Effect of Chronic Illness on Mental Health

Human beings are made of two different aspects — the mind and the body. Holistic care includes spending time and effort on both aspects. Many of our pain centres are in our brains and most people react to any circumstance, positive or negative, emotionally. The key is in realising that there is a difference between the reaction to the pain and the pain itself, says Dr Fadwa L Korchy, Licensed Psychologist & Personality Dimensions Trainer.

Every year, it is estimated that there is a 3-9% rise in Autoimmune Disease — this includes inflammatory arthritis, like Rheumatoid, Sero-negative arthritis and other rheumatological conditions, such as Lupus and Systemic Sclerosis.

How can one process having a chronic or incurable illness and learn to manage and continue to live life with it? Do you psychologically change your frame of mind to manage your illness or are you going to let it govern the rest of your life, affecting even the good aspects? How do patients get through the denial and anger and finally accept their condition? The answer lies in being proactive rather than reactive, to accept the cards that you have been dealt.

Unhappy man sitting on sofa at home and touching hurt knee with grimace of pain and suffering. Young guy with rheumatism, arthritis or osteoarthritis feeling intense severe pain in knee joint

Those with chronic illnesses like arthritis usually suffer from depression or anxiety, built on negative thoughts and hypotheticals as doctors cannot provide a long-term prognosis. There is also a sense of grief for many patients as they have let a part of their life go to manage the disease. This eventually leads to the patient catastrophizing the pain and the situation. With more than 350 million people having arthritis globally, this is a large part of the population who are suffering.

While a patient can cope with their fate, their loved ones often find it more difficult, especially a child’s parents. When a child has an incurable condition, such as Juvenile Idiopathic Arthritis (JIA) a sense of helplessness overtakes the parents and they tend to channel their emotions into anger.

As 60% of people who have arthritis are between the ages of 18 and 64, there is a dire need for guidance on mental health management for this condition:

caucasian little girl wearing blue t-shirt standing outdoors Suffering pain on hands and fingers, arthritis inflammation
  • Both patients and their families should educate themselves on the condition.
  • Realise that you are in control of your thoughts and that “pain is mandatory, suffering is optional”.
  • Instead of focusing on your limitations and pain, start practising yoga and mindfulness to help you reframe your opinion about your condition.
  • The disease does not control you, it only takes away some body function. What are the things that you still can do? And when you feel better under medication, what activities can you start?
  • Join a support group — the UAE has many organisations like the Middle East Arthritis Foundation (MEAF), available for patients and their loved ones to get educated, get different perspectives on the disease and socialise with others affected.
  • Follow up with relevant professionals and take your medication.
  • Exercise, yoga, practice mindfulness etc. — anything that helps you change your frame of mind about the illness and gain some kind of control.

When I started practising here in 2003, mental health was a taboo subject linked to severe illnesses like schizophrenia. Thanks to the UAE’s willingness to become a global City of the Future and high information accessibility due to globalisation, people are more open to discussing mental well-being. The pandemic also helped to dissipate the stigma as it triggered a 25% increase in the prevalence of anxiety and depression worldwide.

Physical and psychotherapy need to come hand in hand as mental health plays a significant part in enhancing physical health. When something negative happens to us, we isolate ourselves and think we are alone. This is a psychological defence mechanism. Support groups tend to normalise the incurable condition and help you meet people from all walks of life and stages of the disease fighting together. We need more professionals to host free support groups to improve accessibility to information. In honour of World Arthritis Day, MEAF is hosting a free community event on October 15 in Dubai, which aims not only to spread awareness but also to empower patients and their loved ones to become more proactive, educate themselves and engage in seminars held by various professionals.

Tips from Dr Nasr Al Jafari, Functional Medicine Practitioner, specialising in Gut Health

Currently, studies have shown that genetic predisposition only accounts for approximately 30% of all autoimmune conditions. The rest, 70%, is due to environmental factors such as dietary components and gut imbalances.

Microbial imbalance and disturbance to the lining of the gut, which leads to increased ‘permeability’, causes immune system dysregulation, paving the way for the development of these conditions. This is caused, in part, by ultra-processed foods devoid of fibre and nutrients, but high in sugars, refined oils, additives, toxins and pesticides.

Eating habits which will help ameliorate such diseases include:

  • Applying fasting-techniques
  • Eating organic and as ‘close to nature’ as possible
  • Diversity of plant-based food, particularly cruciferous vegetables herbs and spices
  • High intake of polyunsaturated Omega-3 fats

In the UAE, the Middle East Arthritis Foundation is championing awareness for the disease with its full-day free-to-attend community event in honour of World Arthritis Day on October 15. The event is open to all to benefit from the informative sessions by the various health experts including Dr Fadwa and Dr Nasr. Attendees can also get several free arthritis tests done — ultrasound scanning of the hands for OA, bone density scan and Vitamin D tests.

The event will start at 8 am. Interested parties can register for the same at http://www.arthritis.ae/wad/.
Updates will be available on https://www.facebook.com/EmiratesArthritisFoundation/.