Long-lasting health conditions such as heart disease, cancer, and diabetes are known to be the leading causes of premature death and disability in many countries in North America. For years, the World Health Organization(1) and the Pan American Health Organization(2) have correctly predicted the steady rise in those and other chronic conditions due to the effects of things like globalization and the growing middle class. These organizations have also indicated that long-term healthcare solutions must take a patient’s mental health, not just their physical symptoms, into consideration when deciding on a course of treatment.

In this article, we discuss the criteria that make a disease or illness chronic and how, if left untreated, it will affect a person’s mental health over time. We also offer helpful tips for those currently dealing with mental health issues related to a chronic condition, especially during the pandemic.

What is a chronic disease and/or illness?

A chronic condition tends to be persistent and long-lasting, with effects that compound over time, often lasting longer than twelve months.(3) One essential thing to know about chronic conditions is they can go unnoticed and untreated for long periods because they are hidden and affect patients internally, with a severity that increases over time. Patients with chronic conditions can be left feeling confused, frustrated and even hopeless in circumstances where their symptoms are very obvious to them but evade proper detection and diagnosis by their doctors. This can weigh heavily on the mental health of a chronically ill patient.

What effects do chronic diseases and/or illnesses have on mental health?

Eventually, a person who has been sick with a chronic condition will discover just how powerfully and fundamentally linked mental health and physical health is. They are twice as likely to develop depression and anxiety compared to those who are not chronically ill.(4) Having co-existing mental and physical conditions can and will diminish the quality of a person’s life throughout their illness, tending to end in longer durations of suffering and worse than average patient outcomes.(5)

Other common mental health conditions that are caused or affected negatively by a chronic condition include:

• Mood and anxiety disorders
• High levels of stress
• Changes in body image and self-esteem
• Poor self-care practices, which could lead to worsening physical symptoms
• Suicidality

Although the mental health outcomes of a chronically ill person can seem grim, there are many proven ways to manage both the physical and mental impacts of disease and improve their quality of life.

Tips on managing mental health when you have a chronic disease and/or illness

You don’t feel yourself when you’re in pain, in the middle of a flare-up, or just unable to engage in life the way you can without the chronic symptoms of your condition. Yet, there are identify-affirming and depression-lifting activities that can help. Pay attention to how you feel on a given day, and choose a tip below that suits your moods, needs, and energy level.

Physical exercise

Evidence from many studies shows us that regular exercise can improve a person’s mood. Walking is an excellent starter option, as it is free, locationally flexible, and can be done while socially distancing. You may prefer more adventurous activities like trail biking, rock climbing, or paddling on the water. Build a routine that incorporates various activities and consult with your doctor to ensure that the plan works with the chosen course of treatment without causing additional harm.(6)

Mindfulness or meditation

Studies suggest that just 10 minutes of quiet reflection, deep breathing, or guided imagery can not only relieve stress, but it can even increase one’s overall stress tolerance.(7) There are many guided meditation apps and videos available online, or you can make your meditation your own by listening to relaxing music, sitting in nature, or doing some light stretching as you meditate.

Serving others

For some people, purpose reveals itself through connections to others through serving them. Some seek meaning through spirituality and religious affiliation in their volunteering. You can explore whatever types of communities you value, like a cleanup program or a companionship program for ageing veterans.

Group and solo counselling

Your healthcare provider needs to know how you are feeling, both physically and emotionally.(8) Coping with a chronic condition can increase the stress of everyday life and affect your feeling of well-being. Depression and anxiety can make it challenging to manage and treat your condition. Your provider can help you explore the best way to address your feelings, which may include referrals for counselling, a social worker, a support group, or other vital support to cope with the challenges of a chronic condition.

Chronic conditions and COVID-19 considerations

The most current information suggests that older people with chronic conditions are at higher risk of developing more severe illnesses or complications. Patients at higher risk for COVID-19 complications include more senior people with chronic conditions such as diabetes, heart disease and lung disease. While most people with COVID-19 recover, those with chronic conditions are also at higher risk of death if they become ill.

