On Tuesday, American pop star Selena Gomez cancelled her Dubai concert, which was set to take place in three months as part of her Revival World Tour. She issued a statement that she would take a career break in order to be proactive about her physical and psychological well-being.
Gomez, like millions of others around the world, has lupus.
The 24-year-old opened up about her struggle with the autoimmune disease last year. She revealed she had taken a break to undergo chemotherapy. In the near future, she will take another break to deal with what she calls ‘side-effects’ of the disease: depression, anxiety and panic attacks.
Gomez is not alone, neither in her chronic illness, nor her psychological symptoms.
“Just because you have lupus — or some other chronic disease — doesn’t necessarily mean that you will have a psychological issue like depression or anxiety,” said Dr Michael Hamarneh, a consultant clinical psychologist at Mediclinic City Hospital in Dubai.
“However, anybody who has a chronic disease to deal with — imagine the enormity, in terms of their psychological well-being, to know that you have something that you need to get treatment for, for the rest of your life.”
Dr Hamarneh said a psychological impact is normal for anyone with a serious or chronic disease.
“They may develop mild, moderate or severe symptoms of depression, anxiety, panic and so on and so forth,” he said.
Lupus, a chronic illness, has many manifestations that can impact nearly any part of the human body. It is primarily found in women between the ages of 15 and 44, and can cause problems in a person’s heart, brain, skin, joints, lungs and kidneys. It can be difficult to diagnose due to the breadth and commonality of some of its symptoms, including hair loss, fatigue and weight changes.
Lupus has no cure and can potentially be deadly. However, persons with lupus can lead healthy and active lifestyles with proper medication and care.
But mental health must also be looked after. Patients of chronic illness who are in remission — a period when symptoms are lessened, or become non-existent — can actually trigger an increase in the intensity and the frequency of their medical condition by neglecting to deal with their psychological stressors.
For lupus patients, this can result in a flare-up, which is when symptoms reappear or worsen.
“They may have other situations in their lives that are impacting them, and if they’re not dealing and coping with it very well, if they don’t have a healthy outlook, healthy nutrition, they’re not sleeping well, it can exasperate the medical condition,” said Dr Hamarneh.
Gomez joins a list of high-profile musicians who have opened up about their mental health struggles, including Adele, George Michael, Leann Rimes, and Gomez’s former boyfriend, Justin Bieber.
Dr Hamarneh applauded this openness, as it can reduce stigma surrounding mental health.
He also pointed to the taxing nature of touring — or going ‘on the road’.
“There’s lots of travel — it’s very gruelling. They don’t get any sleep — the rhythm is disrupted — going from country to country, and experiencing jet lag. That wreaks havoc on the body anyway, and that, in essence, increases a person’s anxiety, and maybe will impact or effect their mood.”
Most recently, pop star Zayn Malik cancelled a festival performance in the UK, where he would have performed in front of 90,000 people, due to what he called the “worst anxiety of my career”. He performs in Dubai on October 7.
“Certainly, people who are in the public eye, people who have to perform in front of thousands, that’s immense pressure. Which, even if they don’t have any conditions like lupus or any other chronic illness, still would be very intimidating or difficult sometimes for some people,” said Dr Hamarneh.
Public figures are under a lot of pressure. But they’re not the only ones. Those with jobs that can impact the safety of others — such as nuclear plant employees and air traffic controllers — or those who work with targets and deadlines are also likely to deal with psychological effects, said Dr Hamarneh. This is true, too, for senior positions such as COO and CEO.
“The larger the pressure, the more likelihood that a person can develop those symptoms,” he said.
Those diagnosed with a serious or chronic illness will often go through a grieving process at first, starting with shock, denial and anger.
For Gomez, a young woman at the peak of her career who is adored by millions, she would also realise that “all the fame, and all the money, and all of that, doesn’t even change the fact that she has this. When people come to terms with that, it’s pretty difficult from a psychological perspective.”
But it also depends also on the person, Dr Hamarneh said. No two people who have lupus will respond in the same way. Some could turn to self-medication or substance abuse. Others are naturally more positive and have better coping mechanisms.
Dr Hamarneh stressed the importance of having a strong support system.
“Somebody who lifts your spirits, somebody who can be there for you, somebody who understands you and provides you unconditional acceptance and support for who you are as a person,” he said, adding that being loved unconditionally is a precious thing.
“We don’t feel that way about everybody in our lives, but there are a few people who we trust with our most intimate thoughts and what’s happening with us.”
He urged persons with a chronic illness to also talk to their health-care professionals, particularly about the medications they are taking or might take. Medicines can cause side-effects that mimic symptoms of mood disorders.
“Many medications cause hallucination, panic, anxiety, depression, and some other things as well. It’s really important for the person to be really aware,” he said.
“I encourage the person to be proactive in terms of their treatment, making sure that they speak to their primary care physician, or the specialist, or the person who’s taking care of their condition, and make sure that they understand and have explored all the different options available to them in terms of the medication.”
Mental health issues are extremely common, and impact about 70-80 per cent of people we encounter on a daily basis, according to Dr Hamarneh.
“Seven to eight people, out of ten people that you pass by on the street, will have had some anxiety or some depression or some kind of a psychological issue in their lifetime,” he said.
“Because we all have to pass through many terrible passages of life — illnesses, death, so many things in life that we have to navigate. It’s actually a lot more prevalent than people think.”
Steps to take when dealing with chronic illness and psychological symptoms:
— Find a venue to share and talk with people; keeping it inside exacerbates the problem.
— Talk to the professionals who are taking care of you and your conditions.
— Be as aware as possible of the potential side effects of your medications.
— Keep an eye out for red flags and watch out for any sudden changes in behaviour or mood.
— Be aware of the impact of chronic illness on your mood, understand the need to get professional help and activate your support systems to the extent possible.
