CHRONIC ILLNESS

Chronic Illness is a condition that may be visible to others (such as paraplegia or a limb deficiency), be invisible to others (such as diabetes or inflammatory bowel disease), or have both visible and invisible manifestations (such as scleroderma or AIDS). It is a dynamic experience that includes physical and/or psychological problems caused by the condition. The person may also experience psychological stress imposed by society because of how the condition is viewed by them.[1] Moreover, Depression and Suicidal Ideation usually occurs with Chronic Illness.[2]

Chronic Illness includes Conditions such as:

  • Heart Disease: An abnormal condition of the heart and circulatory system (e.g. coronary heart disease).[3]
  • Stroke: A sudden impairment or loss of consciousness, sensation, and voluntary movement caused by a rupture or an obstruction in a blood vessel supplying the brain.[4]
  • Cancer: A serious and sometimes deadly disease that is characterized by the growth of abnormal cells that form tumors. These tumors may damage or destroy normal body tissue.[5] Pain can be caused by tumors and cancer treatments (chemotherapy and radiation).[6]
  • Chronic Respiratory Diseases: A diseases of the airways and other structures of the lung. Includes conditions such as Chronic Obstructive Pulmonary Disease, asthma, occupational lung disease, and pulmonary hypertension.[7]
  • Diabetes: A disease where too little or no insulin is produced in the body. It also occurs when insulin is produced but cannot be used, resulting in high levels of sugar in the blood.[8]
  • Asthma: A lung disorder that causes periods of wheezing, coughing, and difficulty breathing.[9]
  • Chronic Ulcers: A long-standing painful sore in the lining of the stomach that is slow to heal.[10]
  • Irritable Bowel Syndrome: A chronic functional disorder of the colon that is characterized by constipation or diarrhea, cramping abdominal pain, and mucus in the stool.[11]
  • Other Chronic Pain Issues: Pain that persists past the normal healing time – usually lasts or recurs for more than 3 to 6 months.[12]

Canadian Statistics

  • Sixty-five percent of all deaths in Canada are caused by major Chronic Illnesses, such as Cardiovascular Diseases, Cancer, Chronic Respiratory Diseases, and Diabetes.[13]
  • More than one in five Canadian adults is living with one Chronic Illness: Cardiovascular Diseases, cancer, Chronic Respiratory Diseases, or diabetes.13
  • In 2011, an estimated 2.3 million Canadians were living with Ischemic Heart Disease. Almost 2 million were also living with Chronic Obstructive Pulmonary Disease and about 700,000 were living with the effects of stroke.13
  • Cancer is the leading cause of death with 800,000 Canadians diagnosed in 2009. Nearly 90% of them were aged 50 years or older.13
  • Four in five Canadian adults have at least one modifiable risk for Chronic Illness: self-reported tobacco smoking, physical inactivity, unhealthy eating, and harmful use of alcohol.13
  • About 2.7 million Canadians are now living with diabetes.13
  • A high prevalence of asthma, Chronic Obstructive Pulmonary Disease, Ischemic Heart Disease, diabetes, and hypertension was observed among people who used health services for Mood and Anxiety Disorders. These individuals attended appointments with physicians; community-based clinics; psychologists, social workers, and counsellors; and psychiatric hospitals.[14]

Behaviours associated with Chronic Illness:13

  • Smoking
  • Lack or inadequate amount of physical activity such as walking, housework, or exercise.
  • Sedentary behaviour (long periods of sitting)
  • Unhealthy eating
  • Harmful use of alcohol
  • Isolating self from others and withdrawing from social activities

Feelings associated with Chronic Illness:[15],[16]

  • Depression
  • Low self-efficacy
  • Psychological distress
  • Hopelessness
  • Anxiety
  • Fear

Thoughts associated with Chronic Illness:

  • “I will never get better. There is no hope for me anymore.”
  • “I don’t want to do anything or see anyone.”
  • “I am useless. I cannot do anything by myself.”
  • “Why did this have to happen to me? Why do I have to suffer like this?”

