Chronic conditions have a far greater impact on a person’s life than the physical effects alone. Understanding and validating this experience from all sides is vital, as our expert columnist Bea Appleby shares, along with essential tips for navigating this

Living with a long-term health condition (LHC) can feel like travelling an exhausting and lonely path. Whether it’s chronic pain, asthma, arthritis, or autoimmune diseases, these conditions take a toll on mental health that is often overlooked.

As a therapist, I’ve had the privilege of supporting individuals with LHCs, and while they show incredible strength in managing their physical symptoms, many are quietly carrying a profound emotional burden. Feelings of isolation, low self-esteem, stigma, stress, and discrimination can increase the risk of mental health problems such as depression and anxiety. In fact, research, published by the King’s Fund and the Centre for Mental Health, shows that people with LHCs are two to three times more likely to experience mental health issues. In the UK, more than 30% of the population lives with one or more long-term conditions, and more than 4 million also face mental health challenges.

Mental health and chronic illness are deeply intertwined, and both deserve compassion, attention, and integrated care. In recent years, we’ve begun to better understand how physical illness can impact mental wellbeing, and how mental health struggles can make physical conditions harder to manage, creating a cycle of suffering for many.

This cycle has real physical effects, and emotional pain can change how we experience physical pain. Research, published in PLOS One, shows that higher stress levels make it harder for the body to manage pain. However, it’s important to note that just because pain can have a psychological component, doesn’t mean a person is exaggerating it. This simply highlights the strong connection between the mind and body – when the mind hurts, the body often does, too.

One of the most distressing emotional responses to chronic illness is shame. I’ve seen clients with health conditions feel different, unworthy, or even like a burden, often leading to a deep sense of guilt. This shame is often rooted in societal pressures to appear healthy, strong, and self-sufficient. Sadly, there is a deeply ingrained cultural belief that illness is somehow our ‘fault’ – whether it’s for getting sick in the first place, or for not being able to heal quickly enough. This judgement can be painful and alienating.

The impact on a person’s sense of identity is, in my opinion, the most difficult psychological aspect of dealing with an LHC. Before a diagnosis, many people define themselves through their work, relationships, hobbies, and abilities – things that may no longer be possible. There can be a loss of independence, too. The grief of losing these parts of who you once were, and the painful shift in how you see yourself, can be heart-breaking. It’s a loss that goes far beyond physical health, affecting the core of who you are.

Taking care of an LHC requires a holistic approach – treating both the body and the mind with equal care and compassion. When we recognise that mental health is just as important as physical health, we begin to create a more balanced and supportive path toward acceptance.

If you’re living with an LHC, I want to remind you that your mental health matters as much as your physical health. You deserve to be heard, supported, and treated with kindness – especially by yourself. Caring for your emotional wellbeing isn’t a sign of weakness; it’s a powerful act of strength and self-love. And remember, you don’t have to face this journey alone.

For those of you who don’t live with a chronic condition, consider reaching out to someone who does. Don’t just ask about their physical symptoms, but how they’re really feeling. Your support could make all the difference.

Tips for managing mental health with an LHC

  • Build your support network. Talking to others about what you’re going through is vital for wellbeing. Whether it’s friends, family, or online, connecting with others helps ease feelings of isolation.

  • Find self-compassion. Be kind to yourself, especially on difficult days. Remember that your worth is not defined by your health, and it’s OK to have moments of struggle.

  • Explore mindfulness and meditation. These comforting practices offer moments of calm and relief when pain or fatigue feel overwhelming. With mindfulness, you can gently shift your focus to what you can still do, and the things that bring you joy, and away from thoughts of loss, helping you stay connected to the present moment.

  • Find a therapist who can help. Look for a therapist who specialises in chronic illness. Many find that Acceptance and Commitment Therapy (ACT) can help in dealing with challenges, and living a meaningful life despite suffering. It’s effective for treating conditions like chronic pain, anxiety, and depression, building resilience, and self-compassion.