Anxiety and Chronic Illness

by Jan E. Estrellado, Ph.D.

Chronic illness affects half of all adults (117 million) in the United States (Center for Disease Control, 2012). These conditions can include chronic pain, fibromyalgia, arthritis, heart disease, HIV, and cancer. While the types of conditions vary broadly, stress and anxiety are common experiences for individuals with long-term illnesses.  

The Stress of Having a Chronic Illness

Image source: https://massage.elitecme.com/blog/chronic-illness-massage-therapy/

Anxiety may result in part from the unpredictable nature of a chronic illness.  For example, a person with chronic pain will likely have some days when he or she can go for long walks and some days when getting out of bed is too challenging.  The tough part is not knowing when the bad days come.  The anticipation and fear of the pain, even more than the pain itself, is a better predictor of long-term functioning  (Turk, 2002). 

Because the experience of a chronic condition is specific to each individual, it can be difficult to feel connected to others.  Isolation is common, which can both disrupt relationships and intensify negative thinking (“No one understands what I’m going through,” “I have to take care of this on my own,” “I don’t want to burden my family,” etc.).  When those negative thoughts start to spin out of control, especially without the support of others, one’s ability to manage anxiety lessens.

For a child with chronic illness, fear and anxiety can be especially common.  The unpredictability of a chronic illness can shape how he or she views the world as an adult.  Knowing that caregivers cannot control discomfort or pain may be particularly terrifying for a young person.  A child may internalize the uncertainty of what life will look like with a chronic illness (“Will I still be able to go school,” “What will my friends think,” “Will I have to take medications forever,” etc.).

Managing Anxiety Related to Chronic Illness

Each person chooses how to manage his or her chronic illness in the best way possible with the resources they have.  An important step in managing anxiety related to chronic illness is to ask one’s self about the benefits, as well as the costs, of those choices.  For example, someone with heart disease may feel that by eating whatever he wants, he is in control of his life and that his condition does not exist.  But the stress of feeling ashamed or of disappointing others also takes its toll.  Being open and honest with one’s self about the pros and cons of choices is a crucial step to managing stress.  When a person can have this conversation with one's self, he or she might be more willing to ask if this choice supports the type of person he or she want to be.

Image source: http://www.huffingtonpost.com/2011/06/30/chronic-pain-13-americans_n_887749.htm

Another way to help manage anxiety about a chronic condition is to be as present as possible, even when it is difficult.  Calling attention to your thoughts, feelings, and bodily sensations in a non-judgmental way is the practice of mindfulness.  This can be especially difficult when what you think, feel, or experience is intense pain or discomfort.  However, a review of research showed that mindfulness-based practices can improve patient outcomes not just for chronic illness management, but also for depression and anxiety (Grossman, Niemann, Schmidt, & Wallach, 2004). 

If you have a family member with chronic illness, your support is very important.  A research review on the relationship between family support and chronic illness found that patients responded most positively when their families emphasized self-reliance and personal achievement, family cohesion, and responding attentively to symptoms (Rosland, Heisler, & Piette, 2012).  Continuing to reach out to your family member with a long-term condition can make a huge difference in their management of their illness. 

Living with a chronic illness is by no means easy.  Living well with a chronic illness, however, is possible.  With the right support and coping skills, individuals with chronic conditions can take concrete steps on the path of living with, but not being ruled by, long-term illness. 

CSAM is here to help

If you or someone you love might benefit from acceptance and commitment therapy (ACT), cognitive behavioral therapy (CBT), or biofeedback for anxiety, depression, stress, or a chronic medical illness, or if you would like more information about our therapy services, please contact us at (858) 354-4077 or at csamsandiego@gmail.com.

References:

Center for Disease Control (2012).  Chronic diseases: the leading causes of death and disability in the United States.  Retrieved from http://www.cdc.gov/chronicdisease/overview/.

Grossman, P., Niemann, L., Schmidt, S., & Walach, H. (2004).  Mindfulness-based stress reduction and health benefits: a meta-analysis.  Journal of Psychosomatic Research 57(1): 35-43.

Rosland, A.M., Heisler, M., & Piette, J.D. (2012).   The impact of family behaviors and communication patterns on chronic illness outcomes: a systematic review.  Journal of Behavioral Medicine 35(2): 221-39.  doi: 10.1007/s10865-011-9354-4.

Turk, D.C. (2002).  A diathesis-stress model of chronic pain and disability following traumatic injury.  Pain Research & Management, 7(1): 9-20.