Chronic Illness and the Body:15

Each type of Chronic Illness has a specific set of symptoms but typically, people who suffer from Chronic Illnesses experience one or more of the following symptoms:

  • Fatigue
  • Shortness of breath
  • Pain
  • Low energy
  • Functional impairment or disability;
  • Coughing

Chronic Illness and the Brain:

Research shows that Chronic Illnesses and Mental Illnesses have one factor in common: inflammation. Difficult life experiences and stress in early life lead to an increase in inflammation in the body (there is an increase of IL-6 protein and C-reactive protein), which leads to a breakdown of serotonin (or the “happy chemicals” in the brain) and triggers an increase in toxic chemicals in the brain (nitric oxide, quinolinic acid, and kynurenic acid). Resultantly, a person develops a dysfunction in the brain and subsequent Depression and/or Anxiety.[17],[18]

Does Psychology Work?

  • Mindfulness Therapy (MT): Research shows that MT is beneficial for the psychological and psychosocial issues encountered by people suffering from Chronic Illness. It appeared to be effective in improving Depression, Anxiety, and Stress.[19] Attention is brought to the experience of symptoms, which subsequently leads to positive changes in the physiological, emotional, cognitive, and behavioral areas.[20]
  • Somatic Therapy: Research shows that Somatic Therapy helps treat people who are experiencing cognitive, sexual, physical, emotional, and existential problems, and has been successfully used for suicide prevention. Somatic Therapists use body focus techniques to help people work through the negative sensations and experiences that they are experiencing and perceiving.[21]
  • Emotionally Focused Couples and Family Therapy (EFT): Research on cardiovascular disease, stroke, cancer, and arthritis show that systematic interventions, such as EFT, lead to significantly better physical health for patients and better physical and mental health for both patients and their family members. Interventions like EFT provide psycho-education about chronic illness and how to manage it, enhance support for the person with Chronic Illness and other family members, and explore ways of coping with the condition and how it impacts the family.[22]

Tips to Help Manage Chronic Illness!16

It is indeed challenging to live with a Chronic Illness and here are a few tips on how to manage and live with this condition:

  • Focus on illness needs. It is important to acquire skills and abilities as well as undergo activities to manage the illness. Learn as much as you can about the condition, develop strategies to manage illness tasks, and take ownership of health needs.
  • Activate resources. Identify and access various resources to support self-management efforts; such as health care, social, spiritual, and community supports. Using these resources also means that you would have to create and maintain relationships with providers and learn to navigate the healthcare system.
  • Living with a Chronic Illness. Living with a Chronic Illness also involves recognizing the emotional responses to living with a persistent illness and developing strategies to integrate the illness into daily life. Part of this process is identifying and expressing emotions, as well as grieving the loss of health, sense of self, and finding meaning in the illness experience.

Chronic Illness is a condition that may last a person’s lifetime and changes the person’s capacity and functioning tremendously. These conditions take away the person’s independence and sense of control in his or her life and this may lead him or her to experience Depression, Stress, or Anxiety. At Hopewell Psychological, people suffering from Chronic Illness are provided with therapies that are tailored to your specific needs and help you address the mental health issues and unhealthy behaviours that may worsen the chronic health condition. Additionally, we can help you address your important relationships because we know that the relationships can suffer when one of you is experiencing a long-term Chronic Illness.

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*Psychologists are covered under Insurance Companies in Canada. You will need to check with your insurance company about the specific details regarding your coverage.

References

[1] Joachim, G., and Acorn, S. “Living with Chronic Illness: The interface of stigma and normalization.” Canadian Journal of Nursing Research 32.3 (2000): 37-48. http://cjnr.archive.mcgill.ca/article/view/1589/1589.

[2] Erlangsen, Annette, Stenager, Elsebeth, and Conwell, Yeates. “Physical Diseases as Predictors of Suicide in Older Adults: A nationwide, register-based cohort study.” Social Psychiatry and Psychiatric Epidemiology 50.9 (2015): 1427-1439. DOI: 10.1007/s00127-015-1051-0

[3] “Heart disease.” Merriam-Webster. 2017. Web. Accessed May 2017.

[4] “Stroke.” Merriam-Webster. 2017. Web. Accessed May 2017.

[5] “Cancer.” Merriam-Webster. 2017. Web. Accessed May 2017.

[6] “Causes and Types of Cancer Pain.” Cancer Research UK. 2015. Web. Accessed 2017.

