The chronic illness healthcare industry is expected to rise to a net worth of approximately ₹1,15,000 Crores by 2050 and the current net worth, as of 2023, hovers a little over ₹40,000 Crores. That is just a smidge from the immense strain that people suffering from chronic illnesses have to endure.
A bigger strain than this, however, is the psychological stress. It is a burden that most disregard when it comes to chronic illness. Chronic illnesses are majorly physiological, but it is also important to acknowledge the feelings of stress, guilt, shame, and dejection that chronic illness patients live with every single day. Hence, it is vital to understand the psychological implications of mental health in chronic illnesses.
Physiological and Psychology Health: A Co-dependent Balance
Dealing with a chronic disease every day means dealing with chronic pain every day. It has been established that chronic illnesses are very, very painful for most people. Hence, when it comes to such pain, emotional distress stands as a highly disruptive feature. This includes a lot of anxiety, frustration, guilt, anger, and a sense of prolonged sadness.
Emotions are major determinants of behavior which also dictate how one reacts to and deals with pain through neural syndicates and connections. Hence, while it is natural for one to acknowledge the sensory factor of pain, focusing on the emotional aspects of pain is also necessary since the pain is doubled by chronic and emotional pain.
Pain is fundamentally a survival signal sent to the brain which triggers its fight-or-flight response. This causes the brain to change physically and chemically. Physiologically, you will feel your heart rate increase along with your blood flow and other subjective reflexes will act up simultaneously.
For temporary pain, this physiological reaction will fade away once the pain has subsided. Now, imagine a chronic pain that never really goes away. Imagine a physiological reaction like this that stays with you every day.
The Pain Matrix
The pain matrix is a syndicate of neural pathways and parts of your brain that light up every time you experience pain. It includes the thalamus, inferior parietal lobe, superior temporal gyrus, cerebellum, middle and superior frontal gyri, anterior cingulate cortex, and primary/secondary somatosensory areas.
Hence, hormones such as pregnenolone, cortisol, and adrenocorticotropin are released. A surge of such extreme neurological and endocrine activity can give rise to irritability, fatigue, stress, anxiety, depression, etc. Hence, declining mental health due to a chronic illness is very common and must be taken seriously.
Your ability to understand, think, and decode external stimuli is part of your cognitive functions. Chronic illnesses and the pain that accompanies them can heavily affect your daily functions such as being able to think clearly, solve problems, focus, etc.
This is primarily due to the physical aspects of your brain and the functional aspects of your endocrine system that changes heavily as you deal with a chronic condition. Your neural pathways, cardiovascular systems, and sensory-motor functions are also affected greatly.
As discussed earlier, the feeling of chronic pain constantly keeps your fight-or-flight response active. The fight-or-flight response is driven by a sudden surge of hormones such as adrenaline and cortisol in presence of danger, be it external or internal. This primal response gives rise to feelings of anxiousness and panic in order to keep you alive.
It takes a lot for your body to deal with prolonged fear, anxiousness, and panic. It is physically taxing, moreover, to deal with pain. The immune system fighting for your life also requires a lot of energy. Hence, this consistent anxiety, racing heartbeat, elevated blood pressure, etc. can be beyond exhausting for the mind and body.
Evolutionally, depression can have a direct connection with chronic illnesses. As a hard-wired mechanism, suffering from an illness or ailment that limits our day-to-day lives as human beings is emotionally distressing and could lead to the feeling of hopelessness.
Moreover, the feeling of prolonged sadness could be a result of or the reason behind closing yourself from the rest of the world. This could be to deal with an illness in your safe space or due to the lack of energy to deal with the rest of the world.
Since the threat is internal, and not external, you could feel a huge lack of control over your situation. Any external threat can be dealt with by eliminating the threat over a short period of time. However, you may feel helpless when this primal threat is internal and can’t be vanquished for a long time.
The Psychosocial Impact: How Do Chronic Illnesses Impact Caregivers and Loved Ones
Even the caregivers of chronic illness patients under any given circumstances have to bear the brunt of stress and anxiety. If you are a caregiver or a loved one of the patient, you must feel like this anxiety, fear, and hopelessness never really goes away and is a constant unwelcome companion.
Many of you must have given up on careers, dreams, and aspirations to support the treatment and care of your loved one. This not only brings a heavy burden of guilt and regret, but it also carries with itself a lot of frustration and anger towards the world or oneself.
The psychological burden comes from all directions, right from financially supporting the patient’s treatment to personally caring for them on a daily basis.
When it comes to financial strain, health insurance plans can be a God-send. As caregivers, you could use such financial support instruments to better help your family or loved ones suffering from chronic illnesses. Not only can you claim monetary coverage or daily cash benefits but also access cashless facilities through your insurance plan. The health insurance TPA (Third-party Administration) will offer you an ID to present at a psychological or medical facility and you can access psychological help cashlessly, in a stress-free manner.
What You Can Do
Due to the lack of research surrounding this particular area of study, it is difficult for people to find various treatment options for those suffering from psychological problems due to a chronic illness. However, there are a few things you can do to bravely deal with the whirlwind in your mind.
- Psychological therapy
- Support groups
- Cognitive reframing
- Stress reduction programs
- Psychiatric therapy
Feeling like the world might come crashing down upon your diagnosis of a chronic illness is justified and it is okay to feel that way. Be it anxiety, paranoia, helplessness, depression, traumatic stress, anger, frustration, regret, or anguish, your emotions are valid. However, you must always stay strong, despite the trajectory of your condition not being under your control.
Remember that you are an alive, sentient being who has a long way to go, and that fighting these circumstances with courage can go a long way for you. Moreover, know that taking help from a psychological or psychiatric professional will help you deal with the psychological pain immensely. Always remember, you’re not alone.