--- title: "Chronic Illness and Mood" description: "Why low mood with a chronic condition is not a reaction, the grief involved, and what counselling can address when the illness will not change." url: https://www.westpeakwellness.com/guides/chronic-illness-and-mood lang: en-CA section: "Guide · Health" date_modified: 2026-09-02 publisher: "Westpeak Wellness" publisher_type: "Registered Clinical Counsellor practice, British Columbia, Canada" delivery: "secure video only; no in-person office" not: "not a crisis service; not a medical practice; not covered by MSP" contact: info@westpeakwellness.com source_html: https://www.westpeakwellness.com/guides/chronic-illness-and-mood index_of_site: https://www.westpeakwellness.com/llms.txt license: "Content © Westpeak Wellness. Quote with attribution and a link." --- # Chronic illness, pain, and what it does to mood Living with a chronic condition or persistent pain carries specific psychological load: grief for a former body and a former future, the exhaustion of managing a system, and the particular injury of not being believed. Counselling cannot change the condition. It can address the parts that are psychological, and there is good evidence that doing so improves how the condition is lived with, including, for chronic pain, the pain itself. Being told the distress is understandable is true, and it is not the same as being offered anything. 7 min read · Updated September 2, 2026 [Book a free consultation](https://www.westpeakwellness.com/book) [All guides](https://www.westpeakwellness.com/guides) > Written by a **Registered Clinical Counsellor** in independent practice in British Columbia. > > Updated September 2, 2026 · 7 min read · [How these pages are written](https://www.westpeakwellness.com/editorial-policy) · [Scope and accountability](https://www.westpeakwellness.com/standards) > > General information, not clinical advice, and not a diagnosis. Sources are listed at the foot of the page so you can check them. ## Why "understandable" is not enough People with chronic conditions are frequently told that low mood is an understandable reaction to their circumstances. It is usually true and it functions to close the subject, because an understandable problem sounds like one that does not need treating. The result is that mood goes unaddressed for years on the grounds that it makes sense. Meanwhile it is doing real damage: to sleep, to adherence, to the energy available for managing the condition, and to relationships already under strain. It also runs in both directions. Chronic pain and several chronic conditions have direct physiological relationships with mood, and low mood measurably amplifies pain perception. Treating them as separate problems where one is merely a reaction to the other misses that they are maintaining each other. The practical position is that distress being reasonable is not an argument against treating it. Grief after a bereavement is also reasonable, and nobody concludes from that it should be endured alone. [![Three stacked bands describing nervous-system states: hyperarousal above the window, the window of tolerance where thinking and feeling work together, and hypoarousal below it.](https://www.westpeakwellness.com/img/window-of-tolerance.svg) (full size, opens in a new tab)](https://www.westpeakwellness.com/img/window-of-tolerance.svg) Therapy works inside the middle band, which is why capacity is built before memory is opened. ## The specific losses - **The body you had** , A real bereavement with no ritual attached. Capacities that were assumed are gone, and there is no funeral, no acknowledgement, and frequently no one who treats it as a loss. - **The future you assumed** , Plans, a career trajectory, a way of parenting, a retirement. Frequently the larger loss and the least discussed. - **Being believed** , For conditions without a clear test: persistent pain, fatigue conditions, several others. The experience of being disbelieved by clinicians, employers and family is its own injury and a well-documented one. - **Spontaneity** , Everything requiring calculation. How far, how long, what it will cost tomorrow. Exhausting in a way that is impossible to convey. - **Identity** , Where the role that was central. The capable one, the athlete, the one who copes, is no longer available, the question of who you are without it is genuine. See [life transitions and identity](https://www.westpeakwellness.com/guides/life-transitions-and-identity) . - **Relationships that reorganise** , Partners who become carers, friendships that thin because you cancel, and the guilt attached to both. If the condition is not going to change and you are exhausted by carrying it, [a free 15-minute consultation is a place to start](https://www.westpeakwellness.com/book). ## What counselling can actually do Not cure anything, and it is important to say so plainly. What it can do is narrower and useful. **For chronic pain specifically, the evidence is more than supportive**: psychological approaches, particularly acceptance-based and cognitive-behavioural ones, have a real evidence base for improving function and quality of life, and in some cases pain intensity. That is not a claim that the pain is psychological; it is a claim about how the nervous system processes it, which is a different thing and frequently mistaken for the first. **Grief work**, for the losses above, which are almost never named as losses by anyone else. **The relationship to the symptom.