Overview
Many people are living with chronic health conditions, but few are aware that their illnesses could have mental health implications. Physical-mental health issues often coexist as a prevalent global public health problem, affecting around one in three individuals with multiple health conditions[1]. More importantly, the presence of both types of conditions often leads to a complex interplay of symptoms that can accelerate health decline and increase the likelihood of premature death[2].
What Is Chronic Illness?
A chronic illness is a medical condition that lasts for a year or more. It requires ongoing medical attention and has the potential to significantly limit daily activities if not managed properly. When a person experiences persistent pain or physical discomfort caused by a specific chronic illness, the individual is likely to develop feelings of grief and sadness following the diagnosis[3]. Chronic diseases include, but are not limited to, diabetes, cancer, heart disease, HIV/AIDS, Alzheimer’s disease, arthritis, and stroke.
According to the World Health Organization (WHO), chronic diseases affect all people of all ages, backgrounds, and countries. Rapid, unplanned urbanization, the globalization of unhealthy lifestyles, and an aging population are the main factors contributing to the development of chronic illnesses[4]. The projected global cost of chronic diseases is anticipated to reach $47 trillion by 2030[5]. Among the chronic illnesses, heart attack, Parkinson’s disease, chronic pain syndromes, cancer, and diabetes tend to be associated with a higher depression risk, ranging from 25% to 65%[6] [7].
Depression Is A Common Complication of Chronic Illness
People diagnosed with chronic diseases are more likely to develop depression. It is estimated that up to one-third of individuals with a serious medical condition exhibit symptoms of depression, making it one of the most common complications of chronic illness.
Unlike acute illnesses, chronic conditions often can’t be completely cured, requiring patients to adopt ongoing management strategies to maintain their quality of life. The constant need for medical attention and lifestyle adjustments can be overwhelming, leading to significant mental health challenges. Below are the reasons why chronic illness may lead to depression[8] [9] [10]:
- Health Management Stress. Managing health tasks (medication, exercises) can lead to stress and frustration.
- Social Isolation and Stigma. Illness may limit physical mobility that can restrict social activities, leading to loneliness and feelings of alienation. Stigma surrounding visible symptoms can further diminish self-esteem.
- Medication Side Effects. Treatments (e.g., steroids, chemotherapy) may cause mood changes, anxiety, or depression, complicating overall health management.
- Changes in Self-Image. Physical changes from illness can negatively affect self-image, resulting in social withdrawal.
- Work Limitations and Financial Strain. Chronic illness may require adjustments in work, leading to financial difficulties if unable to work.
- Household Burden and Role Reversal. Homemaking tasks may take longer, necessitating help and causing a loss of control. Families may experience role reversals as responsibilities shift.
- Accumulated Stress. Prolonged stress of chronic illness can lead to feelings of hopelessness and depression, affecting both the individual and their family members.
Challenges of Co-existence of Physical and Mental Health Conditions
Individuals with both physical and mental health conditions often face compounded challenges. Chronic pain can worsen mental health, while mental health issues can hinder self-care, creating a vicious cycle.
One significant hurdle is that physical and mental health conditions frequently share similar symptoms, such as unexplained fatigue, weight gain, and difficulty concentrating. This can make diagnosis particularly challenging, especially when mental health issues can mask or complicate underlying physical problems[11].
Chronic illness patients often struggle to get depression treatment due to lack of physician training, unawareness of mental health conditions, and stigma. Even specialists may lack understanding of the specific challenges faced by those with chronic illnesses. This necessitates an integrated approach addressing both conditions[12].
Depression Awareness Is Key to Combating Comorbidity
While the connection between chronic illness and mental health is well-documented, many people remain unaware of it. For those living with a chronic condition, understanding the symptoms of depression is key to preventing physical and mental health problems from worsening. Below are the primary symptoms of depression. Keep in mind that not everyone experiences all of these symptoms. If you’re experiencing several of these symptoms for two weeks or more, it’s advisable to consult with your physician.