[7] “Chronic Respiratory Diseases.” World Health Organization. Web. Accessed May 2017.

[8] “Diabetes.” Merriam-Webster. 2017. Web. Accessed May 2017.

[9] “Asthma.” Merriam-Webster. 2017. Web. Accessed May 2017.

[10] “Ulcer.” Merriam-Webster. 2017. Web. Accessed May 2017.

[11] “Irritable Bowel syndrome.” Merriam-Webster. 2017. Web. Accessed May 2017.

[12] Treede, R. D., Rief, W., Barke, A., Aziz, Q., Bennett, M. I., Benoliel, R., Cohen, M., Evers, S., Finnerup, N. B., First, M. B., Giamberardino, M. A., Kaasa, S., Kosek, E., Lavand’homme, P., Nicholas, M., Perrot, S., Scholz, J., Schug, S., Smith, B. H., Svensson, P., Vlaeyen, J. W. S., and Wang, S. J. “A classification of chronic pain for ICD-11.” Pain 156.6 (2015): 1003-1007. DOI: 10.1097/j.pain.0000000000000160.

[13] Public Health Agency of Canada. “How Healthy Are Canadians? A trend analysis of the health of Canadians from a healthy living and chronic disease perspective.” Government of Canada. 2017. Print.

[14] Public Health Agency of Canada. “Report from the Canadian Chronic Disease Surveillance System: Mood and anxiety disorders in Canada, 2016.” Government of Canada. 2016. Print.

[15] Brady, T. J., Murphy, L., O’Colmain, B. J., Beauchesne, D., Daniels, B., Greenberg, M., House, M., and Chervin, D. “A Meta-Analysis of Health Status, Health Behaviors, and Health Care Utilization Outcomes of the Chronic Disease Self-Management Program.” Preventing Chronic Disease. 10. (2013). E07. DOI: 10.5888/pcd10.120112.

[16] Novak, M., Costantini, L., Schneide, S., and Beanlands, H. “Approaches to Self-Management in Chronic Illness.” Seminars in Dialysis 26.2 (2013): 188-194. DOI: 10.1111/sdi.12080.

[17] Slavich, G. M., and Irwin, M. R. “From Stress to inflammation and major depressive disorder: A social signal transduction theory of depression.” Psychological Bulletin 140.3 (2014): 774-815. DOI: http://dx.doi.org/10.1037/a0035302

[18] Bratek, A., Zawada, K., Beil-Gawelczyk, J., Beil, S., Sozanska, E., Krysta, K., Barczyk, A., Krupka-Matuszczyk, I., and Pierzchala, Wladyslaw. “Depressiveness, symptoms of anxiety and cognitive dysfunctions in patients with asthma and chronic obstructive pulmonary disease (COPD): Possible association with inflammation markers: A pilot study.” Journal of Neural Transmission 122.1 (2015): 83-91. DOI: 10.1007/s00702-014-1171-9.

[19] Abbott, Rebecca A., Whear, Rebecca, Rodgers, Lauren R., Bethel, Alison, Coon, Jo Thompson, Kuyken, Willem, Stein, Ken, and Dickens, Chris. “Effectiveness of Mindfulness-Based Stress Reduction and Mindfulness Based Cognitive Therapy in Vascular Disease: A systematic review and meta-analysis of randomised controlled trials.” Journal of Psychosomatic Research 76.5 (2014): 341-351. https://doi.org/10.1016/j.jpsychores.2014.02.012

[20] Phillips, Deborah, and Pagnini, Francesco. “A Mindful Approach to Chronic Illness.” The Wiley Blackwell Handbook of Mindfulness. UK: John Wiley & Sons, Ltd., 2014. Print.

[21] Bloch-Atefi, Alexandra, and Smith, Julie. “The Effectiveness of Body-Oriented Psychotherapy: A review of the literature.” Psychotherapy and Counseling Journal of Australia. 2015. Web. Accessed May 2017.

[22] Carr, Alan. “The Evidence Base for Couple Therapy, Family Therapy and Systematic Interventions for Adult-focused Problems.” Journal of Family Therapy 36. (2014): 158-194. doi: 10.1111/1467-6427.12033

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