Have you ever wondered about the links between physical illness and mental health – how one can affect the other?
The process of a disease on mental health has been shown to have an effect on the experience of illness. This may include unbounded illness, whereby the individual perceives themselves as different to others.
Additionally, how the individual got the illness, as in sudden accident, or a longer term of illness for example a tumour, or many operations, may affect the experience of the illness.
Is the Illness Visible?
It has been shown that individuals with unbounded illnesses, that is, outward issues where the illness is physically visible, affects their mental health.
A recent study by Lambert and Keogh (2015) found children and young people with long term health conditions like diabetes, epilepsy and asthma, can experience feelings of being different physically, socially and psychologically. The review found that children experience restrictions and adjustments in everyday life aspects and treatment regimens, and that communication including disclosure, stigma and support are affected.
Due to these experiences, children with long-term conditions are more susceptible to low self-esteem, body image, social role definition and peer related issues (International Diabetes Federation, 2013). This has been shown to result in difficulties in emotional coping and they are at increased risk of psychological disorders (Petersson, Simeonsson, Enskar, & Huus, 2013).
How did the Physical Illness Develop?
Likewise, how the illness began in an individual has been shown to affect their mental health.
A study by Miyabayashi and Yasuda (2007) investigated how sudden death and prolonged death affected the general health, depression and grief of bereaved spouses and parents in Japan.
Findings indicated that sudden death including suicide, accidents and acute illnesses had a greater effect on general health and depression. Interestingly, differences among groups were greater for emotional reactions than for physical distress, with suicide showing to be the greatest bereavement.
Relationships and social support have been linked with physical health conditions. Studies show that low levels of social support for individuals, indicate higher mortality rates especially for conditions like cardiovascular disease (Rutledge et al, 2004).
A study by Zhang, Norris, Gregg and Beckles (2007) found that social integration affects mortality from diseases like diabetes, while social interactions between family and friends was a predictor of self-reported disease outcomes in individuals with diabetes, hypertension, arthritis and emphysema (Tomaka, Thompson, & Palacios, 2006).
Additionally, social support has been shown to influence health behaviours (Umberson, 1987). For example, a study of cancer survivors found lack of support or loneliness can negatively influence health behaviour adherence (Thompson, Littles, Jacob & Coker, 2006). Health behaviour adherence includes both supportive and controlling behaviours; for example, partners that showed supportive behaviours predicted better mental health, while controlling behaviours showed poor mental health and health behaviours in partners during cardiac rehabilitation (Franks, et al, 2006). This indicates that support to ill partners should be gentle and not controlling, in order to motivate behavioural changes to have a more positive effect on the experience of illness.
The drugs taken and their side effects have an effect on the experience of illness – for example, drugs like corticosteroids have been shown to lead to disturbances in emotions in patients on haematological treatments (McGrath, Patton & Janes, 2008).
Knowledge regarding similar brain functions for illnesses, for example major depressive disorder and chronic pain, have shared neurophysiological mechanisms (Psychiatric Times, 2009). This indicates the importance of including knowledge of drug treatments and side effects, in order to be aware of and listen to the experience of the individual’s illness.
In order to access the individual’s experience of illness, a psychologist may pursue individual sessions with clients or in-group sessions. They may also work within interdisciplinary teams in order to access all aspects of the experience of illness; during individual or group sessions, psychologists may access the client’s experiences using assessment tools to evaluate quality of life.
Likewise, multidisciplinary care is an approach to patient care whereby planning for and monitoring the care throughout the patient’s recovery or treatment is done within a team environment (Mitchell, Tieman & Shelby-James, 2008).
Professionals from a range of disciplines work together to help the individual as extensively as possible; for example, doctors, specialist doctors and nurses all provide treatment and care for an individual with illness, and they all play a role in the experiences of illness for an individual. The team may all work under the same company or may come from varied organisations including private practice.
As the individual’s condition changes, the team will vary depending upon the psychosocial needs of the individual (Mitchell, Tieman & Shelby-James, 2008). Additionally, the ability to contextualise the client’s illness, for example an understanding of the client’s story of illness, and working treatment around the client’s context, will ensure a more productive outcome.
Furthermore, the individual’s treatment may be integrated within the multidisciplinary setting to provide many different approaches, including but not limited to, supportive counselling, behaviour analysis, gestalt therapy, and CBT.
In summary, experience of an illness in an individual is based on the individual’s perception of how their internal world is represented. This may be formed from an early age through schemas and can have an effect on how they experience illness later in life.
In order for a psychologist to best guide an individual, listening to their lived experiences holistically using the biopsychosocial-spiritual model and gauging a benchmark for their subjective wellbeing, can have the best effect for accessing their experience of illness.
Author: Cassandra Gist, BPsych (Hons), MPsych, MAPS.
Brisbane Psychologist Cassandra Gist has a Masters in Health Psychology, and is able to treat clients aged from two years old right through to adulthood. She is experienced in working with Aboriginal and Torres Strait Islander communities, and children and families affected by Autism Spectrum Disorder.
To make an appointment with Brisbane Psychologist Cassandra Gist, try Online Booking – Loganholme or Online Booking – Mt Gravatt. Alternatively, you can call M1 Psychology (Loganholme) on (07) 3067 9129, or Vision Psychology (Mt Gravatt) on (07) 3088 5422.
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