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Living with a chronic disease

Did you know that 25%–50% of people living with a chronic disease, such as arthritis or diabetes, struggle with depression?[1] There is nothing surprising about that, according to Dr. Jeffrey Habert, an assistant professor in the Department of Family and Community Medicine at the University of Toronto. This is why.
[1] Source: Chronic Disease and Mental Health Report, HealthPartners, 2015.

Enduring condition

Chronic illness is a slow and sneaky health problem with symptoms that appear gradually and persist over time. Generally speaking, a chronic disease cannot be completely cured and does not resolve on its own. In addition, it can considerably affect quality of life and the psychological health of anybody who has it.

“Coping with a disease is more than just managing symptoms; often there is a major emotional burden to bear,” explains Dr. Habert. He continues: A long-term physical condition can also lead to social isolation, low self-esteem, stigmatization, etc. It can cause anxiety as well. However, it is vital to distinguish adjustment disorder—a temporary response to stress—from major depression.” Somebody with major depression experiences intense, ongoing negative emotions.

Learning to live with the reality

Marie-France Lemire knows something about this; she has been suffering from severe migraines since she was 9 years old. She was a teacher but had to give up her career in 2012 because of this chronic disease and gradually developed an anxiety disorder. The forty-year-old has also had major depression.

Even though this young mother is doing better today, she still needs to pick her activities carefully, even with the changes she has made to her life to deal with attacks. “It’s an unpredictable health problem, which means you have to let go. I have to live in the moment because I never know when a migraine is going to mess up my plans… And, obviously, there have been losses in different areas of my life,” says the woman who has been disabled for the past 11 years.

Interestingly, depression is also considered to be a chronic illness. It presents with a variety of symptoms (such as fatigue, sleep disorders, absence of libido, loss of appetite, sadness, reduced self-esteem, lack of attention and suicidal thoughts).

Finding solutions for yourself

According to Dr. Jeffrey Habert, it is crucial to recognize what patients are going through to determine the right diagnosis, and then offer them the support they actually need.

Marie-France has used psychotherapy and antidepressants. “I also took a pain self-management program. That was a pivotal step in my journey to wellness,” she says, adding “From then on, things got clearer for me. I also decided to get involved with Migraine Québec; I serve on the Board of Directors and am the volunteer mutual assistance lead. That’s how I managed to compensate for the gap caused by disability. As a teacher, I needed to feel useful, and I have totally regained that feeling with this organization.”

Key facts

• Up to 87% of Canadians will be affected by a chronic disease during their lifetime.[1]
• The prevalence of mental disorders is 11.6% in the absence of a chronic physical disease; it rises to 31.4% in the presence of four or more physical chronic diseases.[2]
• An individual with a chronic physical condition is twice as likely as an individual without such a condition to have a mood disorder.[3]
• Social support may be a protective factor against depression.[4]

Learn more
About the non-profit organization Migraine Québec
https://migrainequebec.org/ [in French only]

[1] Chronic Disease and Mental Health Report, HealthPartners, 2015.
[2] L’effet combiné de la multimorbidité et des troubles mentaux sur les admissions fréquentes à l’urgence chez les adultes québécois, Bureau d’information et d’études en santé des populations, Institut national de santé publique du Québec, 
[3] Association of comorbid mood disorders and chronic illness with disability and quality of life in Ontario, Canada, Chronic Diseases in Canada, Vol. 28, No. 4, 2008.
[4] Psychological health—depression. Health Reports, Statistics Canada, Winter 1999, Vol. 11., No. 3. https://www150.statcan.gc.ca/n1/en/pub/82-003-x/1999003/article/4935-eng.pdf