Living Well: Cognitive Behavioral Therapy for Management of Chronic Illness
October 23, 2019 By Kelly Dunn, LCPC
As modern medicine offers us more options for long-term management of serious illnesses, more Americans than ever before are living with the challenge of managing chronic health conditions. According to recent estimates, 45% of the American population now lives with chronic illness, defined as “a physical or mental health condition that lasts more than one year and causes functional restrictions or requires ongoing monitoring or treatment” (Raghupathi & Raghupathi, 2018). The Centers for Disease Control and Prevention (CDC) reports that 6 in 10 adults and 1 in 4 school-aged children in the U.S. are living with a chronic illness.
A chronic illness diagnosis often comes with high levels of uncertainty, lifestyle changes, and treatments that are costly, time-consuming, and painful. Given these stressors, it is not surprising that individuals living with chronic illness are at significantly higher risk of struggling with anxiety, depression, adjustment disorders, and other mental health concerns (e.g., Patten et al., 2018) compared with those living without chronic illness.
After a diagnosis, individuals are often asked to make radical lifestyle changes, including adjustments that may impact them socially, professionally, and romantically. Common symptoms such as fatigue, pain, brain fog, and dietary or mobility restrictions might lead to less time with friends or changes in one’s ability to work. Grief, a sense of loss, feelings of isolation, and identity shifts often accompany the diagnosis of a chronic illness.
These changes may feel particularly isolating for individuals coping with “invisible illnesses,” a term for conditions not readily apparent to others. These illnesses can be especially challenging, as their impact is deeply felt but not always seen or acknowledged by others. Common invisible physical illnesses include autoimmune diseases, gastrointestinal disorders, chronic pain, migraine, endometriosis, and diabetes, among others. Many mental health conditions are also considered invisible chronic illnesses.
Even for chronic illnesses that are purely medical in nature, there is a growing body of research supporting Cognitive Behavioral Therapy (CBT) as an effective treatment for aiding in illness management. The way an individual thinks about illness and pain has a powerful impact on how the illness is experienced and the perceived limitations that accompany it. Successful treatment of concurrent anxiety or depression also predicts significantly better health outcomes for those living with chronic medical conditions (e.g., White, 2001).
CBT is an evidence-based therapy that focuses on how targeted changes in an individual’s thoughts, feelings, and behaviors can lead to positive, lasting growth. This short-term, structured, and active approach involves changing negative thought patterns and learning skills to improve quality of life and disease management.
Two main components of CBT for managing chronic illness include:
- Becoming an objective observer of your thoughts.
- Increasing valued actions at a pace that is right for you.
CBT for Chronic Illness also includes tailored applications of self-advocacy skills, problem solving, relaxation training, and other lifestyle self-management strategies.
Ultimately, working with a CBT therapist allows you to create a personalized illness management plan and to learn how to improve and maintain your quality of life over time. Although chronic illnesses cannot be cured, CBT can provide the tools needed to play an active role in managing your health and to live a rich and fulfilling life on your own terms.
References
- Chronic Diseases in America | CDC. (2019, September 12). Retrieved October 10, 2019, from https://www.cdc.gov/chronicdisease/resources/infographic/chronic-diseases.htm
- White, C. A. (2001). Cognitive behavioral principles in managing chronic disease. Western Journal of Medicine, 175(5), 338–342. doi:10.1136/ewjm.175.5.338
- Patten, S., Williams, J., Lavorato, D., Wang, J., Jetté, N., Sajobi, T., et al. (2018). Patterns of association of chronic medical conditions and major depression. Epidemiology and Psychiatric Sciences, 27(1), 42–50. doi:10.1017/S204579601600072X
- Raghupathi, W., & Raghupathi, V. (2018). An Empirical Study of Chronic Diseases in the United States: A Visual Analytics Approach. International Journal of Environmental Research and Public Health, 15(3), 431. doi:10.3390/ijerph15030431
- Vaks, Y., Bensen, R., Steidtmann, D., Wang, T. D., Platchek, T. S., Zulman, D. M., et al. (2016). Better health, less spending: Redesigning the transition from pediatric to adult healthcare for youth with chronic illness. Healthcare (Amsterdam, Netherlands), 4(1), 57–68. doi:10.1016/j.hjdsi.2015.09.001
