Mental Health Day 2023: Connection Between Mental Health And Chronic Illness
Mental Health Day 2023: Connection Between Mental Health And Chronic Illness
Dr Vaibhav Chaturvedi, Psychiatrist, Kokilaben Dhirubhai Ambani Hospital, Indore discusses the co-relation between mental health and chronic illness

Chronic illness (Alzheimer, Arthritis, Cancer, Chronic Kidney Disease, Cystic Fibrosis, Dementia, Diabetes is psychologically devastating to those who experiencing it and psychiatric disorders such as depression, anxiety and insomnia are more common amongst such patients. The rate of affective disorders amongst the diabetic and rheumatoid arthritis patient populations is around 25% and rising to over 30% amongst cancer patients, compared to rates of only 4-8% amongst the general population.

A high incidence of anxiety and depression is also reported amongst caregivers of patients. Having a chronic sickness or disease raises the risk of getting a mental illness because of the nature of these conditions, including increased hospitalization, excessive worry, or hormonal changes. The obstacles of navigating puberty are frequently greater for children and adolescents with chronic illnesses than for their healthy peers. Chronic conditions can have an impact on a person’s physical, cognitive, social, and emotional development as well as their parents’ and siblings’ health. Children and teenagers are more likely than their healthy peers to experience mental illness as a result of these restrictions. The psychological strain of providing care for persons with a chronic physical illness can be just as great for caregivers and doctors, who may have to watch a loved one or a large number of patients deteriorate over the course of years or even decades.

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.

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.

The ultimate impact on a person’s 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, may be more significant to the psychology of those experiencing chronic pain than the pain directly experienced. The underlying chronic physical illness may be the direct cause of psychological stress, as in the case of a lung infection that causes hypoxia and low mood, or the course of treatment for the underlying condition itself may result in psychological instability, as in cases where chemotherapy is more harmful than cancer or when taken steroids have an adverse effect on mood.

Chronically unwell children and adolescents deal with a variety of stresses. Parents and medical professionals should be alert for indications of adjustment difficulties, depression, and anxiety.   Patients with chronic illnesses may find psychological treatment helpful in a one-on-one or group environment. For instance, the behavioral and mental reactions to pain are the focus of cognitive behavioral therapy. In an effort to restructure the patient’s unhelpful thoughts about their disease, it makes educational endeavors in the areas of relaxation, mood management, and effective communication.

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

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