Emotional Symptoms
- Persistent sadness
- Feelings of hopelessness or pessimism
- Feelings of guilt or worthlessness
- Irritability or increased anger
- Loss of interest in activities once enjoyed
- Difficulty concentrating or making decisions
Physical Symptoms
- Changes in appetite (increased or decreased)
- Changes in sleep patterns (insomnia or excessive sleep)
- Fatigue or low energy
- Unexplained aches and pains
Prevention Strategies for Comorbidity
Living with a chronic physical illness often involves enduring persistent symptoms such as pain and fatigue, which can create physical limitations that affect daily life and work. Additionally, individuals with chronic illnesses frequently face frustration from the unpredictability of their conditions, leading to emotional distress and withdrawal from social activities. To address the interplay between physical and mental health conditions, it is crucial to adopt protective strategies for managing comorbidity. Here are some preventive strategies for your consideration:
- Health Management Stress. Managing health tasks (medication, exercises) can lead to stress and frustration.
- Social Isolation and Stigma. Illness may limit physical mobility that can restrict social activities, leading to loneliness and feelings of alienation. Stigma surrounding visible symptoms can further diminish self-esteem.
- Medication Side Effects. Treatments (e.g., steroids, chemotherapy) may cause mood changes, anxiety, or depression, complicating overall health management.
- Changes in Self-Image. Physical changes from illness can negatively affect self-image, resulting in social withdrawal.
- Work Limitations and Financial Strain. Chronic illness may require adjustments in work, leading to financial difficulties if unable to work.
- Household Burden and Role Reversal. Homemaking tasks may take longer, necessitating help and causing a loss of control. Families may experience role reversals as responsibilities shift.
- Accumulated Stress. Prolonged stress of chronic illness can lead to feelings of hopelessness and depression, affecting both the individual and their family members.
Final Thoughts
Living with a chronic illness can feel isolating, but it’s a shared experience that many navigate. Embracing this journey means acknowledging both the physical and emotional challenges you face. By seeking support and understanding the profound connection between mind and body, you can empower yourself to thrive.
Sources:
- Barnett, K., Mercer, S. W., Norbury, M., Watt, G., Wyke, S., & Guthrie, B. (2012). Epidemiology of multimorbidity and implications for health care, research, and medical education: a cross-sectional study. The Lancet, 380(9836), 37–43. https://doi.org/10.1016/s0140-6736(12)60240-2
- Momen, N. C., Oleguer Plana-Ripoll, Esben Agerbo, Christensen, M. K., Kim Moesgaard Iburg, Thomas Munk Laursen, … McGrath, J. J. (2022). Mortality Associated With Mental Disorders and Comorbid General Medical Conditions. JAMA Psychiatry, 79(5), 444–444. https://doi.org/10.1001/jamapsychiatry.2022.0347
- The Intersection of Mental Health and Chronic Disease | Johns Hopkins Bloomberg School of Public Health. (2021, December 16). Retrieved October 9, 2024, from Johns Hopkins Bloomberg School of Public Health website: https://publichealth.jhu.edu/2021/the-intersection-of-mental-health-and-chronic-disease
- Noncommunicable diseases. (2023, September 16). Retrieved October 11, 2024, from Who.int website: https://www.who.int/news-room/fact-sheets/detail/noncommunicable-diseases
- Hacker, K. (2024). The Burden of Chronic Disease. Mayo Clinic Proceedings: Innovations, Quality & Outcomes, 8(1), 112–119. https://doi.org/10.1016/j.mayocpiqo.2023.08.005
- Chronic Illness and Depression: Causes, Symptoms, Treatment. (2023, August 15). Retrieved October 11, 2024, from Cleveland Clinic website: https://my.clevelandclinic.org/health/articles/9288-chronic-illness-and-depression
- WebMD. (2022, August 28). Dealing With Chronic Illnesses and Depression. Retrieved October 11, 2024, from WebMD website: https://www.webmd.com/depression/chronic-illnesses-depression
- Same as 6
- Long-term physical conditions and mental health. (2022). Retrieved October 11, 2024, from Mental Health Foundation website: https://www.mentalhealth.org.uk/explore-mental-health/a-z-topics/long-term-physical-conditions-and-mental-health
- Greenwood, M. (2022, November 8). News-Medical. Retrieved October 11, 2024, from News-Medical website: https://www.news-medical.net/health/The-Psychological-Strain-of-Chronic-Physical-Illness.aspx
- The Relationship between Mental Health, Mental Illness and Chronic Physical Conditions. (2021). Retrieved October 12, 2024, from Cmha.ca website: https://ontario.cmha.ca/documents/the-relationship-between-mental-health-mental-illness-and-chronic-physical-conditions/
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