Chronic Disease and Mental Health
There is a strong link between chronic disease and mental health. In Australia, it is estimated that over a quarter of people living with arthritis have a mental health condition.
The links between mental health conditions and chronic disease are not just evident through their causes and symptoms, but also in terms of prevention and management.
The problem with chronic conditions like arthritis, is that a person’s mental health is often seen as secondary to their physical health. The health system often separates the two issues instead of treating them together, which can complicate treatment options for anyone living with both conditions.
Everyone experiences feelings of sadness or feeling low every now and then. Depression is more serious and is defined as ‘a range of mood and other symptoms that are more intense, pervasive and long-lasting, are distressing to the person, and interfere with their day-to-day life and relationships’.
Depression may have been a pre-existing condition that has been exacerbated by pain and the diagnosis of a chronic disease such as arthritis. Depression can also be brought about by the pain, fatigue and feelings of uncertainty and hopelessness that may accompany a chronic condition.
Depression comes in many forms and can affect people differently. Some symptoms include:
- Feelings of sadness most of the day, nearly every day
- Feeling hopeless or worthless
- Having low energy and feeling fatigued
- Losing interest in activities you once enjoyed
- Having problems with getting or staying asleep, or sleeping excessively
- Feeling restless
- Experiencing changes in your appetite or weight
- Feeling sluggish or agitated
- Having difficulty concentrating
- Decreased interest in sex
- Having frequent thoughts of death or suicide
Like most forms of arthritis, the actual cause of depression isn’t known.
If you receive a diagnosis of depression alongside arthritis, behavioural and exercise therapies are consistently recommended as treatments.
GP Mental Health Plan - if you are suffering from any of the above symptoms it is important to talk to your GP about treatment options. A GP Mental Health Plan can provide a Medicare rebate for up to 10 visits per calendar year to a psychologist, psychiatrist, or an approved social worker or occupational therapist. These professionals will work with you on strategies to assist in improving your mental health while living with a chronic disease.
Cognitive behavioural therapy (CBT) is an individualised program that can help you identify unhelpful thoughts and behaviours and learn or relearn healthier skills and habits that improve mood and your ability to cope.
Interpersonal psychotherapy (IPT) involves looking at any problems you might be experiencing in your relationships and expectations about others that may contribute to the symptoms of depression. IPT aims to help you find new ways to develop and nurture relationships, express emotions and communicate more effectively, resolve conflicts with others, adapt to life-role changes, and improve social support networks.
Exercise programs have been found to be useful in improving the mental health of people living with arthritis. Exercise releases chemicals that improve your mood and make you feel good. It can also be a social activity helping to reduce feelings of loneliness and isolation, and put you in touch with other people. Exercise is also good for your arthritis, therefore taking on a more holistic approach to your health than a single treatment in isolation.
If you think you might be experiencing depression, please speak to your GP in the first instance. There are many ways to improve your symptoms and quality of life.
If you or someone you know is experiencing mental health concerns please contact: Lifeline: 13 11 14 www.lifeline.com or
Beyond Blue: 1300 224 636 www.beyondblue.org.au
Adapted by Paula Herlihen, Health Educator, Arthritis Queensland
From an article prepared by Rebecca Davey, R.N. Arthritis ACT