Chronic Illness and Psychological Strain

A chronic illness is defined as a condition that lasts at least a year or more and requires ongoing medical attention or otherwise significantly limits daily activities.

Where the specific chronic illness causes constant or frequent pain and distress, the potential psychological impact is obvious.In many cases, pain relief may be administered long-term to such patients.

However, this strategy does not tackle the root cause of pain, and the continuous use of analgesics 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 illness may discourage engagement in social activities, exercise, and healthy sleep habits that are known to lead to psychiatric disorders such as depression.

Reduced physical activity, in turn, can enhance the probability of obesity and other physical health conditions, subsequently further promoting psychological strain and generating a negative feedback loop.

In cases of severe or terminal illness, the patient experiences additional psychological strains related to fear of dying, leaving their family and loved ones without them, and potentially greater financial pressures for them and their loved ones going forward.

Psychological co-morbidities are extremely common amongst those with chronic illness, with around half of those in England with mental health problems also experiencing some type of long-term condition, or 30% of those with a long-term condition also experiencing a mental health issue.

Chronic illness can induce adverse psychological symptoms in the population, though 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 as much as 100% when accounting for probable outcomes such as lower physical activity.

As may be expected, most studies show that the incidence of psychological illness increases when patients are experiencing multiple chronic conditions.

Data from the World Health Survey suggests that an individual diagnosed with two or more chronic conditions is seven times more likely to experience depression than a person with a single condition.Socio-economic status has also been shown to be a strong predictor of chronic illness frequency and psychological strain concomitance, presumably as those with more financial and personal resources are better able to avoid chronic illnesses and can subsequently better adjust to and cope with any illness that may occur.

Treatment of Psychological Chronic illness

Psychological therapy may benefit patients suffering from chronic illness in a one-to-one or group setting.

For example, cognitive behavioral therapy targets the behavioral and cognitive response to pain. It attempts to educate regarding relaxation, mood management, and effective communication, hopefully restructuring the patient’s maladaptive thoughts about their condition.

Alternatively, operant-behavioral therapy utilizes positive reinforcement and punishment to alter behavior and thoughts relating to the condition.

Interestingly, particular therapeutic approaches have shown the best effect when applied to psychological strain resulting from specific chronic sources.

Complex regional or non-specific pain is adapted to well by patients undergoing operant-behavioral therapy, while those with more specific musculoskeletal pain do well with acceptance and commitment therapy, where participants are encouraged to find ways to work around the impairment.

Any chronic illness is life-changing, and people frequently struggle to adapt to their new situation, resulting in severe psychological strain. As medical interventions and health monitoring improve worldwide, a greater proportion of the general population is living longer and incurring chronic illnesses more frequently, such as arthritis, diabetes, and dementia, among many others. The cost of providing care is also amplified by psychological co-morbidities that require treatment and may incur additional conditions.