The Psychology of Chronic Illness and Food
Understanding the Emotional Side of Chronic Health Conditions
By Ann Goebel-Fabbri, PhD, Assistant Professor of Psychiatry, Harvard Medical School, Boston, MA
“Why aren’t you exercising?”
“You can’t eat that!”
“What would you doctor say about that choice?”
Coping with statements like these, no matter how well intended, is just one of the challenges of living with a chronic health condition. People typically mean well and try to be supportive but often don’t understand what they could do that would actually feel supportive. This can leave a person feeling misunderstood, judged, and even somewhat rebellious at times.
People can also feel isolated with their disease or condition – like they’re the only one who hates it and is struggling. They can often be the only one they know who has the disease.
Anger, burnout, and worry can also be common responses to the ongoing stress of chronic conditions and the burden of managing them. People may be told they are “in denial,” when they are actually having an understandable response to something that nobody would want.
Major depression can result when these things intensify. Symptoms include feeling sad or irritable much of the time, no longer finding pleasure in things, changes in appetite and/or sleep, decreased motivation, low self-esteem, and at worst thoughts of death or suicide. Depression and anxiety occur at higher rates in people with some chronic diseases. They can also contribute to worsened symptoms of the disease and more difficulty managing it independently. In this situation both the depression and the chronic disease require attention and treatment. Depression can be very successfully treated with a combination of medicine and therapy. However, when a chronic disease is present, the prescriber must make certain that the medicines are safe and do not interact poorly with any others being taken. Ideally, the mental health and medical teams would be in close communication so that both agree with the approach to take.
Despite chronic conditions adding genuine difficulty and stress to life, there are many ways to ask for and receive support in order to improve and maintain positive coping and high quality of life.
Practical suggestions for coping:
- Learn how to assertively communicate what you need in order to feel supported by your loved ones. This means speak about it in a way that doesn’t leave them feeling defensive or upset.
- Find a healthcare team that you like and trust to speak openly with about how your condition hits you emotionally. If you feel self-conscious or judged, you won’t feel comfortable showing them when you’re feeling vulnerable.
- If you feel like you’re “doing it all wrong” and not managing your condition, try to identify at least one thing that you feel confident you are “doing right” in managing your condition.
- Consider finding and attending a support group with others who have your condition. This could be in “real life” or online.
- If you feel it could help, connect with a therapist. Ask your healthcare team for recommendations.
- Remember that accepting the condition does not mean liking the condition. It is about tolerating that you have to learn a way to live side by side with it.
- Don’t let your condition become your identity. Be sure to keep doing things you loved to do prior to being diagnosed. You can hate the disease but still have fun and be yourself at the same time.