Patients at higher risk for COVID-19 complications due to a chronic condition must take the same measures to avoid influenza, colds, and other diseases, such as washing their hands regularly and avoiding touching their face.(9) They must also avoid large gatherings and stay away from other people who are ill. Of course, the downside to this is that isolation from people and outdoor activities puts a person who is already sick at further risk of depression, anxiety, and other mental health conditions.

How to help those with a chronic disease and/or illness

If you are reading this because you are the friend or family of someone going through a chronic condition, know that you can do things to help.

Get informed.

The more you know about a chronic condition, the better equipped you’ll be to understand what’s happening to the person you care about and why. Direct your questions to the patient’s doctor or nurse to get the most straightforward answers about their diagnosis and course of treatment.

Perform mental and physical health check-ins.

Check-in on the person you care about regularly and try to notice any changes in the type or severity of the symptoms they are experiencing. Not only will this help you in empathizing with their struggle, but it should help you both get a clear idea of how they are reacting, physically and mentally, to their treatments.

Make a lifestyle change in solidarity.

Treatment for just about any chronic condition involves lifestyle changes — stopping smoking, losing weight, exercising more, and shifting to healthier eating habits. If you can, try to adopt those same changes to improve your health and show support for the person you care about who is chronically ill. It usually pays handsome dividends, ranging from feeling better to living longer.

Understand the symptoms of depression.

Dark, gloomy moods plague many people with chronic diseases and can hamper even a determined patient’s
best attempts to maintain their health. Knowing the signs of depression can equip you to intervene and disrupt
these feelings constructively and beneficially, including mood-lifting activities (as suggested in a previous section) or medication.

Prepare to talk frankly about end-of-life decisions.

The diagnosis of a chronic condition tends to make one come to terms with the idea of a premature death caused by the condition.(10) If you find yourself having conversations with the person you care about that focus on death and end-of-life decisions, do what you can to become informed about the processes behind things like do-not-resuscitate orders, funeral and burial arrangements and estate management. Although these are typically uncomfortable subjects, the patient deserves the peace of mind of controlling what happens if and when they do pass.

It is common for a person’s mental health to slip while dealing with chronic condition but it is essential to remember that not all chronic conditions lead to premature death. Many people can live long and fulfilling lives if they learn to manage the symptoms of their illness, which includes those connected to mental health and overall happiness. Temporary feelings of sadness are commonplace in cases of chronic conditions. Still, suppose these and other symptoms last longer than a couple of weeks. In that case, a person may need additional help from their healthcare professionals, family, and perhaps even their workplace to make coping with and enjoying life as easy as possible despite challenging circumstances. From physical activities to mentally stimulating challenges and even medications, there are many courses of action for someone who is facing a long-term condition that could diminish their mental health. When in doubt, refer to a healthcare professional for guidance on which activities will be the most and least beneficial depending on the specific diagnosis and the current status of the person’s health.

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References:

1. https://www.pwc.com/gx/en/industries/healthcare/emerging-trends-pwc-healthcare/chronic-diseases.html
2. https://www.paho.org/hq/index.php?option=com_content&view=article&id=1646:chronic-diseases-americas-fact-sheet&Itemid=40721&lang=en
3. https://www.cdc.gov/chronicdisease/about/index.htm
4. https://ontario.cmha.ca/document-category/mental-health-and-addictions-conditions/
5. https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml.
6. https://hss.mediasite.com/mediasite/Play/887b823f007045f48c6ca79f42411fe41d
7. https://www.sciencedaily.com/releases/2017/05/170501094325.htm
8. https://www.hss.edu/playbook/living-with-chronic-illness-top-10-tips-to-emotional-well-being/
9. http://www.bccdc.ca/health-info/diseases-conditions/covid-19/priority-populations/people-with-chronic-conditions
10. https://www.health.harvard.edu/staying-healthy/10-steps-for-coping-with-a-chronic-condition