Best Way to Understand the Mind-Body Connection in Chronic Illness

How Chronic Illness Affects Your Mood

Some chronic medical illnesses may have direct effects on mood and energy. Thyroid conditions often cause fatigue and low mood. Neurological conditions like stroke or mul­tiple sclerosis may affect parts of the brain that regulate mood and emotions. Major medical events like a heart attack or surgery can increase levels of stress hormones leading to feelings of depression and anxiety.

More often, chronic illness can contribute to depres­sion because of physical discomfort, disturbed sleep, or limitations on your activities. Withdrawing from pleasant or rewarding activities is both a major effect and a major cause of depression. Persistent pain is also a common cause of depression and fatigue.

Depression and Physical Symptoms

Depression is not just a “mental” problem. Some of the most disabling symptoms of depression are physical ones like fatigue, trouble sleeping, or persistent pain. It can be difficult to sort out whether pain or fatigue is caused by depression or medical problems, but that’s because they can’t really be sorted out. Medical problems and depres­sion often work together to cause physical symptoms. Pain or fatigue from any cause seems much more severe and disabling when you feel discouraged or hopeless.

Biological Effects of Depression

Depression is a mental and physical condition—with sig­nificant changes in hormones and chemical messengers throughout your body. Some of these effects are obvious: changes in appetite, fatigue, disturbed sleep. Some other changes don’t cause immediate symptoms but can have important effects on your health. Depression affects levels of Cortisol and other stress hormones leading to increases in blood sugar and increased risk of heart disease. Effects on blood clotting can increase risk of stroke or heart attack.

Depression and Self-Care

Feeling depressed can also get in the way of taking care of yourself the way you hope to. Managing a chronic illness often involves taking medication regularly and may involve some kind of self-monitoring (like checking your blood sugar on your own). Sticking to those routines can be dif­ficult when you feel that nothing is worth the effort. Chron­ic illness may make it even more important to make lifestyle changes like stopping smoking, exercising regu­larly, or losing weight. Those changes can seem nearly impossible when you feel discouraged or depressed.

Does This Mean That the Problem Is All in My Head?

A chronic illness like diabetes or emphysema certainly isn’t a figment of your imagination. You didn’t make it up, and you certainly can’t wish it away. What you can do, how­ever, is take charge as best you can. When your mood is better, any burden is easier to bear. So the problem is cer­tainly not in your head, but the beginning of the solution is.