Recognizing anxiety in chronic illness

Change is often frightening, and being diagnosed with a chronic illness is a particularly scary change. Dreams and aspirations are shattered or altered. Thoughts of financial difficulties ensue. Some dread the impact on their quality of life.

These feelings are normal and may come and go, settling as you adjust to a new reality. But if such feelings persist and begin to interfere with your ability to function in life, it is time to take action. However, in the United States an estimated 30 percent of individuals with anxiety disorders go through life untreated. Many don’t know the signs to watch for or don’t think there’s anything they can do about anxiety.

If you experience anxiety during an illness, you are far from alone. Significant psychological symptoms are common in patients with chronic medical problems. Even if a person is not diagnosed with a specific or obvious mental disorder, chronic illness can cause unusual and complicated emotions, actions and thoughts worth paying attention to.

Anxiety should not be ignored. Chronic anxiety exacerbates illness and chronic illness exacerbates anxiety. Risk of a coronary event or stroke tripled in women with a history of panic attacks according to data from 3,300 postmenopausal women who took part in the Women’s Health Initiative, a 15-year National Institutes of Health (NIH) research program. Health risks in general are heightened for people with psychological symptoms.

When you learn to recognize the symptoms, seek treatment and break this vicious cycle between anxiety and illness, you can experience better outcomes on both sides of the equation.

Symptoms

Because untreated anxiety can worsen the physical impact of a diagnosis, it is important to be aware of its symptoms so that if they appear you are prepared to locate the tools necessary to improve your overall health.

Feelings associated with anxiety are fear, panic and terror. Anxiety can also manifest in physical symptoms such as hot or cold flushes, dizziness, racing heart, shortness of breath, chest pain or tightness and nagging aches and pains.

Do not assume any symptoms you experience like this are a normal reaction caused by the disease process or treatments involved. This is the assumption that causes anxiety to go undertreated in chronic illness. Seeking help is a sign of strength not weakness. While patience, flexibility and resilience are all good coping mechanisms, the loss of control experienced with chronic illness can overwhelm anyone’s coping abilities. It’s important to understand when to seek help.

It’s time to seek treatment when symptoms cause:

• Anxiety attacks about treatment or future prognosis.
• Avoidance of necessary treatment because it causes unbearable feelings of anxiety or sadness.
• Repetitive nightmares or intrusive thoughts and rumination about diagnosis or treatment of your medical condition.
• Worry over your condition that interferes with sleep.
• Anxiety attacks about not properly following the treatment regimen.
• An inability to talk to others about how you feel about your illness.
• Avoidance of socializing because of your condition.
• Shame and self-blame about your disease.
• Loss of pleasure in activities you once enjoyed.
• Chronic irritability.
• A turn to substances such as alcohol to quell the anxiety.
• Thoughts of suicide because you believe that your condition makes your life worthless or too painful to endure. Such thoughts require immediate professional attention.

Primary care providers are a good place to start for seeking help. They are able to evaluate, diagnose, counsel and even start medication if needed. They can also provide referrals to mental health specialists when greater intervention is required.

Treatment

Treatments can vary, but one of the initial steps and mainstays is cognitive behavioral therapy, often thought of as “talk therapy.” With cognitive behavioral therapy, individuals learn to evaluate and challenge negative patterns of thinking so that they internalize more positive and beneficial strategies.

An individual diagnosed with a chronic illness who believes that they have lost the ability to make a useful contribution to life is likely to experience a depressed mood and avoid previously enjoyable activities. But a different individual with the same condition, who acknowledges that their life will have to change, but who believes that they will be able to discover new ways to make a contribution, is likely to make a better psychological adjustment to their illness. Cognitive behavioral therapy encourages and teaches that more positive outlook, helping the first individual take on the thinking patterns of the second individual.

If cognitive behavioral therapy is not enough, medications may also be used. Medications should only be used in conjunction with psychotherapy. Certain antidepressants known as SSRIs (selective serotonin reuptake inhibitors) are good at calming the symptoms of anxiety, and they help by restoring the brain’s natural chemistry. Another class of drugs known as benzodiazepines can have a more immediate impact but they’re not recommended for long-term use, because patients develop tolerance and require increasing doses. These medications come with risks of abuse and dependency.

Lifestyle changes can help with anxiety as well. Such changes can include:

• Knowing as much about your illness as possible. Knowledge lends to empowerment and informed decisions. This can help you feel like less a victim of your disease.
• Making sure you choose a doctor that is compassionate and that you feel comfortable with
  in your communication.
• Seeking out support groups for your condition
  to avoid social isolation.
• Maintaining a healthy lifestyle regarding diet
  and sleep.
• Engaging in physical activity according to your ability.

Living with a chronic illness is a challenge and involves significant uncertainty. It’s no surprise that anxiety is often married to the news of diagnosis. With a better understanding of anxiety and its impact, you can recognize the signs and know when to seek appropriate treatment, preventing it from impacting your overall health.

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