Life With Chronic Illness and Mental Health Challenges: What Clinicians Should Know
Living with a chronic illness is more than a physical experience. It’s emotional, mental, relational, and exhausting on many levels. One of the most overlooked aspects of chronic conditions like ME/CFS and Long COVID is the profound impact they have on mental health. And yet, when we talk about treatment plans, mental well-being is left on the back burner.
To make matters more challenging, patients who are emotional in a visit may be scrutinized through a psychiatric lens rather than having simply having mental health support as a baked-in treatment plan. It shouldn’t be an “either/or,” but a “yes/and.”
Imagine being someone newly diagnosed with ME/CFS. You might not just be dealing with breathlessness or fatigue—you might also be facing sudden job loss, identity confusion, or even PTSD from medical trauma. These mental health challenges aren't rare, yet they’re not treated with the same urgency, or seen as the responsibility of the healthcare practitioner to address them on the front end as part of a comprehensive plan.
In this article, let’s grapple with the nuanced relationship between chronic illness and mental health. Why are they so deeply intertwined? How does it affect both patients and practitioners? And what needs to shift in how healthcare professionals are equipped for it? Patients and clinicians: there’s something here for you.
When the Body Breaks Down, the Mind Feels It
Chronic illness doesn’t knock lightly on the door. It usually crashes into someone’s life, rearranging everything in sight—careers, relationships, identities. And that crash causes a ripple effect on mental health: depression, anxiety, isolation, and grief can creep in.
Research from the National Institute of Mental Health confirms what patients have known for years: chronic illness and mental health are closely linked. Individuals with chronic illness are more likely to experience mental health conditions.
But more is at play here than just the pain or fatigue. Invalidation, lack of understanding from loved ones, hours in waiting rooms, misdiagnoses, the side effects, and societal pressures to “get better soon” create a cocktail of difficult emotional states.
A Dual Burden: Physical Pain, Emotional Weight
Mental health struggles are intimately connected to chronic illnesses. They show up the same way pain does: in the body, nervous system, and in the day-to-day cadence of life.
For example:
A person with ME/CFS who’s unable to work might develop severe anxiety about finances.
A Long COVID patient dealing with post-exertional malaise (PEM) might feel depressed from a loss of independence.
These aren’t side effects, they’re symptoms of the experience. If we can acknowledge this, we can offer more holistic care.
💡Bonus: Want a more personal look into this reality? My post on navigating ME/CFS pulls back the curtain. →
Patients Aren’t the Only Ones: Clinician Burnout Is Real
While this post is focused on patient care, we can’t ignore clinicians and their mental health.
Therapists, physicians, occupational therapists, and other healthcare providers are reporting record levels of burnout. This is only exacerbated by treating conditions they aren’t fully trained to understand.
The solution isn’t just more education. It’s better education and training that incorporates real-life narratives, patient voices, and trauma-informed care models. Providers need psychological insight, not just diagnostic criteria.
For example, training modules could incorporate patient video testimonials describing their experiences with ME/CFS, or small-group discussions guided by case studies focused on complex chronic illness care.
These approaches humanize textbook content and prepare clinicians for the emotional landscape they’ll encounter in real practice. That’s what my classroom talks bring to institutions like Lincoln Memorial University: a real-life case study that illustrates the human side of chronic care.
“Embedding case studies throughout the lecture to help convey the material was great for keeping the students engaged and applying the content to real-life situations... The students and I really appreciated hearing from your lived experiences.” – Acacia Gambrel, Assistant Professor, Lincoln Memorial University
💡 Bonus: For insights on the link between patient complexity and provider burnout, explore this Mayo Clinic Proceedings article. →
How Are Chronic Illness and Mental Health Intertwined?
One of the most common pitfalls in healthcare today is the tendency to treat mental health and infectious disease as separate issues. This separation is especially harmful to patients with complex conditions like ME/CFS or Long COVID, where the physical and emotional tolls are intertwined.
Patients often need both: mental health support to process the overwhelming changes to their lives and medical diagnostics to understand what’s physically happening in their bodies. It’s not enough to “fix” one and neglect the other.
