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The Relationship Between Chronic Illness and Mental Health

By Natalie Fraize, LMHC, LPC, as told to Alyson Powell Key

It's a two-way relationship. One can cause the other or make the other better or worse. If you have great mental health and you’re faced with a chronic illness, it could help protect you. If you're already struggling with something and you have a chronic illness, then it could make it worse. Depression and pain are strongly related.

Mental Health Conditions Linked to Rheumatoid Arthritis

Anything that causes pain -- which arthritis does -- can cause depression a lot of the time because pain takes a toll on mood.

Think of a toothache -- something a lot of people can relate to. You're really irritable or just don't want to be around anyone when you're in a lot of pain. Imagine these symptoms are prolonged and chronic. You think, “Will this ever stop? Will it ever get better?” Those kinds of thoughts are often associated with both depression and anxiety, two big things that we often see with any type of chronic illness, including arthritis.

With depression and anxiety, your thoughts start to get negative, and you have these unhelpful thinking patterns, imagining the worst things are going to happen or not being able to think of things getting better. That's pretty classic depression.

We also see a lot of behavior like isolating. When things are emotionally or physically painful, we often don't have the bandwidth to socialize with other people. Unfortunately, that just makes everything worse because we never have an experience that reminds us, “Actually, that's a really enjoyable thing for me.”

This happens a lot with arthritis and other chronic illnesses because those things don't physically feel as good anymore.

Signs That You or Someone You Know May Need Help

When looking at whether something is problematic mental health-wise, usually the standard I take across the board is, one, is it causing distress? Is that person suffering, or is whatever they're going through causing suffering for those around them?

The other part is impairment of functioning. That means, is your work life interrupted? What about your social life, your family life? If you’re experiencing high levels of distress or impairment in one or more areas of your life, it's probably a sign that something needs to change.

Managing Mental Health With Rheumatoid Arthritis

There are different ways that you can address these issues. Of course, as a therapist, I would push that aspect, but I really think therapy has to be the right fit for you.

Mindfulness is another thing that has a lot of scientific backing. You can find mindfulness meditation scripts for chronic pain -- either ones you can read and practice or recorded ones you can listen to. There are great mindfulness and meditation apps these days.

The idea is that if you can be focused on the present moment, you'll realize that every sensation, feeling, and thought we have changes from moment to moment. So even if something feels like it's not tolerable, that's OK because it's going to change. We tend to want to avoid noticing these things when they're happening because they're uncomfortable, but [mindfulness] really pushes you to do the opposite of that.

I know it's hard for people to buy into doing something different when you’re drained of energy from a chronic illness. And people often think of therapy as being this long, drawn-out process. Kind of like, “I'm already dealing with something that feels like it's never gonna end. I want a solution now.” But things like CBT (cognitive behavioral therapy) or mindfulness for chronic pain are going to get you some relatively quick results.

I would encourage people to see doctors they trust who line up with the things that are important to them because [managing mental health] is going to take a lot of effort. But there are ways to get things manageable so you can live a full and enjoyable life adapted to your new needs. It's just a matter of learning what those are and then getting the right resources.

Helping Others Help You

When you're bogged down, it's hard to pull yourself out enough to do research, to figure out, “Who would my insurance cover? Who do I even go to for this?” It's hard to take that step, so loved ones may be able to help. Then, just give them a list and try to help walk them through it if they need advice on how to call to make appointments. If you can do that, that's really valuable.

Helping Your Loved One

The other part is maintaining boundaries. When someone you love is struggling and needs emotional support, it's important to know your limit to be able to lovingly maintain those boundaries. You'll really want to help, and you'll find yourself going above and beyond. But if you push yourself too far or allow them to push you too far, you’ll feel resentful, which will change your relationship. So the best thing you can do is know your limit and find resources for anything beyond your scope. If they need help cleaning their home, look for housekeepers. If they need some financial assistance, look into aid programs.

Then just be whatever you normally were to that person before this condition. If you were good at being a distraction to them, continue to be that. Do whatever you know is important in your relationship. Just don't push yourself too hard because that will hurt your relationship.

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Photo Credit: Juanmonino / Getty Images


Natalie Fraize, LMHC, LPC, mental health counselor, Amherst, NY.