Children and teens who live with chronic physical health conditions are understood to be at greater risk for mental health issues than their peers without chronic illness. Whether the child was diagnosed with a physical health condition at birth, or if the diagnosis was acquired later in life, the ongoing experience of illness or difficulty with health can be a stressor on the child. At some point in our lives, we all will encounter health difficulties and challenges, but there is a unique stressor for kids who experience chronic illness, as it may not seem common amongst their peers. A child with chronic illness faces challenges that their friends and classmates may not, like extra doctor visits, symptoms that disrupt learning and attention, and worries about health. In addition, there is extra strain on the family unit who is caring for this child. Caregivers not only have to manage the usual stress of raising a child amongst all their other responsibilities but also must dedicate time and energy to medical treatment, collaboration with doctors, and the emotional weight of caring for a chronically ill child.
Broadly, we know that physical health and mental health interact with each other. For example, going to the gym and eating well are often found to relieve stress and improve mental health. Therefore, it makes sense that when a child is not physically healthy, their mental health may be at risk. With major medical advancements in the field, it is becoming more common for children with chronic illnesses to live longer, making quality of life more important. Children with chronic conditions can range from kids with asthma and diabetes, where integrating healthcare into daily life can be challenging but manageable, to kids who are more dependent on medical devices for essential body functions, which may limit their ability to function as other kids do in their daily lives.
Experiences of chronic illnesses can vary greatly, depending on the impairment in functioning that the illness causes the child, the intensiveness of medical treatment required, and the implications for longer term medical outcomes. A study by Ruth E.K. Stein found that diagnosis of chronic conditions, “especially when accompanied by symptoms, hospitalizations, procedures or medications that are experienced as painful or unpleasant,” can be traumatic for children and their parents. Feelings of shock that can come along with a life-changing diagnosis are normal, and often these feelings are followed by denial, then sadness and anger, for older kids and adults. These are all natural emotions that serve a purpose to protect the child or the caregivers, as long as they don’t interfere with medical treatment, and often result in acceptance of the new reality when there has been time to process life changes. Younger kids may have a harder time understanding the changes in their life, and why they are occurring. With a limitation in understanding, kids may connect unpleasant medical experiences, or being removed from their every-day life routine, with the idea that they are being punished for doing something wrong. With kids this young, explaining to your child the situation in simple terms, and reassuring them that they are not being punished for anything they did, becomes important. Young kids take the lead from their caregivers, if caregivers can express that they wish this were not happening to the child, but that they have confidence in the medical team to do the best they can, the child may be able to approach with more bravery and assurance.
Overall, research shows that most children with chronic and life-threatening conditions continue to develop typically with emotional regulation and mental health. Of these children, those who experience mental health challenges will likely experience periods of depression, anxiety, or be diagnosed with attention-deficit/hyperactivity disorder. However, these are the most prominent diagnoses even in the general child population.
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