The Psychological Factors Influencing Chronic Illness

All chronic illnesses, which are diseases that persist for a long duration in an individual, have physical and substantial psychological impacts. Sometimes, these chronic illnesses can be caused by the psychological factors influencing an individual, or they may even exacerbate existing ones. The psychological implications of an illness become an important aspect to study as it affects the quality of life, the onset, and the rate of progression of the chronic illness. This essay will analyze the different psychological aspects of chronic illnesses, how they affect different individuals, and the best practices for managing individuals with chronic illnesses.

Stress and chronic illnesses

Stress, which can occur to any person, is a natural response to life problems. However, it can become a cause of some of the known chronic illnesses when it is severe, such that it occurs in a prolonged period. Moreover, it can exacerbate the existing chronic conditions in a person who is managing them well. It is widely recognized that ongoing stress can diminish the activity between “HPA axis” interaction with the thoracolumbar network within the suprarenal medulla, leading to increased generation of inflammatory mediators, including cytokines, which are a huge risk factor for the disease atherosclerosis (Yao et al., 2019, p. 29). Studies show that in apolipoprotein E knockout mice subjected to chronic stress, levels of “intercellular adhesion molecule-1, the acute phase reactant C-reactive protein, and the proinflammatory cytokine interleukin-6” are considerably higher than those in untreated mice. Inflammatory markers have additionally been detected in “plasma cluster of differentiation, interleukin-8, 5'-nucleotide ecto, programmed death ligand 1, and plasminogen activator inhibitor PAI-1.”

Additionally, allostatic load disrupts the balance between the cranial nerve X and the flight fight response. Reduced tonality of this cranial nerve leads to an unhealthy state promoting swelling, which can facilitate neurotransmitter regulation, especially enhancing serotonin activation. For instance, stress increases “plasma dipeptidyl peptidase-4 activity while decreasing the levels of plasma glucagon-like peptide-1 and both plasma and adipose adiponectin.” All of these can perpetuate the progression of autoimmune conditions in the body (Yao et al., 2019, p. 38). Research has identified that most diseases caused by abnormality in the metabolism of fats are experienced in areas prone to stress. Research suggests that hyperlipidemia from stress and heightened redox imbalance are closely linked to atherosclerosis. While chronic stress can impact the quality of life, the specific roles of “stress-related adrenocorticotrophic hormone (ACTH) and cortisol” in atherosclerosis still need to be shed more light on.

While stress can be the cause of chronic illnesses, chronic illnesses can be the trigger of stress. Living with a chronic illness can itself be a significant source of stress. To begin with, the experience of being admitted to a hospital is in itself traumatizing. The hospital environment is surrounded by machines that beep, and being dependent on others makes it demoralizing for a patient, leading to stress. Worse is the fear of the medical outcomes or prognosis of their chronic illness (Grooves & Muskin, 2019, p.56). This chronic stress can create a vicious cycle where stress worsens the illness, and the illness, in turn, heightens stress levels. In worst-case scenarios, these patients stop adhering to the prescribed medication and may even want to commit suicide. Effective management of stress, therefore, becomes crucial in breaking this cycle and improving health outcomes for individuals with chronic illnesses.

Social Support

Humans are social beings, which makes social support an essential aspect of effectively managing individuals with chronic illnesses. It can be done through emotional, informational, and even physical assistance by family, friends, healthcare givers, and support groups. Studies have shown that people who have a strong social connection of support often go through life's worst challenges, including chronic illnesses, with ease. In addition, individuals with strong social support networks are healthier psychologically than those with limited support (Singer & Lord, 2020). The rationale behind this is that social support dramatically reduces the present feelings of isolation and depression among these patients.

Coping Mechanisms

While people cope differently with different unfortunate information, some of the coping mechanisms can fasten the disease process of chronic illness, making their prognosis poorer. It can be tough to comprehend the information that you have a disease like diabetes and that for the rest of your lifetime, you have to be on anti-diabetic medications. However, healthy approaches to such information, such as seeking social support, exercising, and eating a balanced diet, can be effective methods of coping that will greatly reduce the bad outcomes from chronic illnesses and promote the overall quality of life for these individuals. Unfortunately, some people diagnosed with chronic illnesses may respond in unhealthy ways, such as denial, substance abuse, and social withdrawal. These behaviors can worsen the already existing psychological distress and even the physical symptoms (Updegraff & Taylor, 2021). For example, drinking alcohol as a way of coping with the stress of being diagnosed with diabetes could lead one to hyperglycaemic hyperosmolar non-ketotic coma, which is a medical emergency. Patients with chronic diseases should be taught and encouraged to engage themselves in healthy coping mechanisms.

Behavioral and Cognitive Interventions

People with chronic illness need a holistic assessment. As chronic illnesses persist for long periods, some of the behavioral mechanisms can improve the outcomes of these patients. Among the many cognitive and behavioral therapies used in the management of patients with chronic illnesses, "cognitive-behavioral therapy (CBT) and Mindfulness-based stress reduction (MBSR)" have proven to be efficacious (Kim et al., 2019, p.801). In CBT, patients are taught to recognize, identify, and locate situations that may cause negative thought patterns. Once they identify them, they can shift their minds or engage in other thoughts, breaking the sequence of negative thoughts. On the other hand, MBSR has also been proven better at managing chronic illness. Here, patients with chronic illnesses are taught mindfulness techniques, including meditation and yoga, which are deemed to reduce stress and improve emotional well-being (Gil, 2023). Other forms of therapy include interpersonal therapy, imagery, support group engagement, and relaxation techniques. Healthcare providers attending to patients with chronic illnesses should help them to choose the most appropriate and effective.

Conclusion

The deterioration in the mental health of a person can also lead to poor physical health. This can be because of stress and interactions between the brain and the body mechanisms. The opposite is also true, making it essential to address both of them as one package. Patients with chronic illnesses need to be assessed holistically to identify not only the physical complications of their illnesses but also the psychological impact. They need guidance and counseling on the best approaches to use so in coping with their sad reality. They need to be educated on ways that will not only prolong their life with chronic illnesses but also improve their quality of life.