How to reduce the mental load of chronic illness

Published February 2025 | 6 min read
Expert contributors Rachel Tomlinson, psychologist; Dr Rebekah Hoffman, Chair, NSW & ACT Faculty, Royal Australian College of General Practitioners (RACGP)
Words by Sabrina Rogers-Anderson

Between endless medical appointments and changes in social relationships, managing a chronic disease can take a physical and mental toll. Here’s how to ease the burden.

As a mum of two young kids who runs a business while managing three autoimmune conditions, Amy, 35, knows how heavy the mental load of chronic illness can feel.

“The uncertainty about the future is what weighs on me most,” she says. “I’m on biologic autoimmune injections [for psoriatic arthritis] and they’re relatively new drugs, so it’s hard to know what the long-term effects will be.”

Amy’s immune system was so compromised earlier this year, she ended up in hospital with a severe case of food poisoning.

“When you add all that to the pressures of having two young kids, including one with autism, and struggling to do housework because of the arthritis, it adds up,” she says. “But then I look at my aunt who's battling leukaemia for the second time and I feel pressure to be grateful. It's an up and down rollercoaster in my brain.”

With 61% of Aussies estimated to be living with at least one chronic condition, most of us will face the mental load of managing ill health – whether it's your own like Amy or that of a loved one – at some point in our lives. Those who live in regional and remote areas have higher rates of chronic conditions than people who live in major cities.

According to the Australian Institute of Health and Welfare, anxiety and back problems are the most common chronic conditions affecting those in metropolitan areas, followed by depression, asthma and deafness or hearing loss. While the Royal Flying Doctor Service (RFDS) reports the leading causes for death in rural and remote Australia are the chronic conditions of heart disease and diabetes.

In some cases, the ongoing pressures and restrictions of living with these chronic conditions can be debilitating, says psychologist Rachel Tomlinson.

“Mental load refers to the invisible tasks that are cognitive or emotional in nature, and the efforts required to plan, make decisions and anticipate needs, as well as the pressure of responsibility,” she says.

The good news, she adds, is the mental load can get lighter through self-care and expert-led advice for how to manage these conditions.

Factors contributing to this mental load

There are many pressures adding to the mental load of managing a chronic condition, says Rachel. These can range from keeping track of appointments and remembering to take medication to making time for upcoming appointments, tests and treatments.

Experiencing and monitoring a range of symptoms caused by the condition or treatment can also be added factors, as well as the financial stress due to the cost of treatment and time taken off work.

These elements of living with a chronic condition can, according to Rachel, cause intense feelings of sadness, anger, grief, helplessness, depression and anxiety – as well as sleep problems.

Dealing with these challenges while trying to act ‘normally’ can ultimately lead to even greater pressure, she adds.

“Many people exert energy trying to present a strong image to those around them, but this can start to cause a divide,” she explains. “Eventually, relationships can suffer because the person may not have the same energy they used to have to engage with their loved ones, or the nature of the relationship has changed.”

One of the hardest parts for a person living with a chronic condition, says Rachel, is the realisation they need to adjust their commitments and expectations with relationships, work, study, diet and movement/exercise.

“They need to accept a ‘changing sense of self’ as they’re not able to fulfil their roles or activities like they used to,” she explains. “This can be incredibly distressing, frustrating or scary – more so if someone is facing uncertainty with treatments and results or even facing mortality.”

Mental health and chronic illness

Research shows that mental and physical health are deeply connected; four in five Aussies with mental illness also have a serious chronic disease and 55% have two or more co-existing chronic illnesses. The life expectancy gap between people with and without mental illness can be up to an astounding 20 years, often due to the focus on treating a person’s mental health condition but overlooking their physical health.

There’s also a range of other factors that can influence our health, like where we were born, the kind of education and housing we grew up with, and the kind of access to affordable healthcare we might have had as a child and currently have now. These factors can increase the likelihood of someone living with a mental illness or chronic physical condition developing an additional condition.

Some people who have a mental illness experience low energy and reduced brain power, sometimes finding it hard to stick to healthy habits. Over time, this can also lead to poor physical health.

Likewise, physical health conditions can have a serious impact on mental wellbeing. One major study found that chronic diseases like cholesterol disease, kidney disease, coronary heart disease and asthma were all significantly associated with mental health concerns.

“Constant pain, fatigue, lack of social interaction, missing out on favourite activities and loneliness associated with chronic illness can all impact mood and mental health,” explains Rachel.

7 ways to reduce the mental load of chronic illness

1. Bring a support person

“When you go to any medical or specialist appointments, try to bring a support person with you,” says GP Dr Rebekah Hoffman, Chair of the NSW and ACT Faculty of the Royal Australian College of General Practitioners. “Having someone there to take notes, help you verbalise questions and make sure you remember to ask everything you wanted to ask is really important. Otherwise, you’re likely to forget important details.”

2. Keep an appointment calendar

Staying on top of your appointments, tests and treatments is important for reducing stress. “It doesn’t matter if you use a wall calendar, an app or a notebook, but it’s important to have one source of truth,” says Dr Hoffman. “We often book appointments 12 months in advance for some chronic and complex diseases, so keeping a calendar for the upcoming year will ensure you don’t miss an appointment and you’re not scrambling for a referral days before seeing a specialist.”

3. Ask for help

“Asking friends and family for help doesn't make you weak or mean you aren't capable,” says Rachel. “Surround yourself with people who care about you, lean into the discomfort and ask them for help. It might be challenging at first, but your loved ones want to support you and care for you.” Dr Hoffman suggests assigning specific tasks to the people in your life who want to support you and do something useful to help. “Don’t be too shy to say, ‘I need you to pick up my groceries’,” she says.

4. Learn to say ‘no’

Just because you’ve been invited to something, or a friend has asked you to help, doesn’t mean you need to say ‘yes’. “Sometimes people's desire to present a ‘normal’ front or accommodate others’ preferences makes them risk their own wellbeing,” says Rachel. The next time someone asks you to do something, she says, consider the day’s plans, how much energy you have, which things are essential or take priority, and then say no to the rest.

5. Practise self-care

Self-care is a term that’s thrown around a lot, but it’s crucial for people with a chronic condition. “Take time to go for a walk, sit in the garden, watch a movie, have a bath or do whatever relaxes you,” says Dr Hoffman. “You have to be a bit selfish because these things are so good for you mentally and physically.”

6. Use mindfulness strategies

“Mindfulness activities can help reduce stress, manage intense emotions and foster a sense of control,” says Rachel. “They include things like breathing exercises, progressive muscle relaxation and engaging your senses.” A simple way to engage your senses and bring yourself back to the present moment is to name five things you can see, four things you can touch and three things you can hear.

7. Lean on new technology

Over the past decade, digital health has become a useful tool for those living with a chronic condition. No time to get to the doctor? Eligible HCF members can access GP2U, an online video service offering GP consultations (up to 10 minutes) for a fee of $50, as well as a range of online mental health programs, including the evidence-based online mental health treatment program This Way Up*.

Supporting your mental and physical health

Now more than ever, we’re committed to showing you a level of care that’s uncommon. That’s why our mental health programs include a free HealthyMinds Check-in^{^} for eligible members. This gives you faster, easier access to PSYCH2U psychologists and digital support services to help you take control of your mental wellbeing.

We also offer cover for mental health services on selected extras. Members with eligible extras cover can claim consultations with an HCF-approved counsellor, accredited mental health social worker or a psychologist if you don't have a Medicare Mental Health Treatment Plan or you've used it up.