Many of us will, at some time, have a serious physical illness. Both the illness, and the treatment for it, can affect the way we think and feel. This leaflet is for anyone who has a serious physical illness and for their friends or relatives. It describes:

 

§  The emotional effects of having a serious physical illness.

§  What does it feel like to be anxious or depressed?

§  Why are depression and anxiety more likely to happen if we have a physical illness?

§  What might make you more likely to become anxious or depressed?

§  When should you seek help?

§  How can depression and anxiety be helped?

§  How can you help yourself?

§  How can family and friends help?

§  Some places to get information and support.

The emotional effects of having a serious physical illness

A serious physical illness can affect every area of your life:

§  relationships

§  work

§  spiritual beliefs

§  how we socialise with other people.

A serious illness can make us feel sad, frightened, worried or angry.

 

It may be because:

§  We feel out of control of our body and our situation generally. We may feel that there is nothing that we can do.

§  We feel lonely and isolated from family and friends. Sometimes it can be difficult to talk about the illness with those close to us. We don't want to worry or upset them.

 

For some of us, the emotional impact of a serious physical illness can be overwhelming. Cancer or heart disease, for example, can make us very anxious and depressed. It can stop us from doing the things we need to do in our daily lives.

What does it feel like to be anxious or depressed?

Anxiety and depression affect both our mind and body. Often the two happen at the same time.

 

Anxiety feels like:

§  Constant worrying thoughts, often about the illness and its treatment

§  Fearing the worst, for example, that our illness will get worse or that we might die

§  Being very aware of our heart beating (palpitations)

§  Tension and pains in our muscles

§  Being unable to relax

§  Sweating

§  Breathing too fast (hyperventilating)

§  Feeling dizzy

§  Feeling faint

§  Indigestion and diarrhoea

 

Depression feels like:

§  Feelings of unhappiness that don't go away, and are there nearly all the time

§  Losing interest in life

§  Being unable to enjoy anything

§  Finding it hard to make even simple decisions

§  Feeling utterly tired

§  Feeling restless and agitated

§  Losing appetite and weight (some people find they do the reverse and put on weight)

§  Difficulty in sleeping and waking up earlier than usual

§  Losing interest in sex

§  Losing self-confidence and feeling useless, inadequate and hopeless

§  Avoiding other people

§  Feeling irritable

§  Feeling hopeless about ourselves, our situation and the world generally. We may feel as if we are never going to get better, or that we are worthless

§  Thinking of suicide - this is common in depression. It is much better to talk about it than to try to hide it

 

Some of these symptoms, such as feeling tired, poor sleep and loss of appetite, may be similar to those caused by the physical illness or its treatment. If you talk through how you are feeling with a doctor or nurse, they can help to sort out whether it is your physical illness or depression that is responsible.

Why are depression and anxiety more likely to happen if you have a serious physical illness?

§  People become depressed and anxious when they are stressed for any reason. Being ill and having treatment are stressful. This is probably the most common reason.

§  Some drug treatments, such as steroids, affect the way the brain works and so cause anxiety and depression directly.

§  Some physical illnesses, such as an under-active thyroid, affect the way the brain works. They cause anxiety and depression directly.

§  Anxiety and depression are common. You may just happen by chance to become anxious or depressed at the same time as you become physically ill.

What might make you more likely to become anxious or depressed?

You are more likely to experience severe anxiety and depression when you are physically ill if:

§  You have been anxious or depressed before.

§  You do not have any family or friends you can talk to about your illness.

§  You are female (women report more anxiety and depression than men).

§  You have other problems or stresses going on in your life at the same time. For example, redundancy, a divorce or the death of a loved one.

§  You are in a lot of pain.

§  Your illness is life-threatening.

§  Your illness stops you from looking after yourself.

 

The times when we are most likely to become anxious and depressed are:

§  When you are first told about your illness.

§  After having major surgery or if there are unpleasant side effects to your treatment.

§  If the illness comes back, after you seemed to be feeling better. For example, a recurrence of cancer or a second heart attack.

§  If your illness stops responding to treatment.

When should you seek help?

 

If your feelings of anxiety and depression:

§  Are worse than the fears, worries and sadness that you have had before.

§  Don't seem to be getting any better with time.

§  Begin to affect your feelings towards family and friends, your work and your interests.

§  If you feel that life is not worth living, or that other people would be better off without you.

 

You may not realise you are depressed, if:

§  You think all your symptoms are due to the physical illness.

§  You blame yourself for being lazy or feeble.

 

Other people may have to reassure you about this. They may need to remind you that seeking help is not a sign of weakness. Some of us try to cope with our feelings of anxiety and depression by keeping busy. This works for some people, but can also be an excellent way of making ourselves even more stressed and exhausted. Sometimes anxiety and depression may not show themselves as feelings of unhappiness and fear, but may produce bodily pain, headaches, or sleeplessness.

 

It may be enough to talk things over with a relative or friend, who may be able to help you through this difficult time. But, if this doesn't seem to help, it is probably a good idea to talk to one of the doctors and nurses who are looking after you.

Is feeling like this a good enough reason to ask for help?

It can be difficult asking for help with anxiety and depression when we are physically ill because:

§  You may feel your distress is understandable and therefore there is nothing that can be done about it.

§  You don't want to appear ungrateful, or as if you are complaining to the doctors and nurses who are providing your physical care.

§  You don't want to interfere with the treatment of your physical illness, by admitting that you are having difficulty coping.

§  You may feel that the doctors and nurses are too busy looking after your physical illness to be interested in your anxiety and depression.

§  You feel the doctors and nurses are more interested in your physical problems than your emotional ones.

 

Of course we can all understand when someone with a serious physical illness becomes anxious and depressed. This does not mean that you should ignore it. Doctors and nurses are concerned about all aspects of your health, including any depression or anxiety that you are feeling. They can help :

§  Knowing about your worries and concerns about your situation.

§  Making sure you know enough about your illness and its treatment.

§  Helping you to talk about your feelings.

§  Deciding if you need treatment for anxiety or depression.

How can depression and anxiety be helped?

There are several different types of professional who may be able to help you. These include your family doctor (GP), trained counsellors, psychotherapists, clinical psychologists and psychiatrists. Any treatment suggested will depend on your symptoms, the severity of your anxiety and depression, and your circumstances. It may involve talking, antidepressant tablets or both.

 

Talking treatments

 

It can be hard to express real feelings, even to close friends. It may be easier to do this with an interested professional. He or she can help you to get things in perspective and to find ways of sorting out your problems. Talking therapies are usually brief, involving up to 8 sessions. You might see somebody on your own or as part of a group. If you have a partner or carer, it could be helpful for her or him to be involved. There are many types of talking treatments but all have the following ingredients:

§  A trusting relationship between the patient and the professional.

§  An opportunity to talk freely and openly about your thoughts, feelings and problems.

§  Help coping with worrying thoughts, bad feelings and practical problems.

 

Will it help?

The thought of seeing someone just to talk may seem frightening or pointless, or both. However, once started, most people with a serious physical illness find it very helpful.

 

How does it work?
Talking treatments work by helping you to be clearer about what is happening to you emotionally. They help us to find ways of coping better with feelings, thoughts and practical problems. It's also helpful to be able to talk freely with someone who you trust and who doesn't pass judgement on you.

 

How quickly does it work?
Some people feel better straight away, simply from being able to talk about their worries. For others, it may take a few weeks.