Chronic disease, particularly if severe, can pose a significant threat to psychological well-being. This condition of continuous suffering, particularly when it is visible, changes body image and is often accompanied by stigma and delegitimization. Considering the psychological repercussions is therefore essential to take care of the well-being of the person as a whole.
Chronic diseases are increasingly frequent. Due to their growing incidence, they often represent a challenge not only for those who live with them, but also:
- for the family who offers support,
- for the company that bears the costs,
- for medicine, whose progress, although significant, does not always manage to alleviate its burden and human cost.
Faced with chronicity, medicine is called to rethink its models of understanding and care, to respond more adequately to people’s needs. An exclusively biomedical approach does not allow us to grasp the complexity of suffering, which is also psychological and relational. In addition to offering treatment paths, including palliative care, it is also important to consider the support of a psychologist.
A broader model for addressing chronic disease
The clinical evolution of people with chronic pathologies does not only depend on biological factors, but also on the psychosocial events and dynamics that characterize their lives. In this constellation, three dimensions take on particular importance:
- the person’s experience of illness,
- the family’s response,
- the methods of encounter between the person and the care system.
To take these three dimensions into account, it is necessary to adopt a biopsychosocial intervention model, suited to complexity of chronic disease and capable of encouraging doctors to broaden their field of action, collaborating more closely with psychotherapists.
In this way, the resources of the person and those around them can be enhanced. Doctors and therapists know, but do not always fully consider, the suffering and destabilization that a long-term illness can generate in a family, together with the resulting sacrifices. In fact, even the family is affected by the disease, which directly influences those who are linked by an emotional relationship with the person who suffers from it.
Epidemiological data and impact of chronic diseases
The chronic diseases represent one of the main public health challenges globally. According to the World Health Organization (WHO), chronic diseases are responsible for approximately 74% of all deaths worldwide, with over 41 million deaths each year (WHO, 2023).
In Italy, according to ISTAT data from 2022, approximately 40% of the population lives with at least one chronic pathology, and 20% have two or more. This phenomenon has a significant impact not only on people’s quality of life, but also on health and social costs, representing approximately 80% of overall health spending (Ministry of Health, 2023).
The increase in life expectancy, changes in lifestyle and the aging of the population contribute to making chronic diseases increasingly widespread and relevant.
The main chronic diseases and their causes
The chronic diseases they include a broad spectrum of conditions that develop slowly and tend to persist over time. Among the most common we find:
- Diabetes mellitus: a pathology characterized by an alteration of sugar metabolism, often linked to genetic factors, overweight and sedentary lifestyle.
- Cardiovascular diseases: include heart attack, stroke and hypertension, often associated with smoking, unbalanced diet, stress and physical inactivity.
- Chronic respiratory diseases: such as asthma and chronic obstructive pulmonary disease (COPD), frequently related to exposure to pollutants and cigarette smoking.
- Tumors: some forms of cancer can become chronic conditions thanks to advances in therapies, but remain among the main causes of mortality.
- Rheumatic diseases: such as rheumatoid arthritis, which affects the joints and can affect mobility.
The causes of chronic diseases are often multifactorial and include:
- Genetic factors: family predisposition can increase the risk of developing certain pathologies.
- Unhealthy lifestyles: incorrect diet, sedentary lifestyle, alcohol abuse and smoking are among the main risk factors.
- Environmental pollution: exposure to toxic substances can favor the onset of some chronic diseases.
- Aging: Advanced age is a major risk factor for many chronic conditions.
An event in a story
Illness can be defined as the process by which a person suffers an attack from their own body. Some changes may arise at the level of cells, tissues, organs, organ systems or the nervous system. However, illness and being patient only become reality when the person tries discomfort, pain, anguishor exhibits behaviors that may indicate a pathological condition.
In this sense, illness is never a purely biological phenomenon, but involves the person in the complexity of his existence: for a human being, getting sick is a real “event”. Spontaneously or involuntarily, this experience transforms the life condition and pushes the individual to adapt to the disorder which, by affecting the body, also involves the personal dimension. The limitation of capabilities, increased vulnerability and the need for possible pharmacological treatments are further aspects imposed by the presence of the disease.
