Psychological Complications of Chronic Illness
Being a teen is stressful even for physically healthy teens. Chronic illness at this
age can complicate development. The illness, treatment, and hospital stays all magnify
concerns about how a teen looks. They also interfere with becoming independent, and
can disrupt relationships with parents and friends. Developmental issues affect a
teen's ability to take responsibility for managing their illness and learning what
is needed for correct treatment.
Developmental complications of chronic illness
Teens who are faced with a brief or long-term illness are more likely to have more
concerns and fears when their illness or healthcare needs conflict with these normal
Body image issues. Teens are normally focused on the physical changes happening in their bodies. Chronic
illness makes these concerns worse with fears or distortions about their bodies. An
example of this are fears that a surgical scar will interfere with physical attractiveness
or the ability to wear certain clothes. To help body image concerns:
Encourage teens to share their concerns about their body and how it may be affected
by their illness or treatment.
Inform teens about possible physical effects of medicines and treatment. Talk about
ways to reduce or cope with the effects.
Independence. Chronic illness often interferes with a teen's comfort in becoming less dependent
on parents. Parents of chronically ill teens may resist the child's efforts to be
independent. To help address the conflict between normal development of independence,
while still addressing healthcare needs of the chronic illness:
Involve teens in health-related discussions. For example, discuss current concerns
about their illness and treatment choices.
Teach teens self-care skills related to their illness.
Urge teens to monitor and manage their own treatment needs as much as possible.
Encourage the development of coping skills to address problems or concerns that might
arise related to their illness.
Relationships with peers. Chronic illness and treatment often interfere with time spent with peers or in the
school setting. This is the teen's main social environment. Self-esteem issues related
to acceptance of one's self and concerns about acceptance by others are intensified
by chronic illness and related treatment needs. To address these concerns:
Encourage spending time with friends as much as possible.
Discuss concerns about what to share with friends.
Help teens find ways to respond if teased by peers.
Urge and help friends be supportive.
Noncompliance with medical treatment and teens
As teens with chronic illness learn more about their illness and are encouraged to
take responsibility for its management, it's common for them to make their own decisions
about management. Teens may try decreasing their medicine or not taking it without
discussing this with their parents or healthcare provider. While this behavior may
be developmentally normal, it may create the need for more healthcare. Angry or self-conscious
feelings related to having a chronic illness, or poor judgment in how to cope with
their feelings about their illness, might also affect following the recommended treatment
or management techniques. For example, teens with diabetes are more likely to use
poor judgment in making food choices when they are with their friends. It's important
for parents and healthcare providers working with teens to help the them develop emotionally
healthy ways of living with and managing their chronic illness. To help teens deal
with the complications chronic illness:
Encourage teens to share their ideas and concerns with healthcare professionals.
When a teen's chronic illness reaches an unstable state because they have not been
following treatment recommendations, encourage discussion of what happened rather
than scold this behavior.
Teach and urge the use of problem-solving skills related to their illness. Ask questions,
such as: "What do you think you would you do if ... ?"or "What do you think would
happen if ... ?" Encourage teens to ask you the same kinds of questions.
Seek mental health services when:
Transplant-related issues and teens
The need for an organ transplant is hard to understand, accept, and cope with for
anyone. The emotional and psychological stress impacts all family members.
For teens who are developing the ability to think in new ways and explore new thoughts,
the idea of facing transplantation triggers thoughts, concerns, and questions about
their bodies, their relationships, and their lives.
Important factors in helping teens cope well with a transplant experience include
Be honest with your teen about his or her illness and his or her healthcare needs.
Include your teen in discussions and decision-making related to the need for a transplant,
the benefits, and the risks involved. This is very important to helping him or her
cope with the process and life after transplant.
Supportive communication is vital. Encourage your teen to ask questions and express
his or her fears and feelings about how this affects his or her life.
Concerns about death and the possibility of dying are hard to talk about. However,
it's important to address with teens in any life-threatening situation.
Encourage humor, as it helps to reduce stress.
Urge friends to visit your teen in the hospital, when possible.
Get help from mental health providers to address fears, feelings, and behaviors that
are hard to deal with for your teen or for other family members.