What is a chronic illness and how does it affect our mental health?
How can the psychological stress of a chronic physical illness be treated?
How does chronic illness affect caregivers?
Chronic physical illness is psychologically draining for those who experience it, and psychiatric disorders such as depression and anxiety are more common among these people, who often must adjust their lifestyle and aspirations to accommodate their physical ailment. For example, the rate of affective disorders among the diabetes and rheumatoid arthritis patient populations is around 25% and rises to more than 30% among cancer patients, compared to rates of only 4-8% among the general population.
The source of psychological stress may be directly related to the chronic physical illness, such as a lung infection causing hypoxia and moodiness, or the treatment regimen intended to treat the underlying chronic illness may induce psychological instability, where chemotherapy is more devastating than normal. cancer. or where administered steroids result in altered mood.
Caring for people with chronic physical illness can be equally psychologically taxing on caregivers and clinicians, who may be forced to watch a loved one or hundreds of declining patients for many years. This article looks at how chronic physical illnesses affect the mental health of those with illnesses and those who care for them.
A chronic illness is defined as a condition that lasts at least a year or more and requires ongoing medical attention or significantly limits daily activities. When the specific chronic disease causes constant or frequent pain and distress, the potential psychological impact is obvious.
In many cases, pain relief can be given long-term to such patients. However, this strategy does not attack the root cause of the pain and the continuous use of pain relievers has complications. Perhaps more important to the psychology of those experiencing chronic pain than the pain directly experienced is the ultimate influence on their lifestyle, where the disease can discourage participation in social activities, exercise, and healthy sleep habits that are known to lead to disorders. psychiatric such as depression.
Reduced physical activity, in turn, can increase the likelihood of obesity and other physical health conditions, which subsequently further promotes psychological stress and creates a negative feedback loop. In cases of serious or terminal illness, the patient experiences additional psychological stresses related to the fear of dying, leaving their family and loved ones without them, and potentially greater financial pressures on themselves and their loved ones in the future.
Psychological co-morbidities are extremely common among people with chronic illness, with around half of people in England with mental health problems also experiencing some form of long-term condition, or 30% of people with a long-term condition. long term who also experience mental illness. theme.
Chronic illnesses can induce adverse psychological symptoms in the population, although, interestingly, strong evidence suggests that having a psychological illness makes one more prone to chronic physical illness. For example, depression increases the risk of coronary artery disease and ischemic heart disease by up to 100% when likely outcomes, such as less physical activity, are taken into account.
Unsurprisingly, most studies show that the incidence of psychological illnesses increases when patients experience multiple chronic conditions. Data from the World Health Survey suggests that a person diagnosed with two or more chronic illnesses is seven times more likely to experience depression than a person with a single illness.
Socioeconomic status has also been shown to be a strong predictor of the frequency of chronic illness and concomitant psychological stress, presumably because those with more financial and personal resources are better able to avoid chronic illness and are subsequently better able to adapt and do better. against any disease that may occur.
Psychological therapy can benefit patients suffering from chronic illnesses in an individual or group setting. For example, cognitive behavioral therapy focuses on the behavioral and cognitive response to pain. She attempts to educate on relaxation, mood management, and effective communication, in hopes of reshaping the patient’s maladaptive thoughts about her condition. Alternatively, operant behavior therapy uses positive reinforcement and punishment to alter behavior and thoughts related to the condition.
Interestingly, particular therapeutic approaches have shown the best effect when applied to psychological stress resulting from specific chronic sources. Complex or nonspecific regional pain is well suited to patients undergoing operant behavioral therapy, while those with more specific musculoskeletal pain are well suited to acceptance and commitment therapy, where participants are encouraged to find ways to fix the impediment.
Those who experience chronic illnesses that often impact quality of life in a way that cannot be avoided, such as cancer, arthritis, irritable bowel syndrome, or chronic migraine, are best treated with stress-reduction techniques based on mindfulness, which teach an “effortless” approach to pain management using breathing and meditation techniques.
A high incidence of anxiety and depression is also reported among close friends and family caregivers of those with chronic illnesses, originating from many potential sources. Those with chronic illnesses may be less able to work and provide income, are likely to express psychological strain through isolation or aggression, and may also pose a direct burden of care for loved ones, presenting psychological stressors for caregivers from multiple angles. In response, their lives are likely to change, having to take on more work to cover the shortfall or abandon their career altogether to provide care.
Therapeutic options to help relieve the psychological strain placed on caregivers also include various support groups and counseling options, most of which strive to foster acceptance through education related to the illness, discussion of how your loved one must be feeling experiencing the illness and preparing for future possibilities.
Physicians are also frequently affected by psychological stress, especially when working with people suffering from serious chronic or terminal illnesses, especially in pediatric cases. Possible consequences of the increasing psychological strain on doctors could include reduced work capacity and possible career dropout, depriving the healthcare industry of a trained professional. Most health authorities monitor the mental health of employees, with special sensitivity to those who work in positions involving high psychological stress and, in general, offer training related to the development of coping mechanisms.
Any chronic disease is life-changing, and people often fail to adjust to their new situation, leading to serious psychological stress. As medical interventions and health management improve around the world, a greater proportion of the general population is living longer and more frequently suffering from chronic diseases, such as arthritis, diabetes, and dementia, among many others. The cost of providing care is also amplified by psychological comorbidities that require treatment and can lead to additional conditions such as obesity.
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