Chronic Health Conditions Can Affect Your Mental Health

More than half of all American adults have at least one chronic health condition such as diabetes, heart disease, cancer, lung or kidney disease, or a chronic mental illness such as depression. A chronic condition lasts for more than a year and requires ongoing medical care. It may also limit your daily activities.

If you have a chronic health condition, it can be comforting to know that many other people do, too. But living with a chronic health condition can take a physical, psychological, and emotional toll on your health, especially if you have multiple chronic health conditions.

The Physical Health/Mental Health Connection

Having a chronic health condition is a risk factor for anxiety and depression. In fact, 51 percent of people living with Parkinson’s disease, 42 percent of people diagnosed with cancer, and 27 percent of people with diabetes have depression. Nearly one in five people who have had a heart attack or heart disease also have depression. Chronic health conditions can affect your attitude, mood, and sense of certainty about the future. They can also make you doubt what you’re capable of physically.

When people feel limited in their ability to participate in social or recreational activities, they often become reclusive, lonely, or hopeless. They might develop poor eating or sleeping habits, which worsens their health. It’s common for people to focus so much on their physical condition that they don’t get the mental health support they need.

“Chronic health conditions and mental health diagnoses often go hand in hand,” says Dr. Luz Ramos, Medical Care Director for Clinical Care Transformation at Independence Blue Cross. “When someone is dealing with these challenges, their low mental and physical states can create a negative cycle, making it harder to take care of their health.”

Overcoming Chronic Health Challenges

Living with a chronic health condition can be difficult, but you don’t have to face it alone. Most chronic health conditions, whether physical or mental, can be managed.

“Sometimes, the biggest challenge people face is knowing where to start and who to reach out to,” says Dr. Ramos. “The best place to start is with a primary care provider who can look at your chronic conditions and mental health hand in hand. They can send you to specialists for any follow-ups needed, and help you navigate through the complex health care system – both for physical and mental health needs.”

There are other ways people living with chronic health conditions can improve their well-being. The National Institute of Mental Health suggests the following:

  • Exercise regularly. Being active doesn’t have to mean training for a marathon or lifting heavy weights. Thirty minutes of walking every day can boost your mood and health.
  • Eat a balanced diet. Good food choices can improve energy, mood, and health outcomes.
  • Get enough sleep. Sticking to a regular sleep schedule and getting enough rest is important for your mental, physical, and emotional health. When you’re well-rested, you can take better care of yourself.
  • Practice gratitude. Reminding yourself daily about the things you are grateful for can have positive effects on your mental health.
  • Stay connected. Spending time with loved ones who provide emotional and practical support can improve your well-being.

Many hospitals and patient organizations also offer online or in-person support groups where people with the same health condition can share their experiences and find helpful resources as well as a sense of community. For some, it can also be meaningful and empowering to participate in fundraising walks, research advocacy, or other activities that support those affected by the condition.

“While living with chronic health conditions can be challenging, it’s important to understand that health and medical care should always focus on the whole person,” says Dr. Ramos. “Physical and mental health are connected, and by taking care of one, you can take care of the other.”

For resources on chronic health conditions, visit:

For more information about mental health, self-care strategies, and where to find help, visit

It’s Not Always Sunny in Philadelphia: Coping with Seasonal Affective Disorder

Daylight saving time is coming fast. If you are like many, the thought of an extra hour of sleep seems glorious. Plus, the fall brings pretty colors, fun holidays, crisp air, and pumpkin spice lattes. For others, fall brings with it feelings of depression—seasonal depression.

This type of depression is called seasonal affective disorder or SAD – a type of depression that happens seasonally. Its symptoms usually last through fall and winter, about four to five months each year. For some individuals, SAD occurs in summer. However, this is not common. 

SAD is thought to be caused by a chemical imbalance in the brain. This imbalance happens when the days shorten and there is less daylight available. Being exposed to less daylight can throw off someone’s biological clock. Because SAD is linked to lack of sunlight, it is more common in areas that are farther from the equator. It is also more common in people with a family history of mood disorders.  

Symptoms of SAD are like symptoms of depression. People may feel sad, overly tired, and like they do not have energy. They might have changes in their appetite, weight, and sleep. They may feel agitated, restless, guilty or worthless. Concentrating might be difficult. They may isolate themselves from other people and no longer be interested in things they used to enjoy. They may also have thoughts of suicide or of dying. 

