Psychological Complications of Chronic Illness in Adolescence

Adolescence can be a stressful developmental process even for physically healthy teens. Acute or chronic illness can further complicate adolescent development.

Medical issues, treatment requirements, hospitalization and surgery (when necessary) all intensify concerns about physical appearance, can interfere with the process of gaining independence, and disrupt changing relationships with parents and friends.

Also, adolescent developmental issues can complicate a teen's transition toward taking responsibility for managing his or her illness and learning to comply with recommended treatment.

Adolescents who are faced with acute or chronic illness are likely to have more concerns and fears when their illness or healthcare needs conflict with the following normal developmental issues:

Body Image Issues

Adolescents are normally focused on the physical changes occurring in their bodies. Chronic illness can make these concerns worse because of fears or distortions related to their illness (such as fearing a surgical scar will interfere with physical attractiveness or the ability to wear certain clothes).

Things that may improve these issues:

  • Share concerns related to their body and how it may be affected by their illness or treatment.
  • Talk about possible physical effects of medications and treatment with your doctor.
  • Discuss ways to reduce or cope with the effect.

Developing Independence

Chronic illness often interferes with an adolescent's comfort in becoming less dependent on parents. Parents of chronically ill adolescents often are more resistant to an adolescent's efforts to act independently. Some ways to address the conflict between normal development of independence, while still addressing healthcare needs of the chronic illness, include:

  • Adolescents must be involved in health-related discussions (i.e., concerns about their illness, treatment choices)
  • Adolescents need to be taught self-care skills related to their illness. This is a process that should start before adolescence if possible.
  • Adolescents need to monitor and manage their own treatment needs as much as possible
  • Adolescents need to develop coping skills to address problems or concerns related to their illness. Talking with other teens with similar illnesses, healthcare providers or other professional support may be helpful. 

Relationships with Peers

Chronic illness and treatment often interfere with time spent with peers or in the school setting, which is an adolescent's primary social environment. Chronic illness and related treatment needs may make self-esteem issues worse. To address these concerns, your child should consider the following:

  • Spending time with friends as much as possible
  • Plan what to share with friends and how to share that information
  • Find ways to respond if teased by peers
  • Develop an ability to see humor in the situation in terms of both illness and interaction
  • Foster friendships that are supportive

As adolescents with chronic illness learn more about their illness and are encouraged to take responsibility for its management, they may attempt to make their own decisions about their health needs. Often, a teen may change the way he or she takes medication without talking to the doctor first.

While this behavior may be developmentally normal, it may create the need for additional healthcare intervention. 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 make it less likely for teens to follow the recommended treatment or management techniques.

It is important for parents and healthcare professionals working with adolescent patients to help the adolescent develop emotionally healthy ways of living with their chronic illness and its management requirements. Some ways to help adolescents deal with the complications chronic illness often imposes on development may include:

  • Encourage adolescents to share their ideas and concerns with healthcare professionals.
  • When chronic illness becomes unstable because of not following treatment recommendations, talk with the teen about what happened instead of scolding. Teach and encourage 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 ... ?" or "What would make it easier for you to ... ?" Encourage adolescents to ask you the same kinds of questions.
  • Seek mental health services when:
    • An adolescent seems overwhelmed with emotional issues related to living with a chronic illness
    • A pattern of not following medical treatment recommendations continues
    • An adolescent's development regresses, overly dependent behavior continues, and/or the adolescent withdraws from or gives up interest in age-appropriate activities 

Last Updated 06/2015