Couples and Chronic Invisible Illnesses

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Chronic Illness and Mental Health

Half of all adults in the United States have at least one chronic illness. This can range from around 20% of people ages 45 to 64 and jumps to 80% of people over the age of 65. With these rates, about 45% of adults help aid a loved one with a chronic condition at some point in their life. Chronic illnesses are those that are not immediately curable and are present for an extended period of time. Some of the most common examples in the United States include diabetes, chronic headaches or migraine, epilepsy, arthritis, and asthma.

It is well known that physical health is strongly related to mental health. A person with a chronic medical condition is up to three times more likely to have depression than someone without a chronic condition, and higher levels of stress lead to worsening symptoms overall. Some theories as to why chronic illnesses specifically affect mental health take into account the possibility of decreased mobility, shame, judgement, high stress, poor sleep, pain, and difficulty adjusting to the challenges associated with chronic illness.

Partners of those with a chronic condition may also experience more depressive symptoms due to the influence of reduced social activity, higher stress, sleep disturbance, lack of energy, lack of emotional support, and other relational distress.

Relationship Satisfaction and Illness Management

Relationship satisfaction is an important factor in dealing with the day-to-day stressors of a chronic illness, and it has been shown to affect depression symptoms, self-esteem, and life satisfaction.

Recent research has shown that relationship satisfaction is tied to illness management. That means that those who are happier in their relationships tend to follow medical advice more closely, therefore experiencing fewer or less intense symptoms for physical and mental conditions. Because of this, there has been a slowly increasing awareness about the importance of including loved ones in treatment for mental and physical health services. If a person with a chronic illness is able to include a partner in therapy, the couple can address any issues of illness management, hostility, criticality, and lack of emotional support that may be present in the relationship.

One of the most common issues that arises when a couple is trying to manage a chronic illness is differing opinions about how it should be done. It is normal for two partners to have different opinions about how things should be done, but differing opinions about how to load the dishwasher or drive to the grocery store have a different and less consequential impact than decisions about long-term health. Talking about complicated health issues can bring up intense feelings and worries that a couple may find it hard to navigate.

Family Stress Can Contribute to Health Complication

Family stress is associated with higher incidents of health complications. Having a supportive family and partner may help reduce the impact of stress through building resilience and encouraging the client to manage their illness themselves or to ask for help when it is needed.

Medical treatment alone is often not enough to adequately manage a chronic condition, so collaborative care between medical and mental health professionals is highly encouraged. Collaboration between family members, partners, and medical professionals can be transformative to the process of dealing with a chronic illness.

Putting an emphasis on figuring things out together and working as a team instead of putting pressure on one person to do everything not only helps relieve stress from any one person, but the connections between everyone involved can create a level of emotional support that is often forgotten in long-term treatment. Processing a daunting medical issue is a big weight on anyone's shoulders, but it doesn't need to be dealt with alone.

There are many support groups in our area. If you are looking for a group of people with similar experiences to you, check out for a list of local support groups. Ask your doctors or other medical providers if they know of a group that may be a good fit for you. See if the condition that is relevant to you has its own website, such as, to see if they have other specific resources.

This information is an adaptation of a presentation Sierra Stein conducted at the Indiana Association of Marriage and Family fall conference in October 2019. Sierra won third place for her presentation. Sierra Stein is a Marriage and Family Therapy intern at Clarity Clinic NWI. Contact us at 219-595-0043 to set up an appointment if this topic is relevant to you or your family!

Academic References
Chiang, J. J., Turiano, N. A., Mroczek, D. K., & Miller, G. E. (2017). Affective reactivity to daily stress and 20-year mortality risk in adults with chronic illness: Findings from the National Study of Daily Experiences. Health Psychology, 37(2), 170-178. doi:10.1037/hea0000567.
Chopik, W. J., Kim, E. S., & Smith, J. (2018). An examination of dyadic changes in optimism and physical health over time. Health Psychology, 37(1), 42-50. doi:10.1037/hea0000549.
Lee, A. A., Piette, J. D., Heisler, M., Janevic, M. R., Langa, K. M., & Rosland, A. (2017). Family members' experiences supporting adults with chronic illness: A national survey. Families, Systems, & Health, 35(4), 463-473. doi:10.1037/fsh0000293.

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