If you are experiencing mild symptoms of SAD, there are things you can do to cope. They include: 

  • Going outside and getting exposed to natural light 
  • Exercising regularly  
  • Keeping a healthy diet 
  • Regularly seeing family and friends 
  • Having hobbies that you do regularly 
  • Taking a Vitamin D supplement (people get Vitamin D from sunlight) 
  • Cutting down use of alcohol or drugs, which might make SAD symptoms worse 
  • Maintaining a routine around bedtime for better rest

For some people, these coping strategies may not be enough. If you are experiencing severe symptoms of SAD, you might consider: 

  • Contacting your doctor (primary care provider) to discuss your symptoms and ask for help managing the,
  • Working with a doctor to see if there is medication that might help 
  • Working with a doctor to see if light therapy might help 
  • Discussing seeking therapy to learn how to best cope with SAD.

For more information about SAD, see: 

About the Author: Jaymes Fairfax-Columbo, JD, Ph.D. is a clinical-forensic psychologist. He works with the City of Philadelphia Department of Behavioral Health and Intellectual disAbility Services (DBHIDS) serving individuals who have behavioral health issues and are involved in the criminal justice system.

The Impact of Social Isolation and Loneliness on Mental Health

In a time where we have near instant connections with people, it’s strange to think that as a society, some have never been lonelier. Loneliness is a subjective emotional state, often resulting from social isolation and lack of social connections, according to the U.S. Department of Health and Human Services. Loneliness and social isolation can negatively impact mental and physical health. Some of these effects include depression, decreased quality of sleep, poor cardiovascular health, and decreased brain health or cognitive functioning.

Among older adults, chronic loneliness and social isolation are linked to a dramatically increased risk of dementia and accelerated cognitive decline (DHHS, 2023). However, the link between social isolation and both depression and anxiety transcend age, showing consistent results from children to adults (DHHS, 2023). Social isolation is a symptom of and a risk factor for depression and anxiety. Since depression is marked by symptoms including social withdrawal, lack of energy, and decreased motivation and pleasure, it can perpetuate social isolation. Conversely, social isolation can increase the risk of someone developing depression (DHHS, 2023).

The importance of increasing our social connection to combat loneliness and isolation

We are approaching the time of year where fall-onset seasonal affective disorder may begin to appear. In anticipation of the change of season, it is important to understand what we can do to increase our social connections in an effort to combat our subjective loneliness and perceived social isolation. By making a conscious effort to increase our social connections with others, we are directly increasing our overall health and well-being.

Social Connection

Social connection is not black and white, rather it is on a spectrum that changes throughout our lives. Furthermore, social connection is not simply how many people we speak to or interact with on a daily basis; much of it depends on the structure, function, and quality of our relationships (DHHS, 2023).

According to the U.S. Department of Health and Human Services (2023), from 2003 to 2020, the amount of time spent in-person with friends declined significantly, especially among those between the ages of 15-24, with a reduction of almost 70 percent. When thinking about the role technology plays in the frequency and quality of our social connection, there are pros and cons. Technology brings people together and fosters a sense of community, especially for those in marginalized groups; however, it can also replace in-person engagement and reduce the quality of our interactions (DHHS, 2023).

To grasp the importance of social connection to our health, understand that lacking it is the equivalent of smoking 15 cigarettes per day (!!!) (DHHS, 2023).

In order to increase our social connections as individuals, think about the following:

  • Understand the impact of social connection and social disconnection
  • Invest in your relationships by checking in with a friend or family member daily
  • Minimize your distractions
  • Support others within your community
  • Seek out various social groups
  • When struggling with loneliness, reach out to others for help

For more information on social connection visit Social Connection — Current Priorities of the U.S. Surgeon General

About the Author: Jessica Marcacci, M.S. is a psychotherapist at River Wards Wellness Collective located in Philadelphia (Fishtown). She sees both individuals & couples, focusing mainly on life stressors, relationships, emotions, self-worth, and anxiety.

Making Sure the Kids Are Alright

It’s a question parents, teachers, and researchers alike are asking. The COVID-19 pandemic robbed many teens and young adults of precious learning and socializing time. Add to that the challenge of not having enough mental health providers to meet the demand for counseling, and you’ve got a serious problem.

According to the Harvard T.H. Chan School of Public Health, the pandemic led to a decline in kids’ overall mental health. But that impact varies, depending on factors including age, family circumstances, and preexisting conditions.

Results from a 2021 National Survey on Drug Use and Health showed that nearly half of kids ages 12 to 17 who had a major depressive episode (MDE) in the past year said the pandemic negatively impacted their mental health either “quite a bit or a lot.” That’s concerning because only 12.4 percent of their peers without an MDE reported similar levels of impact.

Not a New Problem

Although the pandemic may have put a spotlight on teen mental health, rates of depression and anxiety in children have risen steadily in the last ten years. Many experts think this trend is unlikely to improve without rethinking how we approach teen mental health care. As a result, the U.S. Preventive Services Task Force now recommends regular anxiety screenings for children ages 8 to 18 and regular depression screenings for adolescents ages 12 to 18.

