (ACT): ACT involves components of both CBT and mindfulness as well as other strategies to help people take an acceptance approach to chronic illness.
- Schema Therapy: In schema therapy, people explore unhelpful beliefs, understand them and work to change them.
- Family or Couples Therapy: It can be helpful to involve family members or partners in therapy. This provides a forum for them to learn about the person with the chronic illness and how to best support them.
What to look for in a therapist for chronic illness
There are several factors to keep in mind when selecting a mental health professional, including:
Education and credentials
Look for a licensed mental health professional with experience and specialized training in chronic illnesses. Many therapists, such as health psychologists, have a particular interest and specific training in treating chronic illness. They will often include this information in their biographies so that it’s easy for you to find when searching for a therapist.
It’s important to find a therapist with whom you feel comfortable working. The trusting working relationship between you and your therapist, known as the “therapeutic alliance” can have a huge impact on the efficacy of therapy. Many people with chronic illness struggle with the feeling that nobody understands what they are going through. It’s particularly important that you are working with a therapist you trust and helps you to feel that they do understand your experience.
Talk in advance
The best way to judge how you might feel about your prospective therapist is to ask for a preliminary phone call (you can do this with our vetted Zencare therapists). Most therapists will be happy to oblige. This gives you the opportunity to ask about:
- The therapist’s qualifications
- The therapist’s experience working with people with chronic illness
- Whether they consider themselves to be specialists in the area
- Any ongoing training they are undertaking in the area or treatments related to chronic illness
- What therapy they suggest and what that will be like
- Their participation in insurance plans and cost of therapy
Try to speak to a few different therapists before making your mind up.
New to therapy? Learn about how to find a therapist here.
Sources and references:
- Centers for Disease Control and Prevention, “The Institute of Medicine’s New Report on Living Well With Chronic Illness”
- (1) Better Health, “Chronic Illness”
- (2) Centers for Disease Control and Prevention, “Chronic Diseases in America”
- (3) An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach to Public Health
- (4) American Psychological Association, "Data on behavioral health in the United States”
- (5) American Psychological Association, “Coping with a diagnosis of chronic illness”