The Balancing Act: Chronic Conditions and Mental Health

Key takeaways:

• Chronic physical conditions can spawn mental health concerns, like anxiety. But, there are ways to find a balance between getting help and being independent.
• One-on-one or group therapy can help. Experts also says you should know when you're burnt out and speak up.
• Caregivers should watch for signs that their loved one is struggling, such as not taking their medicine.

A chronic condition like diabetes, lupus, arthritis or brain fog is a lot to handle on its own. Doctor appointments, pill bottles, physical therapy and more might be your new normal.

So it’s not surprising that long term physical conditions can spawn mental health concerns.

“You can no longer do the things you used to do. Sometimes you can no longer work. Your identity is affected. That causes feelings of depression,” says Lea Anne Varble, a clinical psychotherapist who runs a chronic illness support group at OSF HealthCare in Alton, Illinois. “There’s also anxiety. People with certain illnesses get very anxious when they leave the house. They don’t know how it’s going to affect them in an hour.”

Luckily, Varble and other mental health professionals have ways that you and your loved ones can make the best of the situation and find the right balance of help and independence.

In one-on-one therapy, Varble says you’ll talk about making changes to your thoughts and actions to improve your mood.

“What you think determines how you feel, and how you feel determines your behavior,” Varble sums it up. “So if we can change the way someone is thinking about something, many times it changes how they feel about it. And then it changes how they address it and behave toward it.”

“What you think determines how you feel, and how you feel determines your behavior. So if we can change the way someone is thinking about something, many times it changes how they feel about it. And then it changes how they address it and behave toward it.

Lea Anne Varble, OSF HealthCare clinical psychotherapist

Varble says many of those same concepts are covered in group therapy. The benefit of a group is having a shared experience. You hear from others in your shoes, feel less isolated and become open to new ways of thinking.

“Maybe they all agree they can’t tell their family [about their struggles]. They won’t understand. Then the therapy part of the group is for me to challenge that. I’ll ask: How else can we think about this?” Varble says.

• Learn to be assertive and advocate for yourself.

“Speak directly. Communicate what your needs are. Maybe even argue for what you need,” Varble suggests.

She adds that after a long day of the daily grind while dealing with pain, perhaps the last thing you want to do is talk a lot. But it’s important to speak up. She gives the example of going for a medical procedure. It’s not wrong to tell your provider, “My anxiety and pain are bad today. Is there anything you can give me to calm me down before I go in the MRI machine?”

• Recognize that chronic illness burnout (physical, mental or emotional exhaustion that makes it difficult to navigate life) is real. Varble says constant doctor appointments and the logistics that come with them can wear you down.

“[Friends and family] should watch for the person not taking their medications, becoming more apathetic about taking care of themselves and isolating more,” Varble says.

“Burnout might be resolved by having someone in your circle make the appointments. Or give in and get a case manager who can do these things for you,” Varble adds. “Using resources doesn’t mean you’re not independent. It means we’re independent enough to know what resources to use.”

• Also for friends and family, “listening to their needs is always good,” Varble says. Offer to run an errand for the person struggling. Or propose a way for you to tackle the task together and let your loved one keep some independence.

“See how they innovate new ways of doing it. Encourage their creativity. Have them find their own resources,” Varble says. “They then build confidence.”

For example, if someone is dealing with pain flare ups while grocery shopping, they could explore “plan Bs.” Could I bring someone with me to help? (Varble says to frame this as a blessing of fellowship, not a burden.) Could I leave the store mid-trip? If so, what’s the plan to return the items to the shelves and get to the car? Or could I explore other ways to shop, like curbside pickup or delivery?

Learn more

Read more about healthy thoughts and behaviors on the OSF HealthCare website. If your mental health concerns have reached a crisis where you are thinking about harming yourself or others, talk to a trusted adult or mental health professional or go to the emergency department right away. The 988 Suicide & Crisis Lifeline is also available.

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