The Power of School Connection

According to the Centers for Disease Control and Prevention, one of the most important factors in boosting students’ emotional resilience is “school connectedness.” This is the feeling of being supported and belonging at school. Students who felt connected to adults and peers at school were significantly less likely to report feelings of sadness or hopelessness.

Experts believe that students can benefit from multiple support systems in school. But given the shortage of available counselors, only about half of U.S. public schools offer mental health assessments, and even fewer offer treatment services.

In Philadelphia’s public schools, the STEP Program provides mental and behavioral health and social services to students and families. The school district works with the Mayor’s Office of Education, Community Behavioral Health, Drexel Community Partners, and the Department of Human Services to provide this support.

At the state level, Pennsylvania recently made $190 million available for school mental health and safety programs for the 2022‒23 school year. Districts that applied by August could receive a base grant of $100,000 for safety and security improvements, with another $100,000 for mental health programs and training. Additional funding may be available based on population.

“What we need is to build capacity through all of the systems that are part of children’s lives — in families, in schools, in the education of everybody who interacts with children,” says psychologist Ann Masten, Ph.D., a professor of child development at the University of Minnesota.

Focusing on Student Mental Health at Girard College

Youth from underserved communities are less likely to receive mental health care services. To address this disparity, the Independence Blue Cross Foundation is funding a multi-year pilot initiative to provide access to mental health care for every student at Girard College. Girard College is an independent, five-day boarding school in Philadelphia. It serves approximately 300 students in first through twelfth grades from families with limited financial resources. More than 80 percent of the student population identifies as African-American.

This innovative care model integrates school support with telehealth services provided by Children’s Hospital of Philadelphia. “The pandemic amplified the urgent need for access to mental health care as young people were faced with additional difficulties such as school closures, family stress, social isolation, and economic challenges,” said Foundation Executive Director Heather Major. “A key goal of this collaboration is to create a replicable model for bringing mental health services into schools in a sustainable way.”

The pandemic showed us students of all ages need greater access to mental health care. “The focus needs to shift up toward preventive care and secondary and early intervention,” says Archana Basu, research scientist and clinical psychologist at Massachusetts General Hospital. Independence Blue Cross will continue to support efforts to improve access to mental health care for youth in the community.

If you or someone you know may be experiencing anxiety or depression, please seek help. If you don’t know where to begin, visit If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline by dialing 988.

Loneliness is a Serious Condition Among Seniors

In Japan, 65 percent of seniors live with their children, and in Italy, about 39 percent do. But in the United States, the figure is only about 20 percent, despite a rise in multi-generational households in recent years.

It’s just one of many factors that cause approximately one-quarter of Americans aged 65 and older to be socially isolated. People over age 50 are more likely to experience the risk factors for social isolation or loneliness, such as living alone, the loss of family or friends, chronic illness, and reduced vision and hearing abilities.

It’s not surprising that being lonely is associated with higher rates of anxiety, depression, and suicide. However, a substantial body of evidence shows that social isolation also poses a major risk for physical problems including premature death — a risk level that’s comparable to having high blood pressure, smoking, or being obese.

Social isolation — a lack of social connections — is associated with a 50 percent increased risk for dementia. And loneliness among heart failure patients was associated with higher risks of death, hospitalization, and emergency department visits.

Pandemic Fallout

“Senior isolation was a tremendous problem during the pandemic,” notes geriatrician Heidi J. Syropoulos, MD, medical director of Government Markets at Independence Blue Cross (Independence). “It affected people who would never have considered themselves socially isolated before — whose children visited them all the time, or who perhaps had a caregiver that took care of their finances, or brought them a meal once a week, or went grocery shopping for them.”

“During the pandemic, some of those things still happened, but the affected individuals did not see those caregivers. They just dropped off the groceries or a meal at the front door and then left. So social isolation definitely increased during the pandemic. I think it’s gone back down a little bit now, but not to where it was before.”

Technology has helped bridge the loneliness gap to some degree, as seniors have become accustomed to using computers and other devices to keep in touch with family, friends, and health care providers. However, there’s no substitute for face-to-face social contact. For this reason, many local houses of worship and community service organizations are working to fill the gap to help seniors build relationships and maintain their quality of life.

Local Supports Deliver Connection

If you’re feeling socially isolated, the World Health Organization offers three key pieces of advice:

  1. Get in touch with friends by either meeting them in person or contacting them by phone or through social media.
  2. Do the things you enjoy, like engaging in a hobby or spending time outdoors.
  3. Reach out to local services that can connect you to new people, communities, or professional help.

