What chronic health conditions are there? 

Autoimmune diseases 

This huge group of diseases includes rheumatoid arthritis , lupus, type 1 diabetes and psoriasis. For many of these diseases, the symptoms can be managed, but almost all are chronic conditions. 

Chronic gut problems

Inflammatory bowel disease (IBD), Crohns and colitis are painful, isolating chronic conditions that affect thousands of people. People with chronic gut problems may worry about how the disease affects their ability to live normally, and in some cases the condition might have already hospitalised or put their life at risk. 

Chronic pain

Fibromyalgia, chronic neck or back pain is isolating and restrictive. Pain and depression are closely correlated, and the risk of developing depression increases with pain symptoms. 

Cancer

A cancer diagnosis can be devastating, whatever stage a person is diagnosed at and whatever the prognosis. For many people, it will be the first life-threatening diagnosis they ever face, and will raise a host of feelings and thoughts – some of which will be hard to voice. Experts have also remarked on an increase in the risk of depression after successful treatment of cancer. 

Some therapists specialise in working with cancer patients (and some of those, chose to specialise after surviving cancer themselves).

Endometriosis

This painful gynaecological condition was for years misdiagnosed as psychosomatic, or as a mental health problem. Treatment can be aggressive, but leaving a person to suffer without a diagnosis can be equally brutal. 

Multiple sclerosis (MS)

MS is a degenerative autoimmune disease without a cure, and a diagnosis is life-changing. It is difficult to know how to cope with news of the condition, and it may be hard to share with loved ones. 

Polycystic Ovarian Syndrome (PCOS)

This chronic gynaecological condition affects fertility but often affects the way a person feels and looks. It can put pressure on relationships and marriages if one or both people in a couple is worried about difficulty getting pregnant. For women who aren’t ready to have children, it can create anxiety about the timeframe in which to decide and act quickly on what kind of family they want. Women with PCOS are at higher risk of depression and anxiety. 

How do chronic health conditions affect mental health? 

People with chronic health problems are at greater risk of developing mental health problems such as depression and anxiety. Some chronic health conditions can trigger anxiety disorders such as phobias or PTSD, particularly if a person has had a traumatic hospital stay or procedure. 

Am I depressed or anxious, or just sad about my chronic illness?

It would be unusual not to feel low or worried about a chronic health diagnosis, but if signs of depression or anxiety persist then a person might ask for extra support to cope with their mental health. 

Language around ‘survivorship’ and ‘fighting’ a chronic condition can create unnecessary pressure on people with chronic health diagnoses and their families. Doctors might expect patients to ‘rise above’ their feelings about diagnoses, updates, prognosis, procedures and treatment. Therapists help people with chronic conditions use their own language and perspective to describe their experience. 

How many people have chronic health and mental health problems? 

People with chronic health conditions also suffer from mental health problems. Risk of developing depression and anxiety varies according to chronic health diagnosis:

• Depression and anxiety affect up to 20% and 10% of patients with cancer respectively, across prognoses and time since diagnosis. 
• Crohn’s disease-specific post-traumatic stress is frequent.
• A 2016 study found the rates of depression in IBD patients are three times higher than in patients without IBD. 

What treatments are there for depression and anxiety with chronic health conditions? 

Therapy for patients with chronic health conditions

Psychotherapy is an ideal place to get help and support, and to share the experience of living with a chronic health diagnosis. Some therapists specialise in working with people who have a chronic health diagnosis. 

Medication to support mental health

Some people with depression related to their chronic illness respond well to taking antidepressants. They can take medication by itself, or combine it with therapy.

Developing new habits

There is growing evidence that there are some behavioural interventions that support the treatment of mild depression in people with chronic health conditions. Exercise, sleep, stress management and social interaction are all recommended during treatment or to manage symptoms.