The emotional effects of having a serious physical illness
A serious physical illness can affect every area of your life: relationships, work, spiritual beliefs, how we socialise with other people.
A serious illness can make us feel sad, frightened, worried or angry.
It may be because:
* You feel out of control of your body and your situation generally.
* You may feel that there is nothing that you can do.
* You feel lonely and isolated from family and friends.
* Sometimes it can be difficult to talk about the illness with those close to you. You don't want to worry or upset them (125).
For some of us, the emotional impact of a serious physical illness can be overwhelming. Cancer or heart disease, for example, can make us very anxious and depressed. It can stop us from doing the things we need to do in our daily lives.
What does it feel like to be anxious or depressed?
Anxiety and depression affect both our mind and body. Often the two happen at the same time.
Anxiety feels like
* constant worrying thoughts, often about the illness and its treatment;
* fearing the worst, for example, that your illness will get worse or that you might die;
* being very aware of your heart beating (palpitations), tension and pains in your muscles,
* being unable to relax,
* breathing too fast (hyperventilating),
* feeling dizzy,
* feeling faint, indigestion and diarrhoea.
Depression feels like
* feelings of unhappiness that don't go away, and are there nearly all the time,
* losing interest in life, being unable to enjoy anything,
* finding it hard to make even simple decisions,
* feeling utterly tired, feeling restless and agitated;
* losing appetite and weight (some people find they do the reverse and put on weight);
* difficulty in sleeping and waking up earlier than usual,
* losing interest in sex,
* losing self-confidence and feeling useless, inadequate and hopeless;
* avoiding other people, feeling irritable, feeling hopeless about yourself, your situation and the world generally - you may feel as if you are never going to get better, or that you are worthless;
* thinking of suicide - this is common in depression.
It is much better to talk about it than to try to hide it.
Some of these symptoms, such as feeling tired, poor sleep and loss of appetite, may be similar to those caused by the physical illness or its treatment. If you talk through how you are feeling with a doctor or nurse, they can help to sort out whether it is your physical illness or depression that is responsible (125).
Why are depression and anxiety more likely to happen if you have a serious physical illness?
People become depressed and anxious when they are stressed for any reason. Being ill and having treatment are stressful. This is probably the most common reason.
Some drug treatments, such as steroids, affect the way the brain works and so cause anxiety and depression directly.
Some physical illnesses, such as an under-active thyroid, affect the way the brain works. They cause anxiety and depression directly.
Anxiety and depression are common. You may just happen by chance to become anxious or depressed at the same time as you become physically ill (102).
What might make you more likely to become anxious or depressed?
You are more likely to experience severe anxiety and depression when you are physically ill if -
* you have been anxious or depressed before;
* you do not have any family or friends you can talk to about your illness;
* you are female (women report more anxiety and depression than men);
* you have other problems or stresses going on in your life at the same time, for example, redundancy, a divorce or the death of a loved one;
* you are in a lot of pain; you illness is life-threatening; your illness stops you from looking after yourself.
The times when we are most likely to become anxious and depressed are -
* when you are first told about your illness,
* after having major surgery or if there are unpleasant side-effects to your treatment;
* if the illness comes back, after you seemed to be feeling better, for example, a recurrence of cancer or a second heart attack;
* if your illness stops responding to treatment.
When should you seek help?
If your feelings of anxiety and depression are worse than the fears, worries and sadness that you have had before; don't seem to be getting any better with time, begin to affect your feelings towards family and friends, your work and your interests; if you feel that life is not worth living, or that other people would be better off without you.
You may not realise you are depressed, if you think all your symptoms are due to the physical illness, you blame yourself for being lazy or feeble. Just because we can all understand why someone with a serious physical illness becomes anxious and depressed, this does not mean that we should ignore the problem (125).
It can be hard to express real feelings, even to close friends. It may be easier to do this with an interested professional.
He or she can help you to get things in perspective and to find
* ways of sorting out your problems (125),
* a trusting relationship between the client and the professional,
* an opportunity to talk freely and openly about your thoughts, feelings and problems.
There are many types of talking treatments, but all have the following ingredients: help coping with worrying thoughts, bad feelings and practical problems (125).
The thought of seeing someone just to talk may seem frightening or pointless, or both. However, once started, most people with a serious physical illness find it very helpful (125).
Talking treatments work by helping you to be clearer about what is happening to you emotionally. They help you to find ways of coping better with feelings, thoughts and practical problems. It's also helpful to be able to talk freely with someone you trust and who doesn't pass judgement on you (125).
Caring for someone who is both physically ill and troubled with anxiety and depression can be exhausting.
If you are getting worn out, do ask for help.
Counselling and Psychotherapy may be provided via Skype and FaceTime in the comfort of your home, office or any place of your choice.