Do you have an acute or a chronic illness?

By David Joel Miller, MS, Licensed Therapist & Licensed Counselor.


Acute or Chronic Illness?
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Getting the right kind of treatment for your illness is important.

Whether it’s a physical, emotional or mental disorder, getting the right treatment makes all the difference.

One of the problems we have in the behavioral health field is a tendency to treat chronic illnesses as if they were acute illnesses.

What is an acute illness?

Acute illness is something like breaking your leg. It happened suddenly, you go to the hospital and the Doctor sets it in a cast.  Eventually, the broken leg heals and you walk normally. Another example of an acute illness would be a case of pneumonia.  This can be quite serious and may result in a hospital stay.  You may need emergency treatment.  When that pneumonia goes away and you can return home.  You may have some after effects, But at some point, you will be pronounced cured of your pneumonia.

How is a chronic illness different?

Chronic illnesses have to be managed not cured.  Things like diabetes and heart disease are managed.  With a chronic illness, the Doctor continues to provide care and monitoring to keep the disease from getting worse.  In the past, acute illnesses were the main things doctors treated, today more than 75% of what doctors’ treat are chronic illnesses.

Mental health and substance use disorders are chronic illnesses.

For years we’ve made a mistake by thinking that we can treat mental and emotional illnesses as if they were acute. Someone is under the influence of a substance and are sent to detox for 72 hours.  As if substance use disorders were the same sort of things as a broken leg or an overdose of poison.

The belief used to be that once the drugs were out of their system that person was cured.  If the substance use disorder was an acute disorder, like poisoning, that would have work.  It is common for people straight out of detox to pick up drugs again within a few days. Detoxification does not work to cure substance use disorders because they are chronic illnesses.

The person sent to the psychiatric hospital for a suicide attempt might be released after two or three days when they no longer were feeling suicidal.  Sometimes that person gets additional care after the hospitalization.  But not always.

This is often another case of treating a chronic illness as if it were an acute illness. Without further treatment, after the brief hospitalization, there is a good chance that the depression and thoughts of suicide will return.

Mental health problems and substance use disorders require long-term treatment.

Repeatedly we have found that people with mental health problems who get treatment over a longer period of time are less likely to have a return of symptoms. Those people who continue to stay in treatment for up to two years after an episode of depression are less likely to have a recurrence of that depression.

With substance use disorders we find that those people who continue to stay in some form of continuing care are less likely to have a relapse.  Staying connected to whatever program or treatment helped you to recover from your substance use disorder improves the chances that you will stay recovered. In drug and alcohol treatment this continuing care is often referred to as aftercare.

One thing that has been sorely missing in mental health treatment is some form of continuing care after the initial episode. Far too often mental health issues are treated as if they were acute illnesses rather than the chronic conditions they are. Providing some kind of continuing support, groups, or individual counseling, reduces the risk of relapse into an active state of mental illness.

One highly effective continuing care system is the development of a written wellness and recovery plan.

For more about aftercare see the post in the “What is.” series.

Staying connected with David Joel Miller

Two David Joel Miller Books are available now!

Bumps on the Road of Life. Whether you struggle with anxiety, depression, low motivation, or addiction, you can recover. Bumps on the Road of Life is the story of how people get off track and how to get your life out of the ditch.

Casino Robbery is a novel about a man with PTSD who must cope with his symptoms to solve a mystery and create a new life.

For these and my upcoming books; please visit my Amazon Author Page – David Joel Miller

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For more about David Joel Miller and my work in the areas of mental health, substance abuse, and Co-occurring disorders see my Facebook author’s page, davidjoelmillerwriter. A list of books I have read and can recommend is over at Recommended Books. If you are in the Fresno California area, information about my private practice is at


2 thoughts on “Do you have an acute or a chronic illness?

  1. I totally agree. The funny thing is I have diabetes that was out of control for about 2 years. I felt miserable physically and grew more and more depressed. I didn’t even link those things with my high blood sugar. Then I got it treated and now it’s under control and not only did my physical energy return, my mental energy has also and the depression lifted. As a therapist, I think it’s important to remember both that mental illness is a chronic condition for most people and that other chronic conditions when left untreated can drastically affect ones mental health and their response to therapy.


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