** [ACT](https://www.westpeakwellness.com/approaches/acceptance-and-commitment-therapy) in particular was developed partly in this context. The aim being to reduce the cost of the struggle against a symptom that will not resolve, and to reclaim the life that the struggle was consuming. **The practical psychology of a long illness:** managing appointments and disbelief, deciding what to disclose at work, handling the anger, and pacing rather than boom-and-bust. **And the strain on relationships**, which is frequently the thing that finally prompts the call. > Keep reading > > [Individual counselling for illness and mood](https://www.westpeakwellness.com/services/individual-therapy) [![Two overlapping circles. Burnout is tied to a specific context and often lifts on extended leave; depression is present across contexts. Shared features include exhaustion, poor sleep, difficulty concentrating and withdrawal.](https://www.westpeakwellness.com/img/burnout-vs-depression.svg) (full size, opens in a new tab)](https://www.westpeakwellness.com/img/burnout-vs-depression.svg) Overlapping symptoms, different reach. ## What should not happen Being referred to counselling is sometimes used as a way of implying that a symptom is not real. That happens, it is a genuine harm, and people who have experienced it are right to be wary of the suggestion. A counsellor should be clear that they are not assessing whether your symptoms are physical, are not qualified to, and are not treating them as psychological in origin. The work is on what living with them costs, which is a separate question that does not require any position on causation. It is also worth saying that counselling does not substitute for medical care and should never delay it. A new or changing symptom belongs with a physician, and a counsellor who suspects something is being missed medically should say so. Practically, a virtual practice matters here more than almost anywhere: for someone whose condition makes leaving the house a project, a session from home is frequently the difference between having support and not. ## Common questions **Does this mean my symptoms are psychological?** No, and a counsellor is not qualified to make that assessment. The work addresses what living with symptoms costs, which requires no position on what causes them. **Can counselling help with pain?** Psychological approaches have a genuine evidence base for improving function and quality of life in chronic pain, and in some cases pain intensity. That is about how pain is processed rather than about it being imagined. **I am tired of being told to think positively. Is this that?** No, and that advice is reasonably resented. The approaches used here are about making room for a difficult reality rather than reframing it as fine. **Can I do sessions on bad days?** Sessions run by secure video from wherever you are, camera off if you prefer, and pacing is something to plan around rather than push through. ## Sources - [HealthLink BC, mental health and substance use](https://www.healthlinkbc.ca/mental-health-substance-use) - [Canadian Mental Health Association, BC Division](https://bc.cmha.ca/) - [Pain BC](https://painbc.ca/) This guide is general information, not clinical advice, and it cannot diagnose anything or replace an assessment. If you are in crisis, call or text **9-8-8** (Canada, 24/7) or BC Mental Health Support at **310-6789**. ## Who you would talk to Taking new clients and seeing people across BC by secure video. Each is a Registered Clinical Counsellor; the registration is on the profile and can be checked on the BCACC register. ![Camille Granda, Registered Clinical Counsellor, seated and listening](https://www.westpeakwellness.com/_next/image?url=%2Fimg%2Fphoto%2Fcamille-chin.jpg&w=256&q=75&dpl=dpl_5oWqSyeZ3Dmx9o1tJgbj87jckevt) ### Camille Granda, RCC, CCC English and Tagalog · Trauma, Anxiety and chronic stress, Grief, loss and life transitions In her words: “I want sitting with me to feel like the biggest belly breath you have ever taken.” [Book with Camille](https://www.westpeakwellness.com/book?with=camille-granda#calendar) [More about Camille](https://www.westpeakwellness.com/practitioners/camille-granda) ![Savneet Singh, counsellor at Westpeak Wellness, smiling at the camera](https://www.westpeakwellness.com/_next/image?url=%2Fimg%2Fphoto%2Fsavneet-singh.jpg&w=256&q=75&dpl=dpl_5oWqSyeZ3Dmx9o1tJgbj87jckevt) ### Savneet Singh, RCC English and Punjabi · Anxiety, Depression, Trauma and attachment In her words: “Comforting, safe and supportive, is what I aim for.” [Book with Savneet](https://www.westpeakwellness.com/book?with=savneet-singh#calendar) [More about Savneet](https://www.westpeakwellness.com/practitioners/savneet-singh) Individual sessions are $140 for 50 minutes, after a free 15-minute consultation; card at booking. Many [extended health plans](https://www.westpeakwellness.com/resources/does-my-plan-cover-counselling-bc) reimburse a Registered Clinical Counsellor, depending on