Is there a link between chronic illness and mental illness?

Today’s guest post comes from Ann-Marie, who discusses this topic and shares her own experiences.

I live with bipolar disorder, fibromyalgia and arthritis.

Over the years, I’ve noticed a correlation between my mental illness and chronic illness. When I’m struggling mentally, my chronic pain symptoms often flare. After learning more about the mind and body connection, and the science behind chronic pain, I came to understand that our mind does in fact significantly influence our body. 

Depression can worsen my chronic pain

Bipolar disorder involves mood swings between two extremes: an elevated mood known as mania or hypomania in my case (a less severe form of mania) and depression. My depression can last for weeks or months at a time and is often extremely debilitating. 

As I learnt more about pain science, I discovered that depression can impact chronic pain for many reasons including:

• Lack of activity: When you’re depressed, it can be hard enough to muster the energy to get out of bed or take a shower, never mind stay active and keep up with your usual routine. I know that even if my depression is ‘mild’, I tend to withdraw from a lot of my usual activities including exercising because I just don’t have the energy.

This withdrawal from activity can cause deconditioning, which means that your muscles weaken because they aren’t being used. This can cause stiffness and worsen chronic pain.

• Stress: Depression often correlates with high stress levels. This is understandable. It’s stressful to be struggling with mental illness and all that comes along with it. Unfortunately, stress can cause and worsen chronic pain, creating a cycle which can be tough to break. 

When my stress levels are high or I’m trying to juggle a lot in my life, I find that my fibromyalgia in particular flares. 

• Lack of self-management: Just as it’s hard to get the energy for day to day activities when you’re depressed, it can be really tough to motivate yourself to self-manage your mental or physical symptoms. 

When I’m depressed I find it hard to care about taking my medications at the right time, about eating well or exercising. It can also be incredibly difficult to stick to a regular sleep schedule, which is something that significantly impacts chronic pain. It’s hard to practice self-care when you’re struggling so much. Of course, if you aren’t managing your symptoms well, they worsen. 

• The same neural pathways: Science shows that depression and chronic pain literally share the same pathways in the brain, so it’s easy to see how they can influence each other.

This study explains that research shows, “considerable overlaps between pain- and depression-induced neuroplasticity changes and neurobiological mechanism changes.”

Chronic pain can cause depression

Living with chronic pain is really tough in itself. Many aspects of the chronic pain experience can contribute to depression. This study talks about the impact of chronic pain on mood, and explains that “For some people, the burden of pain is difficult to manage and may lead to the emergence of a mental disorder.”

Some of the factors of chronic pain which contribute to depression are listed below:

• The pain itself is hard to deal with.
• Chronic pain can take a toll on loved ones and this can make you feel like a ‘burden’ at times.
• It can feel as though chronic pain has taken away a lot from your life. Your ‘new normal’ can be difficult to adjust to.
• Needing to ask for help can feel embarrassing and frustrating. 
• Chronic pain can often lead to social isolation.
• Many people find they are unable to work, and this can lead to financial worries and increase feelings of guilt or lack of independence. I am not able to go out to work but am lucky enough to have found a way to follow my passions and work from home.
• When you feel like your body has betrayed you or is letting you down, it can knock your confidence and make you see yourself in a different light. 
• Thinking about the future can be worrying when you are unsure about how to improve your chronic pain or you have been told that there’s nothing which can be done about your pain.

For all these reasons and so many more, chronic pain can cause and contribute to depression and mental illness.

How to break the cycle

So if chronic pain can cause depression, and depression can worsen chronic pain, how are we supposed to break free of this cycle? As much as it’s not an easy fix, there are ways to manage your physical and mental health and create a balance. 

There is a wide range of psychological therapies which can help you to get better control over your emotions and your chronic pain symptoms, including cognitive behavioural therapy (CBT), mindfulness, psychotherapy, and general counselling.

Self-management is also really important. Even when you’re engaging in structured therapy, it’s important to keep up with your self-management at home and implement any techniques you are learning from your therapy.

You can find out more about the link between depression and chronic way, and the treatments available here: https://www.pathways.health/the-link-between-depression-and-chronic-pain-and-what-you-can-do-about-it/

These are some ways I’ve learnt to manage both my physical and mental illness which I’ve found really helpful: 

• Talking to someone I trust about what’s on my mind: When I’m struggling, instead of keeping things bottled up or letting them play on my mind which then leads to stress, I talk to someone I trust. Usually, this is my husband, who is always there for me. Even just getting things off my chest makes me feel like a weight has been lifted, and often we can find solutions to problems together. 
• Being self-aware: I’ve learnt to be more aware of my own body and mind, so I can notice signs that I may be getting stressed or that my mood is dropping. That way I can reach out for help in advance and try to turn things around. Of course, this is always a learning process and it isn’t always possible, but it’s a helpful strategy. 
• Eating well: As cliche as it sounds, I’ve found a huge difference in both my physical and mental health now that I am trying to eat a healthier diet. I even find that I’m enjoying food more and having fun trying new meals and ways of cooking. 
• Keeping a regular sleep routine: This one is really tough for many reasons, but when I don’t sleep well, my bipolar is quickly negatively impacted followed by my chronic pain. I try to keep a regular sleep routine by going to bed at the same time each night, winding down before bed, and getting up around the same time each morning. 
• Doing more exercise: Since I’ve begun overcoming my chronic pain and started exercising more, I’ve been able to hike in the countryside with my dogs regularly. This is my happy place. It keeps me grounded, it brings me joy and it has improved my physical and mental health significantly. 
• Keeping up with my medication and professional appointments: As hard as it can sometimes be, keeping up with my medication, attending appointments and keeping my doctors informed has allowed me to gain greater control over my symptoms. 
• Finding friends who ‘get it’: I’ve found an amazing community of people online who understand what I’m going through because they’re going through it themselves in one way or another. This makes me feel understood, accepted, and free to express my feelings.
• Being kind to myself: I’m learning to be kinder to myself. For example, I’ve learnt not to be hard on myself when I don’t get things right, when I don’t feel up to exercising, when I don’t sleep well or if I have a bad day. As I learn to treat myself with kindness and compassion, I find that I feel much more positive.

 

Even though it’s tough, there are ways to manage chronic pain and mental illness and to live a full life despite your struggles. You can find effective treatments which work for you! 

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References

• Alex Holmes, Nicholas Christelis, Carolyn Arnold, (2013), “Depression and chronic pain”. Med J Aust 2013; 199 (6): S17-S20.
• Sheng, J., Liu, S., Wang, Y., Cui, R., & Zhang, X. (2017). “The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain.” Neural plasticity, 2017, 9724371. 

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A big thank you to Ann-Marie for sharing her experiences. You can find more from her at her blog, Highs & Lows: A Bipolar Journey.

 

Do you have experience with chronic illness and mental illness? What do you think about the links between the two? Maybe you have some coping strategies you’d like to share? Let me know in the comments.

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