Stress, Anxiety, Body Image Changes with Chronic Illness

Stress, anxiety, body image changes with chronic stress happen to people of all ages that are living with a chronic illness. Living with a chronic illness is tough for anyone, an adult or child, as you juggle medications, doctor appointments, your regular routine in the home is no longer regular, and at the same time you are dealing with stress, anxiety and body image changes.

The doctors are focused on the disease and the treatment regarding tests and medications. You are learning about the disease and how to cope on a day by day basis. No one usually helps you deal with the anxiety, stress or possible body image changes that are occurring along with this illness. Your family is also trying to adapt to your chronic illness and all its ramifications.

When an adolescent becomes ill things are even more complicated. Adolescence alone is a stressful developmental process, even for physically healthy teens, so chronic illness occurring during adolescence further complicates their development. Hospitalizations, surgery if necessary, all intensify concerns about physical appearance; it interferes with the process of gaining independence and disrupts changing relationships with parents and friends. Plus, adolescent development issues complicate a teen’s transition toward taking responsibility for their illness. Since teens are typically focused on the physical changes occurring in their body’s chronic illness intensifies their concerns with fear or distortions related to their illness. Anxiety can be disabling in itself. They need encouragement to share their concerns related to their body, and they need to know about what to expect from the medications and treatments.

Chronic illness often interferes with a teens comfort in becoming less dependent on parents. Parents of chronically ill adolescents often are more resistant to the adolescent's efforts to act independently. The things you can do to help include involving the adolescent in health care discussions, including any current concerns about their illness or treatment choices. They need to be taught self care skills related to their illness. Encourage them to monitor and manage their own treatment as much as possible. Encourage the development of coping skills to address problems and concerns. Also, encourage them to spend time with their peers as much as possible.

While the adult isn’t dealing with the independence issues, their stress levels and anxiety often lead to depression while learning to cope with a chronic illness. Sometimes it is difficult to differentiate between anxiety and stress VS depression. There is a GAD test administered by are best top healthcare professionals that help to answer that question which is posted on the Lexapro (an antidepressant) webpage

Gad Self Screener which is an anxiety depression test:

Not at All Several Days Over half the Days Nearly Every Day

• Feeling nervous, anxious or on edge
• Not being able to stop or control worrying
• Worrying too much about different things
• Having trouble relaxing
• Beings so restless that it is hard to sit still
• Becoming easily annoyed or irritable
• Feeling afraid as if something awful might happen

(Adapted from Spitzer et al, 2006

If you checked off any problems, how difficult have these problems made if for your to do your work, take care of things at home, or get along with other people.

References: 1. Spitzer RL, Kroenke K, Williams JBW, Löwe B. A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006;166:1092-1097. 2. Kroenke K, Spitzer RL, Williams JBW, Monahan PO, Löwe B. Anxiety disorders in primary care: prevalence, impairment, comorbidity, and detection. Ann Intern Med. 2007;146:317-325

• I have trouble falling asleep or staying asleep.
• I sleep for 10 or more hours some nights.
• I feel sad a lot of the time.
• I don’t have much of an appetite and eat less than usual.
• I eat more frequently and overeat more than usual.
• My weight has either decreased or increased by more than 2 pounds in the past 2 weeks.
• I have trouble concentrating and making decisions.
• I believe I cause problems for others.
• I have frequent thoughts of suicide or death.
• I have less interest in people or activities that I usually enjoy.
• My energy level and thinking speed have slowed down.

If you know of anyone having suicidal thoughts, call the suicide help line or 1-8100-273-8255.

References: 1. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders. 4th ed (Text Revision). Washington, DC: APA; 2000. 2. Quick Inventory of Depressive Symptomatology - Self Report (QIDS-SR). Available at: http://counsellingresource.com/quizzes/qids-depression/index.html. Accessed July 10, 2007

These tests can only be evaluated by a health care professional and I only included them in this hub so you would be aware of some of the symptoms they typically evaluate, not to do a self evaluation. Acute depression symptoms need professional help either with a medication or some therapy.

Your body doesn’t know the difference between fiction and reality. If you are stressed over a busy schedule, an argument with a friend, a traffic jam, a drawer full of bills to pay or failing health your body reacts in the same way, just as strongly as if you were facing a life or death situation. You can easily develop anxiety attack symptoms or may experience anxiety attacks. If you have a lot of problems, responsibilities or worries your emergency stress response may be ready at all times. The more your body’s stress system is activated the easier it is to trip it and the harder it is to shut it off.

Long term chronic stress disrupts nearly every body system from raising your blood pressure to suppressing the immune system which increases the risk of heart attack, stroke, contributes to infertility and speed up the aging process. If you already have a chronic illness, this just further complicates things. Long term stress can actually rewire the brain leaving you more vulnerable to anxiety and depression. You must learn how to control stress and there are many methods to help.

Tools to recover:

• You may need your doctor to treat you with an anti-depressant
• Eat healthy and exercise.
• Yoga is a great stress reducer.
• Set realistic goals so you are not setting yourself up for failure.
• Learn to meditate and do so daily.
• Listen to your favorite music.
• Learn to use guided imagery.
• Learn self hypnosis.
• Avoid excessive competition.
• Manage your anger.
• Choose to keep quite when you feel a negative reaction.
• Use deep breathing several times a day.
• Reduce the urge to be perfect accepting yourself the way you are.
• Crying is okay as it is a stress reducer.
• Be flexible.
• Give yourself some me time each day.
• Silence your phone at night.
• Dab essential oils on your wrists at night to remind yourself to relax.
• Take a hot bath or shower before bed.
• Epsom salt is a natural stress reducer and relieves muscle and joint pain, so add 2 cups to your bath water at night.

We live in a very stressful world at this time and many people are dealing with greater stress and depression. The list above is incomplete as there are many ways to reduce your stress. If you are deeply depressed and have thought of suicide, please get some help. Suicide is a permanent solution to temporary problems.

The most constant thing in life is change and nothing stays the same forever, so try to keep problems in perspective. Get help when you need it! Try to do some things for fun as humor is a wonderful stress reliever. Try to relieve that stress, anxiety and the effects of body image changes with chronic illness, as the negative emotions will surely not heal you and often exacerbate your symptoms.

The copyright to this article is owned by Pamela Oglesby. Permission to republish this article in print or online must be granted by the author in writing.