This year has been especially difficult for those with chronic illnesses. These are diseases that do not represent an immediate risk to life, but bring significant damage to everyday life and can lead to death in the medium and long term. I am referring, for example, to autoimmune diseases and chronic mental health disorders – conditions that are very sensitive to stress and have a huge impact on individual autonomy.
In 2020, Covid-19 came into the spotlight, not only because of its magnitude – how could we not focus on a pandemic? but for its high mortality rates. Thus, the most focused subject by health institutions was an acute illness, which may have the side effect of reducing general interest in the above-mentioned ones. With Covid-19 focused we have learned about some chronic conditions as high blood pressure and diabetes that increase the vulnerability for worst forms of the infection. But what have we learned about patients with mental health issues and other diagnostics that are not directly associated with the pandemic?
In 2020, people with chronic illnesses had to deal not only with the risks of covid-19 but also with the high level of stress that came with it and the limited access to treatments. Private offices and health centres have been operating in a very limited way; physiotherapies, hydrotherapies, complementary therapies of all types have been offered in a restricted way or have not been offered at all. The same is true regarding basic services that significantly contribute to the wellbeing of those people, such as recreation facilities, gyms, open markets, temples, etc. For many people, the barrier to access those services means more inflammation, pain, anxiety and more general damage. How to enter 2021 after this intensely hard experience?
I believe that the calls from governments and health professionals for each person to do their part in this pandemic can be extended to other health conditions as well. Because, in reality, all of them are partially determined by social context, which means that each person can play a relevant role in the rehabilitation of others with chronic diseases. For instance, it is not only the therapist who can help an individual with depression but the entire network of friends, family, acquaintances … Even our cultural values can impact depression outcomes. Then, the first important lesson 2020 has given us is the crucial role of solidarity or, in other words, social responsibility, for our health.
I do believe that in 2021, we will need to show even more empathy, care and responsibility towards the ones next to us, especially the most vulnerable ones; and we can gain from this pandemic experience to improve that. One important attitude in this regard is to recognize privileges and the potential to help. This means that we have to take responsibility for our power to help others. It is known, for example, that children and adolescents with chronic illnesses rely heavily on adults to deal with their symptoms and to have treatments. It is also known that women suffer a higher global burden of chronic diseases than men and that the latter tend to suffer more from accidents and violence and are less willing to prevent diseases. Those are statistics insights. But, in reality, each family has its particularities, each neighbourhood its dynamics. And each one knows or has the opportunity to know what role to play in the health of their close ones.
For instance, if you are a parent of a teenager with mental health symptoms, such as alcoholism and intense emotional dysregulation, you may have had an even more crucial role in their rehabilitation in 2020, and you will need to maintain your loving and responsive presence for them throughout 2021. If you are married to someone with a rheumatological disease who is in pain and has reduced mobility, you must have become even closer to their suffering in 2020, and you will need to care and help relieve their symptoms more than you are used to, in 2021.
Another lesson can also be learned: if you yourself have any of those chronic diseases, maybe you have tried some ways to overcompensate your limitations in 2020, perhaps even denying your physical and emotional boundaries and submitting yourself to riskier situations. But now, you have the opportunity to learn how to improve your awareness and communication in asking for help. It is so important to communicate your vulnerabilities and to trust further on the ability of others to help you. After all, individual autonomy is the result of a collective system, from birth to the end of life. And the same can be said about health. It is healthy to accept your symptoms and to know how to name them, explain them and when needed, ask for help.
In 2021, with vaccines, but still with the necessary measures to prevent covid-19, we will continue to adapt our family and social systems to this disruptive experience brought by 2020. I invite you to reflect on your role in these systems, your needs and your potentialities. May it be a year of consolidation of everything we have learned, and may it be much happier!
The Lancet. Global Burden of Disease in https://www.thelancet.com/gbd