Psychology for chronic illness
Did you know that psychologists play a central role in supporting people not only with mental illnesses, but chronic physical conditions too?
Almost half of all Australians live with a chronic illness. Common chronic physical illnesses include arthritis, asthma, back pain, cancer, cardiovascular disease, chronic obstructive pulmonary disease (COPD), diabetes, chronic kidney disease and osteoporosis. Chronic illnesses differ in whether they are progressive (ie. get worse over time), constant (ie. stable but consistent over time), or episodic (ie. involve periods of stability following flare-ups). People living with a chronic illness will experience a wide range of emotional responses according to where they are in the phase of their illness – initial diagnosis, chronic ‘long-haul’ stage, or terminal.
These conditions are often invisible - meaning the symptoms aren’t observable by others – for example, pain or fatigue. The impact on an individual’s quality of life and identity can be devastating. Unfortunately, we also know that living with a chronic physical illness places people at much higher risk for developing a psychological condition like depression or anxiety. This article highlights some of the common challenges of living with a chronic illness, and how a psychologist can help.
Emotional challenges of living with a chronic illness
The mental load of living with a chronic health condition can quickly result in feelings of burn out, hopelessness, stress, shame, guilt and grief.
A person’s sense of self – their identity – can be severely challenged and impacted by chronic illness. 
The negative impact on work, study and finances can lead to feelings of frustration, stress, embarrassment and exhaustion.
Optimal ‘self-management’ of a chronic health condition can feel like a full-time job, leaving little time for enjoyable and meaningful activities.
Significant lifestyle changes are often required which can be overwhelming for the person and their families.
Lack of certainty about ever feeling better.
Relationships can be affected if loved ones aren’t supportive or understanding.
Experiencing invisible symptoms may lead to constantly feeling the need to explain, or withdrawing from activities to avoid explaining the impact to others.
It may be difficult to tell if mood fluctuations and emotional distress are features of the actual illness, or as a result of it.
How can a psychologist help?
Identify and target problems: Psychologists are experts in human behaviour. They can help people identify specific emotional, interpersonal, regimen or physician-related aspects of a condition that are impacting a person’s mood and/or quality of life. From there, psychological treatments can be tailored and targeted towards specific problems.
Promote positive adjustment to illness: Psychologists are trained to support people adjust and adapt to significant life events, whether this be a personal crisis, major unexpected event or diagnosis of an illness. This support ranges from processing the emotions associated with the diagnosis or experience of the illness itself, through to supporting people find new and meaningful activities consistent with their values and identity.
Support lifestyle modifications: Psychologists use a variety of strategies and approaches to support people set healthy lifestyle goals, track and monitor progress, and deal with relapses in effective ways.
Increase your self-awareness and sense of control: Psychologists teach skills and techniques to help people focus on what is within their control and change their relationship to things outside their control. Skills like mindfulness and reframing thoughts can be powerful tools in reducing emotional distress.
Make connections: Psychologists can assist people to access appropriate support groups (in-person or online) and recommend evidence-based self-help programs and apps which can reduce the emotional distress associated with living with various chronic conditions.
With support, it is possible to move from resentment or rejection of a chronic illness towards acceptance and even enrichment (ie. recognising how the illness has led to personal growth).
If you, or someone you care about, is struggling with the emotional burden of a physical illness, consider seeking the support of a professional as you navigate the impact on your life and sense of self.
B Psych (Hons), M Psych (Clin), MAPS
Lisa Abraham is a Clinical Psychologist at Clinical Therapy and also works in a diabetes outpatient service at a public hospital in Sydney. She has a special interest in health psychology - particularly the impact of chronic illness, body image issues and weight stigma on identity and psychological wellbeing.
References:  https://www.aihw.gov.au/reports/australias-health/chronic-conditions-and-multimorbidity  https://in.bgu.ac.il/en/fohs/communityhealth/Family/Documents/ShlavB/chronic%20illness.pdf  https://www.mja.com.au/journal/2009/190/7/depression-anxiety-and-their-relationship-chronic-diseases-review-epidemiology  https://journals.sagepub.com/doi/full/10.1177/1474515118811960