the plan, so check yours; MSP does not cover private counselling. [All fees](https://www.westpeakwellness.com/pricing). ## Still deciding? A free 15-minute consultation is the least committal way to find out whether this is a fit. No pressure, and no obligation to book a session afterward. [Book Free Consultation](https://www.westpeakwellness.com/book) Not ready to book? [Send a line about what is going on](https://www.westpeakwellness.com/contact). A reply comes within one business day. Or a smaller step: [What sessions cost](https://www.westpeakwellness.com/pricing) · [What the free 15 minutes is like](https://www.westpeakwellness.com/resources/before-your-first-consultation) Looking on behalf of someone else? [What to send them, and what not to](https://www.westpeakwellness.com/refer), including the funded routes most people do not know they qualify for. Keep reading ## Related pages [Individual counselling for illness and mood](https://www.westpeakwellness.com/services/individual-therapy) [How to get stress leave in BC](https://www.westpeakwellness.com/guides/stress-leave-bc) [Online counselling in Kelowna](https://www.westpeakwellness.com/online-counselling/kelowna) [Acceptance and commitment therapy](https://www.westpeakwellness.com/approaches/acceptance-and-commitment-therapy) [Grief without a timeline](https://www.westpeakwellness.com/guides/grief-without-a-timeline) [Life transitions and identity](https://www.westpeakwellness.com/guides/life-transitions-and-identity) [Mental health and work in BC](https://www.westpeakwellness.com/resources/workplace-mental-health-bc) [Book a free consultation](https://www.westpeakwellness.com/book) Keep going ## More counselling guides [Workplace bullying: what it is, and what you can actually do](https://www.westpeakwellness.com/guides/workplace-bullying-in-bc) [How much medical EI pays in BC, and how the 26 weeks work](https://www.westpeakwellness.com/guides/ei-sickness-benefits-and-therapy) [Getting a doctor’s note for a mental-health leave in BC](https://www.westpeakwellness.com/guides/doctors-note-for-a-mental-health-leave) [Returning to work after a mental-health leave](https://www.westpeakwellness.com/guides/return-to-work-after-a-mental-health-leave) [Sick days and mental-health days in BC: what you’re actually entitled to](https://www.westpeakwellness.com/guides/sick-days-and-mental-health-days-bc) Where you are ## Online counselling across British Columbia Every session is by secure video, so the counsellor you see does not depend on where you live. Each city page covers coverage, local public services and who is taking new clients there. [Online counselling in Vancouver](https://www.westpeakwellness.com/online-counselling/vancouver) [Online counselling in Surrey](https://www.westpeakwellness.com/online-counselling/surrey) [Online counselling in Burnaby](https://www.westpeakwellness.com/online-counselling/burnaby) [Online counselling in Abbotsford](https://www.westpeakwellness.com/online-counselling/abbotsford) [Online counselling in Langley](https://www.westpeakwellness.com/online-counselling/langley) [Online counselling in Chilliwack](https://www.westpeakwellness.com/online-counselling/chilliwack) [Online counselling in Victoria](https://www.westpeakwellness.com/online-counselling/victoria) [Online counselling in Kelowna](https://www.westpeakwellness.com/online-counselling/kelowna) [Online counselling in Kamloops](https://www.westpeakwellness.com/online-counselling/kamloops) [Online counselling in Prince George](https://www.westpeakwellness.com/online-counselling/prince-george) [Online counselling in Saanich](https://www.westpeakwellness.com/online-counselling/saanich) [Online counselling in Maple Ridge](https://www.westpeakwellness.com/online-counselling/maple-ridge) [Online counselling in Vernon](https://www.westpeakwellness.com/online-counselling/vernon) [Online counselling in Mission](https://www.westpeakwellness.com/online-counselling/mission) [Online counselling in Courtenay](https://www.westpeakwellness.com/online-counselling/courtenay) [Online counselling in Langford](https://www.westpeakwellness.com/online-counselling/langford) [Online counselling in Cranbrook](https://www.westpeakwellness.com/online-counselling/cranbrook) [Online counselling in Campbell River](https://www.westpeakwellness.com/online-counselling/campbell-river) [Online counselling in North Vancouver](https://www.westpeakwellness.com/online-counselling/north-vancouver) [Online counselling in New Westminster](https://www.westpeakwellness.com/online-counselling/new-westminster) [Online counselling in White Rock](https://www.westpeakwellness.com/online-counselling/white-rock) [Online counselling in Richmond](https://www.westpeakwellness.com/online-counselling/richmond) [Online counselling in Coquitlam](https://www.westpeakwellness.com/online-counselling/coquitlam) [Online counselling in Delta](https://www.westpeakwellness.com/online-counselling/delta) [Online counselling in Nanaimo](https://www.westpeakwellness.com/online-counselling/nanaimo) [Online counselling in Penticton](https://www.westpeakwellness.com/online-counselling/penticton) [Online counselling in Fort St. John](https://www.westpeakwellness.com/online-counselling/fort-st-john)