Will I get sick if I go to the store? Am I going to cancel the plans I made for this weekend?
Will I be able to afford the biologic my doctor suggested for me? If I switch meds, will I have less pain?
Living with a chronic illness can cause a great deal of anxiety for many people, as it can be unpredictable and disruptive. Chronic pain, in particular, can heighten anxiety levels, as the brain’s inability to regulate pain can increase both pain and anxiety. In addition, managing a chronic illness can be emotionally and financially draining, further exacerbating anxiety.
Experts note that individuals with chronic pain are at a higher risk of experiencing anxiety. Health Psychologist Laurie J. Ferguson, PhD, Director of Patient Well-Being at the Global Healthy Living Foundation, explains that “Anxiety is a physiological reaction — you can’t think your way out of it.”
However, there are ways to manage anxiety triggers associated with chronic illness. By identifying these triggers and developing effective coping mechanisms, individuals can improve their overall well-being. Dr. Ferguson suggests the following tips to get started.
Should I commit to going to that event? What will my friends think of me if I cancel…again?
Glancing at a calendar can spark anxiety for those living with a chronic illness. We don’t want to be the person who constantly cancels plans with friends and family, but chronic conditions, particularly autoimmune conditions, are often unpredictable.
We may feel fine one day but struggle to move the next due to extreme pain or swelling. It would be helpful to have a crystal ball and know when a bad day is coming. The frustration of not knowing when our body will betray us can be overwhelming.
For some, scheduling events in advance is impossible due to the fear of having to back out at the last minute. This can lead to anxiety over needing to stay home because of our chronic illness.
- Be honest. You don’t have to justify why you need to cancel or decline an invitation, but being open with close friends and family can be helpful. If you’re upset about missing out, let them know that you can’t make it this time but would love to be included next time. This can prompt a friend to reschedule with you.
- Let go of guilt. It’s not your fault. You didn’t choose to have that chronic condition, nor can you control it.
- Write loving thoughts. “You can help by observing your thoughts and noticing which ones are particularly upsetting or frightening, and if possible, write down loving or caring responses to that thought,” suggests Dr. Ferguson. “The physical act of writing can help.”
- Know your limits and expend your energy strategically. If you are forced to stay at home, transform that disappointment into restful or productive time.
Fear of Getting Sick
Going out makes people more susceptible to illnesses like the cold, flu, and COVID-19. Even before the pandemic, individuals with chronic illnesses were concerned about picking up germs at work or in public places. Needing to go buy groceries, pick up medication in person, or travel, for example, sparks anxiety for many people with a compromised immune system or who take immune-suppressing medications.
To minimize your risk of getting sick, it’s important to follow suggested guidelines such as the COVID-19 action plan for people with weakened immune systems released by the U.S. Centers for Disease Control and Prevention.
People living with chronic illness may worry about asking for workplace accommodations and wonder whether their coworkers will understand their fatigue and pain at work. With the prospect of returning to in-person work after months of remote work, those with autoimmune conditions may experience immense fear and worry. Seeing colleagues and commuters without masks can be a source of anxiety for them.
Aside from the fear of virus exposure, chronic illness can impact one’s physical, mental, and emotional well-being at work. It can be distressing to wonder how others perceive us, from our decisions related to our illness to our physical abilities and even how we’ve changed since our diagnosis.
- Learn from others. It is helpful to learn how other people who live with chronic illnesses cope with the physical, mental, and emotional stressors at work. These strategies are helpful in reducing anxiety related to work.
- Tell your boss. Sharing about your diagnosis with your employer or co-workers is a personal decision, but it can be helpful to let them know you live with an illness that affects your immune system or that you have some physical limitations and require accommodations due to your illness.
It’s natural to have concerns about the effectiveness of medication for chronic conditions like rheumatoid arthritis, psoriatic arthritis, or ankylosing spondylitis. Questions like “What if my medication stops working?” or “Will the next prescription work better or worse for me?” Or “What type of side effects can I expect” can create moments of intense anxiety or so-called “med dread.”
It’s important to remember that while there are treatments available to slow disease progression and manage symptoms, there is currently no cure.
Stopping treatment abruptly can cause adverse health effects and may worsen symptoms over time. Seeking support is a helpful step in overcoming med dread and feeling more comfortable taking medication.
Changing the Channel
Dealing with feelings of anxiety can be challenging, but distraction can help change the channel in your brain and disrupt cascading worries. “We get lost in anxious thinking as one anxiety ‘velcros’ to another, so being able to do something physical can help change the channel or disrupt the cascading worries,” explains Dr. Ferguson, who recommends trying the following forms of healthy distraction:
- Wash your hands or face.
- Go outside and get a whiff of fresh air.
- Walk into another room and sit somewhere you don’t usually sit.
- Call someone who will offer a calm response so you hear a different voice.
- Play music.
- Turn on a television show or game to distract yourself.
- Spend time with a pet.
- Go for a walk or stretch.
Dealing with anxiety can be tough, and sometimes, even trying to distract yourself may not work. It’s normal to feel anxious from time to time, but if you find yourself experiencing frequent and persistent feelings of anxiety that interfere with your daily activities, it’s important to take action.
One thing that can be helpful is to keep track of your anxiety levels and identify patterns and triggers that may be contributing to your anxiety. It’s also a good idea to let your doctor know how you’re feeling. Your doctor can work with you to adjust your treatment plan, and if necessary, refer you to a mental health professional who can provide additional support.
Remember, it’s okay to seek help when you need it. There are many effective treatments available for anxiety,
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Bobo WV, et al. Association of Depression and Anxiety With the Accumulation of Chronic Conditions. JAMA Netw Open. 2022. doi: https://doi.org/10.1001/jamanetworkopen.2022.9817.
Interview with Dr. Laurie J. Ferguson.
Lebel S, et al. Health anxiety and illness-related fears across diverse chronic illnesses: A systematic review on conceptualization, measurement, prevalence, course, and correlates. PLoS One. 2020 Jul 27. doi: https://doi.org/10.1371/journal.pone.0234124.