Living with chronic illness does more than hurt your body. It causes emotional stress, increases mental fatigue, lowers energy levels, and causes muscle pain. Plus, it may even lead to depression or anxiety. Diseases like arthritis, fibromyalgia, and IBS can create a cycle of pain flare-ups and relapses that affect your emotional and mental state. Plus, they can knock your diet, exercise, and health goals way off-course. Here’s how chronic illness impacts your mental health, and what you can do about it.
What constitutes chronic illness or pain?
Chronic pain may show up in the form of significant injury, migraines, back pain, fibromyalgia, general arthritis, repetitive strain injury (RSI), Crohn’s Disease, or inflammatory bowel syndrome (IBS). Types of chronic illness include cancer, spinal injuries, diabetes, HIV, Parkinson’s, multiple sclerosis, chronic fatigue syndrome (CFS), rheumatoid arthritis, lyme disease, chronic obstructive pulmonary disease (COPD), and heart disease.
“Chronic pain is technically defined as pain that lasts longer than three months, although some may set the duration at six or 12 months,” explains Dr. Eddie O’Connor, a clinical and sport psychologist who specializes in chronic pain and rehabilitation, anda representative of the Association for Applied Sport Psychology (AASP). “It is pain that persists past the healing cycle. Chronic illnesses are illnesses that will not be cured or healed. People with chronic illness must learn to make management of their illness a part of their lifestyle.”
While chronic pain and illness are considered two distinct categories, they often go hand-in-hand. For example, if someone has fibromyalgia, they’re technically suffering from a chronic illness that creates ongoing pain. Additionally, constant pain or discomfort in your body during exercise can also lead to a chronic situation down the road. Or, it can exacerbate any current symptoms.
How does chronic illness or pain impact mental health?
“Often, people living with chronic pain or illness experience anxiety. [This is] because they are not sure exactly how severe their symptoms will be on a given day. This makes them worry about having to cancel plans or not be able to make commitments,” says Erin Dykhuizen, a Minnesota-based psychotherapist and clinical social worker who treats adults with chronic pain and trauma. “When someone is in the early stage of a chronic illness or chronic pain, anxiety can also come from not knowing what can trigger their symptoms. So, they end up avoiding a lot of activities, which then leads to depression. When we stop doing what we love to do, our mood suffers. The low mood then results in even less motivation to do what we love to do. It’s a vicious cycle.”
It interferes with positive thought processes.
Chronic pain can also directly impact your emotions, adds Dr. O’Connor. He says that depression related to a shift in function or identify is common. This could be the loss of a job, a shift in your ability to work, and compromised health. Or, it could even just be anxiety about the future. Researchers say the emotional components of chronic conditions are often overlooked. Plus, there’s a strong link between chronic diseases and psychiatric impairment. In fact, in two different studies of children, a chronic illness diagnosis either led to mental health issues or tripled the risk for such problems. Side effects of certain medications may also interfere with cognitive abilities, such as difficulty thinking clearly, notes Dykhuizen.
Mindfulness Coach Clarissa Hughes says chronic pain may lead to irritation, anger, sleeplessness, and substance abuse. Plus, it can also lead to symptoms such as rumination, magnification, and helplessness. She says that individuals suffering from chronic pain or illness might find themselves thinking negative thoughts. For example, “I can’t stop thinking about how much it hurts,” or, “I’m afraid that something serious might happen.” Or, they may feel hopeless and think, “There is nothing I can do to reduce the intensity of my pain.”
“Living with chronic pain can impact emotional well being,” agrees Therapist Mikela Hallmark. “Pain has a way of isolating people. It’s important for people living with chronic illness or pain to work to actively connect. [This] can be hard because of the physical and emotional challenges related to this.”
Does exercise hurt or help chronic pain or illness?
“Diet, exercise, and sleep are important for all of us. But when chronic pain is involved, they are even more important to provide the best foundation for health and recovery,” says Dr. O’Connor. “These have long been proven to improve not only physical health but mental and emotional health as well. [They] decrease the effects of stress and promote recovery.”
But some people worry that exercising will cause more pain, so they avoid working out entirely, says Physiotherapist Kulraj Singh. When that happens, a lack of exercise weakens and stiffens muscles. This can then increase pain symptoms overall.
“Often people with chronic pain develop a fear of movement,” agrees Dykhuizen. “This is understandable. We think that we are doing something to cause the pain when that is usually not the case. Most people, no matter how severe their pain is, can benefit from some form of exercise. And they also find that exercise helps their mood and pain. You may not be able to do everything you used to do for as long as you used to do it. But it’s important to continue to engage in exercise and activities you enjoy, even if it’s just for a short period of time.”
With respect to workouts, Aaptiv Trainer Mike Septh recommends addressing imbalances that contribute to bodily pain, which typically start in the feet, knees or hips. If you’re not sure which parts of your body need to be focused on, pay attention to any area where you feel discomfort or pain. From there, you can work with a physical therapist or personal trainer to treat symptoms, as well as identify the underlying cause.
What are some ways to help manage chronic illness or pain?
“From a nutrition standpoint, stay away from major inflammatories—gluten, alcohol, sugar, and red meat. Attempt to find more plant-based products,” advises Septh. “Stress management and quality sleep patterns are also two major factors in your body’s ability to decrease stress throughout your entire nervous and muscular system.”
You can also look at therapy and meditation to combat chronic pain. Both hone the power of the mind to treat chronic pain. Plus, they teach you skills to relax your mind and body, as well as cope. “Working with a therapist on adjusting to chronic illness and evaluating the factors in your life that you do have control over can be very helpful,” says Dykhuizen. “Therapy focused on connecting to your personal values also helps you come back to what is important in your life.”
And, if you seek professional help, says Dr. O’Connor, look for multidisciplinary treatment programs over pain relief only. The latter is certainly appropriate for some people for a specific period of time. But, in general, aim for a goal of restoring function to your body and managing emotional and physical pain. Also, focus on getting back to the types of activities you love best.
Above all, prioritize your own self-care and sense of community. “I’ve noticed that a big need for people living with chronic pain is to find a sense of hope and purpose,” says Hallmark. “So, if you’re dealing with chronic pain, make these items a priority. Find something to give to, someone to speak into, somewhere to show up. You may be limited because of the pain. So the things you do might need to be small, but keep doing them.”