Coping, News & Research

The Stress Caused by Illness

We all know that stress can be a cause or a trigger of illness, but we rarely hear about the inverse — that illness itself is a major stressor. In a national poll by the Harvard School of Public Health, the Robert Wood Johnson foundation and NPR, illness, whether one’s own illness or that of a loved one, stands out as huge source of stress.

When asked what their biggest source of stress was in the previous year, 43% of respondents to this open-ended question said health-related problems.

Respondents who were ill or disabled were most likely to have experienced a lot of stress in the month prior to being polled. The top three groups experiencing high stress in the previous month were all health-related:

  • Poor health condition: 60%
  • Disabled: 46%
  • Has a chronic illness: 36%

(The next most common stressor was income less than $20,000, which applied to 36% of respondents.)

Illness is stressful in so many ways: not being able to participate in your normal life, grief and identity loss, not being able to work and financial concerns, being cut off socially, fearing for your quality of life (or life itself), and many, many other issues. There’s also the physical stress of illness itself. Episodes of a illness, like a migraine or cluster headache attack, physically stress the body, as does the daily grind of a chronic disorder.

And, as this poll shows, our most important self-care mechanisms — the ones that are likely to make our bodies and spirits more resilient — go out the window when we’re stressed. The top four things that change when people are stressed? Sleep, proper nutrition, exercise and spiritual practice (listed in descending order).

Stress definitely can be a trigger for a lot of illnesses, but the fact that illness itself is a stressor is too often overlooked. People with chronic illness are told they’d feel better if they reduced their stress. Those who offer such advice are rarely aware that illness itself is responsible for a large part of our stress.

Fortunately, there are programs that specifically teach people how to cope with illness-based (and other) stress. Mindfulness-based stress reduction (MBSR) was a major help for me. Unfortunately, these programs can be expensive in terms of money, time and energy. You can get a decent approximation of the course for less than $30 by reading Full Catastrophe Living and listening to Jon Kabat-Zinn’s Guided Mindfulness Meditation Series 1 CD set. (A lot of libraries carry the book and CDs, so you may be able to introduce yourself to the concepts for no charge). There’s also a $199 interactive online MBSR course offered by the UMass medical school, which developed the program.

News & Research, Society

HIPPA Doesn’t Always Protect Your Health Records

Legally, law enforcement or an “officer of the court” — which includes private attorneys in some states — can subpoena your health records, according to an NPR report on digital information. Even under HIPPA, health care providers “may disclose protected health information” in response to subpoenas. Think this doesn’t apply to you? Your health records could be subpoenaed for legal disputes with an employer, insurance company, or former (or soon-to-be former) spouse, for example. The NPR story tells of a father whose mental health records were used against him in a custody case.

When asked why health care providers provide records willingly, an attorney interviewed for the story said, “The companies generally want to comply with the law in the way that’s least expensive to them. They don’t want to have to hire lawyers; they don’t want to have to send doctors or other representatives to depositions or court hearings. They just want to give you the records and move on.”

While the law has always allowed for the subpoenaing of health care records, electronic records typically turn up more detailed information and cover a longer time span than paper records, according to the NPR story. Logistically, it’s also easier and faster for the office staff to print or send electronic records than it was for them to dig through and copy paper files.

Despite the unlikelihood my medical records will ever be legal fodder, the thought that they could be is chilling. As soon as I heard the story, I wanted to share it so that you all would be aware of it, as well. I’m relying on the accuracy of NPR’s report, since I have no legal background. If you can share a legal perspective, please leave a comment with your insight.