When a healthcare provider refers the patient to chronic illness mental health therapy from the beginning, it establishes trust. And trust is critical to the physician-patient partnership. Strong patient trust promotes honesty about symptoms, treatment plan adherence, and long-term engagement with their health teams. Focusing on mental health support at the outset also allows the clinician to feel like they’re actively helping their patient as they continue unraveling a complicated clinical history.
The bottom line? Patients require a dual approach: emotional and diagnostic support. This compassionate care can forge stronger relationships and better outcomes for everyone involved.
Therapy Can Help—But It Should Be Chronic-Illness Informed
Sometimes, patients are referred to therapy for chronic illness support. The problem is, not all therapists are equipped to hold space for the unique cocktail of experiences that comes with it.
For example, take the pervasive medical trauma many patients carry from years of being dismissed or misdiagnosed. A patient might enter therapy in grief over big life changes and their new illness identity. Or they may be struggling with hypervigilance and mistrust around medical authority.
In these scenarios, therapists must move beyond conventional approaches toward illness-informed, paced care.
Chronic illness mental health therapy should:
Recognize the legitimacy of the patient’s condition, and are willing to hear recurring struggles of grief for the identity loss.
Use pacing and low-energy support strategies.
Help reframe identity and self-worth without toxic positivity.
I’ve personally been in therapy for years as part of my ME/CFS care plan, and it’s helped me tremendously.
Healthcare Professionals: You Can Be the Difference
If you're an OT, PT, or physician reading this, know that your role is much more than prescriptions and protocols. You may be the first person a chronically ill patient feels safe enough to be honest with. Your tone, your words, and your body language all matter.
At CNN Courage, I often work with healthcare teams and students to rethink the foundation of care: patient first, story-informed, human-focused.
💡 Bonus: Read more about what being a patient care advocate looks like →
Bringing Lived Experience Into Classrooms
Some of my most meaningful work happens in classrooms, speaking directly with future healthcare professionals.
During my guest lecture at the University of New England Physical Therapy School, one of the students had an “ah-ha” moment about the importance of tracking and identifying unpredictable symptoms.
And OT students at my Lincoln Memorial University talk were hungry to know how they can effectively communicate about chronic illness to a patient’s support system.
These moments are why I do this.
As a former veterinarian and long-time ME/CFS patient, I speak both languages: clinical and personal. My talks blend real-life case studies from my experience with ME/CFS with the kind of insight you can’t get from textbooks.
Students walk away with a deeper sense of:
What it actually looks like to live with chronic illness.
How to support patients with sensitivity and care.
Why their own well-being matters, too.
I teach from the inside out because I believe empathy should be a core clinical skill.
Want to bring me to your classroom? Tell me about your program.
FAQ: Chronic Illness and Mental Health
Is it normal to feel depressed when living with a chronic illness?
Yes. Chronic illness often brings life changes, losses, and pain that can lead to depression. It's a common and valid response, not a personal failure.
Can therapy help if the illness won’t go away?
Yes. While therapy may not treat the illness itself, it can provide tools to cope emotionally, manage grief, reduce anxiety, and rebuild your life with your new identity.
How can clinicians better support mental health in chronic patients?
By listening actively, validating their experience, offering illness-informed mental health referrals, and learning from patient narratives like Dr. Caroline Niederman’s.
What is patient-first care?
It’s an approach that integrates the patient’s lived experience, needs, and goals into care and treatment.
Where can I learn more about ME/CFS?
Visit the CDC’s official page on ME/CFS for clinical guidelines and research updates.
When We Treat the Whole Person, Healing Begins
Chronic illness care that ignores mental health can cause real harm. We need care that sees the whole person and understands that grief isn’t weakness. Real healing happens in these safe, empathetic relationships.
I’m Dr. Niederman, a speaker, educator, and advocate. If you're a healthcare professional, educator, or institution looking to expand your understanding of chronic illness and mental health, I offer powerful workshops, keynotes, and guest lectures.
📩 Book a connection call to explore a speaking or consulting opportunity.
