Many of the clients I have seen over the years have a diagnosed chronic illness, including Crohn’s/IBS, multiple sclerosis, cystic fibrosis, diabetes, Lyme Disease, and many others. Coping with the physical difficulties of an illness is often accompanied by emotional and psychological distress.
According to the Cleveland Clinic, up to one-third of patients with chronic medical issues experience depression. In the case of multiple sclerosis, for example, the National Multiple Sclerosis Society reports that clinical depression occurs more frequently among patients with MS than any other chronic condition.
Many chronically ill clients with whom I have worked have struggled with depression and anxiety. The emotional difficulties experienced by some clients may be caused by physical pain, financial stress, frequent doctor visits, and even by some medications.
For many, the basic activities of life can become a struggle: cooking a meal, doing the laundry, or going to the grocery store are common routines that become difficult.
The need to ask for help with simple chores can also create a deep feeling of depression.
Closely linked with depression is loneliness. According to Elizabeth Aram, PsyD, loneliness affects all human beings, no matter what their race, gender, culture, religion, or socioeconomic status is, and no matter their physical state.
The American Psychological Association (2017) states that loneliness and social isolation today are becoming a greater health hazard than even obesity. Chronic illness with its accompanying symptoms, can aggravate feelings of loneliness.
Jenny Lelwica Buttachio author of Long-Term Loneliness: The Hidden Suffering of the Chronically Ill (2018)) states that to effectively navigate through feelings of loneliness, it takes commitment, self-care, and a willingness to step out of one’s comfort zone and try something new.
There are a number of ways to combat these negative feelings. According to Paul Greene, author of Living with Chronic Illness, the first step is to accept what you can’t change and then change what you can.
These two concepts may seem simple, but they require great thoughtfulness and dedication, and often, outside help.
In terms of accepting what you cannot change, Greene states that utilizing your doctor - not just for physical help but as a resource for guidance about an illness (e.g. understanding and adjusting expectations and focusing on what you can do) - is important. Gaining a feeling of control over your illness, instead of letting it control you, can be very empowering.
For example, your doctor can explain behavioral changes you can make on your own: exercising, modifying your diet, and complying with medication are just three examples.
Navigating these feelings of depression and loneliness can also be helped by psychotherapy. There are several avenues to explore, and patients who wish to have professional help can decide which one appeals most to them.
Talk therapy is an unstructured approach to therapy that gives patients the opportunity to verbalize the emotional impact of the illness on them and others in their life (family, friends, spouses). Cognitive behavioral therapy is a solution-focused approach to therapy that helps to identify negative feelings related to coping with illness and teaches patients strategies to help shift these negative thoughts (e.g. re-framing). Family/couples therapy can help explore how a change of routines, lessening intense emotions, and maintaining normalcy within family life can be helpful.
According to the American Association for Marriage and Family Therapy, having the patient’s medical provider present at the meetings might clarify the treatment and expectations of the patient’s future functioning.
It is clear that patients with chronic illnesses often need emotional and psychological help, in addition to their medical care, in order to achieve maximal well-being.