DEPRESSION / MARITAL CONFLICT / ANXIETY / STRESS / CHRONIC ILLNESS

COPING WITH CHRONIC ILLNESS

Factors Contributing to the Onset of Illness

The Biopsychosocial Model demonstrates that biological, psychological, and social factors contribute to health and to the onset and treatment of most diseases.
A Positive Attitude towards one's life and having mind and body in balance significantly promote health.
Unhealthy Lifestyle Choices and negative attributions about an illness can have a negative impact on the outcome of the illness.
Chronic Stress results in the release of chemicals in the brain, which over time can suppress the immune system and contribute to the onset of illness.
Biological Factors such as genetic predisposition, physiological changes, injury, toxic exposure, and infection can contribute to the onset of an illness.
Psychological & Social Factors can also contribute to the onset of an illness:

Behavioral Factors include exercise, diet, sleep & substance abuse
Cognitive Factors include perceptions, attributions, & values
Emotional Factors include conscious and unconscious emotional states, stress, & psychological disorders
Spiritual Factors include sense of purpose and beliefs about a higher power
Sociocultural Factors include family & social support, economic status, ethnicity & gender

Coping with a chronic illness can worsen pre-existing emotional problems or lead to the development of new problems such as anxiety, depression, work & relationship issues, cognitive & sleep disorders, anger, fear and shame.

Psychotherapy for Chronic Illness

Psychotherapy can be an essential part of an individual's ability to develop coping mechanisms for, and eventual recovery from, a chronic illness.
Disease Type, Severity & Course will have an impact on the course of treatment and interventions which a therapist chooses. A chronic illness can have or a mild and relatively stable course, a moderate with waxing and waning course, or a progressively deteriorating and debilitating course.

Crisis Phase of Illness: Emotional Chaos

In the Crisis Phase, the onset of a chronic illness often triggers a crisis, and individuals often seek relief through medical diagnosis and treatment, spiritual help, or substance abuse. Family members, colleagues, and friends may respond with disbelief or even rejection.
Denial of Illness is a coping strategy which allows an individual time to adjust to the painful realization that his or her life may never be the same. Denial may mean avoiding prescribed medications, diets, or treatments or hiding one's diagnosis from others. If denial persists, however, it prevents individuals from getting necessary medical treatment and learning adaptive coping skills.
Dealing with Emotional Issues associated with the new illness is essential. It is important to express emotions such as anxiety, frustration, anger, depression, or shame about being chronically ill. Some individuals feel that their bodies have let them down and feel a loss of control because they are unable to work, relationships become strained, and they feel physical discomfort or pain.
Avoid Negative Thoughts such as, "I'm an incomplete person", "I'll never get better", or "My life is worthless." It is also important to build hopefulness about the possibility of improving, recovering, or learning to cope with one's illness.

Stabilization Phase of Illness: New Coping Mechanisms

In the stabilization phase, a plateau of symptoms is reached and individuals become familiar with their illnesses. This can remind an individual of his or her pre-illness "normal life", and he or she may feel a false sense of relief leading to a return to pre-illness activity levels and possible relapses and feelings of failure.
Illness Acceptance entails developing more accurate and positive perceptions of one's illness and taking charge of managing one's illness.
Educating Family Members who may be in denial about an individual's chronic illness is essential. Healthy spouses may not accept the ill spouse's illness, conflict can arise, and this must be dealt with so that the healthy spouse can accept the illness and help the ill spouse engage in health promoting activities.
Pacing is essential in the recovery process in order to stop periods of over-activity alternating with periods of exhaustion. Balancing activities with relaxation and setting limits will result in more stable energy levels and fewer illness relapses.
Relaxation Skills such as progressive relaxation, hypnosis, meditation, guided imagery, and biofeedback can improve one's health and help with coping.
Exercise can also help an individual feel better about his or her body, and non-strenuous activities like walking, light swimming, or yoga can be helpful.

Resolution Phase of Illness: New Sense of Self

In the resolution phase, an individual has experienced symptoms and relapses and has come to accept that he or she has an illness with identifiable patterns. There is greater acceptance that the pre-illness life will not return.
Mourning parts of one's life that have been lost is key because chronic illness can strip an individual of most of his or her customary ways of deriving self-esteem, pleasure, and mastery.
Accepting that one's body may never be the same and that there will be changes in one's work, social, and recreational lives is essential.
Develop new sources of self-worth and life satisfaction by trying new activities that are not restricted by one's illness, such as: gardening, getting a pet, listening to books on tape, writing, drawing, or enjoying nature, art or music.

Dealing with Integration Phase of Illness: Creating a New Lifestyle

In the integration phase, an individual integrates parts of the old self into the new self. The task in this phase is to return to some form of work if possible, to create a support network, and to integrate one's illness within a spiritual framework. The goal is to achieve the highest degree of wellness that is possible knowing that an illness is only one aspect of a person's life.
Social support is very important for medically ill individuals. Good friends are the ones who are willing to alter the relationship and be flexible with plans to meet an ill person's needs. It is good to plan activities that don't require a lot of energy- quiet talking, eating in, watching a video, or listening to music.
Joining a support group can also help decrease feelings of social isolation. Individuals with chronic illness may also benefit from couples or family therapy.
Getting back to work or finding work that one can manage given the limitations of one's illness is an important part of coping with a chronic illness.
Getting in touch with one's spirituality can help an individual increase hope and sense of purpose, put his or her illness in perspective, and develop new life goals. Finding greater meaning in relationships and daily activities is key. During this phase, individuals also work on finding meaning in their suffering without denial, anger, or regrets.