The role chronic disease plays in mental health

Getting diagnosed with a chronic disease can bring up feelings of frustration, anger, and even grief. And learning to live with a long-term illness can sometimes leave you feeling overwhelmed. These are normal emotions. But if you can’t seem to shake a low mood, you may also be dealing with depression or anxiety.

Research suggests that people living with chronic disease (such as diabetes or high blood pressure) have an increased risk of facing such mental health issues. Experiencing anxiety or depression can make it tougher to take care of yourself, including managing your chronic disease. That’s why it’s so crucial to work with your doctor to find the right mental health treatment.

The first step to feeling better is understanding the link between chronic disease and mental health — and the role chronic inflammation plays in that connection.

To learn about managing chronic conditions, browse HMSA Health and Well-Being Support resources.  

What is chronic inflammation?

Inflammation is part of the body’s healing process. When the immune system recognizes a threat or an injury, such as a bacterial infection or a sprained ankle, it reacts by creating inflammation to protect and heal the affected area. This is called acute inflammation.

However, not all inflammation is helpful. Chronic Inflammation refers to long-term inflammation that lasts for several months or years. This type of inflammation can damage healthy tissue and cells and lead to serious health conditions.

What health conditions are marked by chronic inflammation?

Chronic inflammation is the culprit in a wide range of serious conditions. They are collectively referred to as chronic inflammatory diseases, and they include:

• Allergies and asthma.
• Arthritis and other joint diseases.
• Cancer.
• Diabetes.
• Heart disease, including coronary heart disease and heart failure.
• Lung conditions, such as chronic obstructive pulmonary disease (COPD).
• Stroke.

How many people are affected by chronic disease and mental illness?

Chronic diseases are the leading causes of death and disability in the United States. At least 60% of adults have at least one chronic disease, and 40% live with two or more.

Mental illnesses also affect millions of people. In the United States, 1 in 5 adults have reported experiencing a depression, anxiety, or other mental health condition, with 1 in 20 adults experiencing a severe mental illness.  

Despite the frequency of mental health conditions, not enough people get the help they need. On average, there’s an 11-year gap between the time when people notice their symptoms and when they seek treatment. Fewer than half of adults with mental illness receive treatment each year.

If you are experiencing symptoms of depression, anxiety, or other mental health conditions, talk to your health care provider. 

How does chronic disease affect mood?

The stress of living with daily physical pain can change your brain chemistry, which affects your mood, thinking, and behavior. This can lead to conditions such as depression and anxiety.

In a study of arthritis patients, for example, those who reported the highest levels of pain were also the most likely to be depressed. Another study estimates that 57% of people living with COPD have depression.

What’s more, some chronic diseases have symptoms that mimic those of depression. For example, high or low blood sugar levels in people with diabetes can cause mood changes that could be mistaken for depression. Breathing issues due to conditions like COPD and asthma can lead to fatigue, which can also mimic depression symptoms.

Feel better with HMSA’s Behavioral Health Program. Eligible HMSA members can receive help choosing a mental health professional, find referrals to HMSA Case Managers, as well as other behavioral health services and resources. Learn more here. 

How do mental health issues worsen symptoms of chronic illness?

Having a mental health condition like depression or anxiety can get in the way of living a healthy lifestyle. These conditions make it tougher to follow the treatment plan for your chronic disease, such as eating a nutritious diet and taking medications as prescribed by your doctor.

Depression can also worsen chronic inflammatory conditions and may even contribute to conditions such as heart disease and Alzheimer’s disease. Yes, depression is a mental illness, but when left untreated, it can result in physical changes to the body, including:

• Abnormalities in stress hormones.
• Changes in heart rate or blood circulation.
• Increased inflammation.
• Metabolic changes, such as those in people with diabetes.

Anxiety and depression can even lower your pain tolerance. In turn, chronic pain may worsen your anxiety and depression. It’s a vicious cycle. The relationship between chronic disease and mental health is so strong that it can sometimes make it difficult to pinpoint the cause of your symptoms.

How to reduce inflammation in the body

The good news? There are ways to tame inflammation and help ward off symptoms of chronic disease and mental health disorders. In addition to regular visits with your care team, try these lifestyle tweaks:

• Avoid alcohol and tobacco. Both have been linked to an increased risk of cancer and heart disease. Drinking alcohol can worsen symptoms of depression. If you smoke cigarettes, cigars, or e-cigarettes, your doctor can help connect you with resources so you can take steps to quit. Go to hmsa.com/well-being/stop-smoking for more information on resources to help you quit tobacco and cravings. 
• Eat the rainbow. Nutrition plays a big role in inflammation. Limit fast food and processed foods and try to eat as many colors of the rainbow as you can each day. You can choose foods such as strawberries, carrots, yellow peppers, leafy greens, blueberries, and purple sweet potato.
• Get moving. A lack of physical activity can increase your risk of diabetes, obesity, and cardiovascular disease. Try to sneak more exercise into your day by taking the stairs when possible or parking further away from the grocery store entrance. (Here are some simple steps to getting more active.)

Seeking treatment for your mental health issues may motivate you to better manage your chronic disease. And keeping up with your care plan for your chronic disease can help keep you mentally strong. Together with your doctors, you’ve got this.

See our sources: 
Depression: National Institute of Mental Health 
Mental health by the numbers: National Alliance on Mental Illness  
Chronic illness and mental health: National Institute of Mental Health 
How inflammation, stress, and other factors can lead to depression: American Psychological Association 
Inflammation in obesity, diabetes, and related disorders: Immunity 
Arthritis and mental health: Arthritis Foundation 
Anxiety/depression among cancer patients during the COVID‐19 pandemic: Psycho-Oncology 
Do COPD and major depression share genetic risk factors? Human Molecular Genetics 
Emotions, stress, and depression: Asthma and Allergy Foundation of America 
Heart disease and mental health disorders: Centers for Disease Control and Prevention  
Diabetes and mental health: Centers for Disease Control and Prevention 
That salad may help stave off depression: American Psychological Association 
Alcohol use disorder: Biomedicines 

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