Social Support, Psychopathology, and Chronic Disease

I’m sure I will get all kinds of fact check flags and shadow bans for this, but because of the arenas and areas I work in I have to bring the point to light. We are living in a time where, one year ago if I said that my business needed to stay open because it was essential for me to survive, I would then (and still likely now) be heavily criticized for being negligent of other people’s safety.

Yet, the very population I’d be accused of exposing are also the most likely to suffer adverse effects from vaccination (1, 2). Let’s be clear, I’m not trying to convince anyone to not get vaccinated, I’m creating context to the point I want to make. That is, continuing on what I started with last week about the importance of social engagement in maintaining our mental health which creates catalysts to our physical health – as we’ll see.

In the past 4 months there have been almost 440k confirmed COVID-related deaths in the United States (3). Again, I’m not making any judgments or inferences about comorbidities or “cause of death” here, I’m just creatingn context. In 2019 one person in the United States killed themselves every 11 minutes – to the tune of about 26 / 100,000 people. But, those were completed suicides; 1.2 million suicides were attempted in 2018 – that’s one every 26 seconds (4). This is is all prior to various forms of isolation, social distancing, unemployment, food supply fragility, and varieties of infections diseases that were rife in 2020.

In January of this year, The Journal of Health Psychology wrote (5):

The transformation that COVID-19 has brought upon the world is unparalleled. The impact on mental health is equally unprecedented and yet unexplored in depth. An online-based survey was administered to 413 community-based adults during COVID-19 confinement to explore psychological impact and identify high risk profiles. Young females concerned about the future, expressing high COVID-related distress, already following psychological therapy and suffering from pre-existing chronic conditions, were those at highest risk of psychological impact due to the COVID-19 situation.

The CDC has acknowledged that a multitude of chronic diseases increase the risk of severe COVID outcomes; amongn them: type 2 diabetes, coronary artery disease, obesity, severe obesity, and immune compromise (6). Another publication, again in the January 2021 edition of The Journal of Health Psychology (7, noted the impact of social support in diabetes treatment:

Diabetes patients experience significant distress. Improving health-related quality of life (HRQoL) is cardinal in the management of all chronic health conditions. We investigated the moderating role of social support (SS) in the relationship between diabetes distress (DD) and HRQoL. Three hundred and ninety-six type 2 diabetes mellitus (T2DM) patients (M age = 57.71 years) completed measures of relevant variables. Results showed that SS moderated DD-HRQoL association. Our findings provided a guide on extent of support for T2DM management behaviors that may be helpful in ameliorating impacts of stress on patients’ health.

Yet another publication in the same journal (8) suggested that:

Multilevel models indicated that enjoying nature with others tended to predict affect at the within-person level, while enjoying nature alone did not. However, enjoying nature alone did predict affect at the between-person level. Lastly, many of these associations remained, even while controlling for exercise and social interaction.

This is huge. This means that, even without the hormone and endorphine boosting effects of exercise, simply being exposed to nature and other people improves our mood and treatment of chronic diseasae. I didn’t intend for this to be a COVID post as much as I’m hoping it will illustrate the vivid complexity of our lives when it come to our health – be that in all of it’s overlapping varieties.

There is no action wtihout a consequence.