Physical and mental effects of chronic disease
The presence of a chronic disease can have consequences that go far beyond physical symptoms. The effects can be divided into two broad categories:
Physical effects
- Persistent pain: Many chronic conditions are associated with continuous or recurrent pain, which can limit daily activities.
- Fatigue: Chronic fatigue is a common symptom that can reduce work capacity and social participation.
- Functional limitations: the loss of autonomy or the need for assistance can profoundly affect the quality of life.
Mental and psychological effects
- Anxiety and depression: Living with a chronic disease can increase the risk of developing mood disorders, as confirmed by numerous clinical studies (for example, according to a review published in “The Lancet Psychiatry” in 2021).
- Social isolation: physical limitations and the perception of being different can lead to a progressive withdrawal from social relationships.
- Alteration of body image: Visible physical changes can affect self-esteem and self-perception.
These effects, often intertwined with each other, require an integrated approach that takes into account both the physical and psychological dimensions.
What does “chronicity” mean for a human being?
From an existential point of view, chronic illness represents a “challenging and inevitable” event. It leads the person to transform to adapt to an unchangeable fact of one’s life history, making it necessary to actively redesign one’s existence.
Time and space must be reorganized to reshape personal, social and working life. The person finds himself having to review:
- living conditions,
- professional activities,
- family responsibilities,
- household tasks,
- moments of leisure,
in order to adapt to the functional limitations that the disease may entail. Chronic illness, therefore, modifies the bodily experience and the sense of self, becoming an inevitable “life companion”.
The encounter with the cure
The healing function constitutes the foundation of the relationship between doctor or psychotherapist and patient. This function is based on the encounter with the history of each individual person, with their fears, their new image, the perception of a body that may seem to have betrayed them, and with the disappointment and anger that may emerge.
“Life is listened to just like the waves of the sea… The waves rise… They grow… things change… Then, everything goes back to the way it was before but it is no longer the same.” A. Baricco
Coping strategies and practical advice for people with dementia and carers
Coping with a chronic illness may require not only medical care, but also practical strategies for managing daily difficulties. Here are some helpful tips:
For people living with a chronic illness
- Accept your emotions: Recognizing feelings such as anger, sadness or fear is the first step in dealing with them in a constructive way.
- Establish flexible routines: Organizing your days in a way that adapts to your limits can help you maintain a sense of control.
- Seek support: Sharing your experiences with family, friends or self-help groups can reduce feelings of isolation.
- Practice relaxation techniques: Breathing exercises, mindfulness or meditation can relieve stress and promote general well-being.
For caregivers
- Find out about the disease: knowing the pathology helps to better understand the needs of the person being cared for.
- Take care of yourself: Dedicating time to your passions and rest is essential to prevent burnout.
- Ask for help when necessary: Don’t hesitate to turn to professionals or support services to deal with more complex difficulties.
Integrating these strategies into everyday life can promote a better quality of life both for those living with the disease and for those offering support.
The importance of psychological support: examples and tools
Psychological support represents a key element in the treatment path of people living with a chronic illness. The intervention of a psychologist can help manage difficult emotions, rework the self-image and find new adaptation strategies.
For example, a person with rheumatoid arthritis may experience frustration over the loss of independence. Through psychotherapy, you can learn to recognize your limits without feeling defined by the disease, developing new ways to maintain social relationships and personal interests.
Among the most useful tools are:
- Individual interviews: allow you to explore personal experiences and find internal resources to deal with the chronic condition.
- Support groups: they offer a space for sharing and discussion with those who live similar experiences, reducing the sense of loneliness.
- Psychoeducation: helps to better understand the disease and manage expectations, both for the person and for the family.
Integrating psychological support into the treatment process can promote greater resilience and a better quality of life, as also underlined by the World Health Organization guidelines (WHO, 2023).
Take care of yourself: start your online psychological support journey today
Dealing with a chronic illness can be a challenge that involves body, mind and emotions. You are not alone: psychological support can help you find balance, strength and new strategies to live better every day, even in difficulties. With Evidence Network you can count on professionals ready to listen to you and build a tailor-made path with you, for you or for those you love. Take the first step towards more complete well-being: start the questionnaire to find your psychologist online.