The Philadelphia Corporation for Aging, for one, provides Community & Connection programs at 28 PCA-supported senior centers in the City of Philadelphia. They also offer health and wellness programs, volunteer support, and job training services that keep seniors active and engaged. To learn more, call the PCA Helpline at 215-765-9040 Monday through Friday, 8:30 a.m. to 5 p.m., except for major holidays.

In Montgomery County, the Senior Adult Activities Center helps seniors continue to be active, creative, healthy, and engaged in the community. Other resources include three Meals on Wheels programs, two senior centers, and an inter-generational art center — the Ambler Senior Adult Activity Center.

Similar organizations and services exist in Bucks, Chester, and Delaware counties.

Isolation can take a devastating emotional, cognitive, and physical toll over time. If you are an older adult, any steps you can take to maximize your social interactions will have a huge benefit.

If you or someone you know may be experiencing anxiety or depression, depression, please seek help. If you don’t know where to begin, visit If you are having suicidal thoughts, please call the National Suicide Prevention Lifeline by dialing 988.

Behavioral Health at Any Age: No One Needs to Struggle Alone

Many areas of behavioral health can be something of a mystery to the general public. Myths and misconceptions about mental health and substance use are often significant obstacles to looking out for the well-being of ourselves and our loved ones. Talking about suicide does NOT plant the idea in someone’s head. Many mental health conditions are preventable. Depression is NOT a normal part of aging.

Let’s focus on that last one. It’s worth repeating; experiencing feelings of depression is not a given as we grow older. However, behavioral health problems like depression often go undiagnosed in older adults.

Older adults as well as their loved ones and even their healthcare providers sometimes dismiss symptoms of depression as “normal” signs of frailty – inevitably, our bodies grow physically weaker as we age. However, the National Institute of Mental Health (NIMH)notes that many equivocate symptoms of depression with the physical weaknesses of aging, leading them to ignore these indicators of a potential mental health issue.

Others believe that feelings of depression are just the natural result of changes in life that typically happen to older adults. Major life events more common to older adults – such as retirement, the death of a loved one, or moving out of the family home – can be stressors that impact our behavioral health.

Facing the loss of someone or something important to us, we all feel sadness at times, but such episodes need not necessarily lead to depression. In fact, “many older adults will eventually adjust to the changes. But some people will have more trouble adjusting,” says the U.S. National Library of Medicine. Being unable to grieve and move on to prior feelings after a loss may be a sign of depression – in individuals of any age.

So What IS Different About Depression in Older Adults?

  • Just as symptoms of depression may differ between women and men, older adults may experience a different range of symptoms than younger individuals. Memory problems, confusion, vague complaints of pain, and/or delusions (“fixed false beliefs”) can indicate depression in older adults in addition to more typical symptoms such as loss of appetite, inability to sleep, or irritability (National Alliance on Mental Illness (NAMI)).
  • The Centers for Disease Control (CDC)reports that depression is more common in those who have another illness, and “we know that about 80% of older adults have at least one chronic health condition, and 50% have two or more.” This higher likelihood of having a physical illness puts older adults at greater risk of depression.
  • For older adults, the interplay of mental and physical health issues works both ways – not only does the presence of some chronic illnesses increase the likelihood of experiencing a behavioral health condition, but some mental health problems like depression – if untreated – can increase risk for heart disease, suppress the immune system, and elevate the danger of infection (NAMI).
  • The World Health Organization points out that while older adults may experience the stressors common to everyone that can weigh against behavioral health, they may also experience stressors unique to them. Reduced mobility, chronic pain, bereavement, change in socioeconomic status due to retirement, and frailty or other health problems are all additional factors that can have a negative impact on the mental health or substance use of older adults.

Closing the “Treatment Gap”

The Pan American Health Organization (PAHO) describes a “treatment gap:” while at least 1 in 4 older adults experience some mental health problem, two-thirds of those individuals do not receive the treatment they need. The first step in connecting those struggling with their behavioral health to treatment and recovery options is to identify the issue.

A great place to start if you’re worried about your mental health or substance use – or that of a loved one – is with a quick, anonymous online behavioral health screening. In about two minutes, you can find out if what you’re experiencing is consistent with symptoms of depression, anxiety, or other behavioral health conditions. If you’re concerned about a loved one – regardless of their age – encourage them to take a screening. No one needs to struggle alone.

If you or a loved one needs immediate mental health or addiction support, do not hesitate to call your insurance company or family doctor, or call 888-545-2600 if you have Medicaid coverage. You can find additional resources that support older adult mental health here.

If your loved one is ever in crisis, contact the National Suicide Prevention Lifeline at 1-800-273-8255 or text the word, “ACT” to the Crisis Text Line at 741741

Original Article here: