Chronic Illness and Mental Health Part 2: Chronicity
Listen to this article on YouTube or Soundcloud. According to the U.S. Department of Health and Human Services, nearly 45% of Americans live with a chronic illness. That means almost half of us are living with daily symptoms and do not experience complete wellness! Given this number, chances are that you or someone you love suffers from the grips of a prolonged illness.
Whether the symptoms are severe or just plain annoying, chronic illness can take a heavy toll on a person’s mental health, be physically draining, and affect day-to-day life. Know this: There is help for those living with chronic illness and improving quality of life is within reach.
In part 1 of my Chronic Illness and Mental Health series, I discussed the Unpredictability (link) of Chronic Illness and ways to cope. In this installment, my focus will be on Chronicity and how to face the truth in the service of self-care.
The chronic nature of certain illnesses makes coping challenging. Everyone has gone through having a cold or flu, and it is miserable! One consoling thought is that you know it will pass, and you will feel better again; you do not always have that comfort with a chronic illness. In addition to the unpredictability of symptoms, you may not know when or if you will fully recover. Days turn into weeks, weeks into months, and sometimes those months can turn into years of feeling ill, and it can take its toll. Sometimes you think you are getting better, only to find yourself struggling with symptoms once again.
Most of us can cope with short-term emotional and physical pain; we have been through break-ups, death and loss, the stress of losing a job or starting a new one, the pain of childbirth or even a stubbed toe. No, I am not comparing childbirth to a stubbed toe! The point is that we have all survived time-limited emotional and physical pain. When pain is short-lived, we are equipped to cope. The same is true for emotional health. If you see a spider and experience fear or feel nervous anxiety anticipating giving a speech at work, you typically feel the emotion flow through you and then feel relief and move on. An anxiety disorder develops when the feelings and behaviors associated with fear (escape, avoidance) are chronic and do not disappear when the stressful event is over.
With chronic illness, such as autoimmune disorders, diabetes, SIBO, painful arthritis, and others, the stressful event does not immediately disappear; your body is under prolonged stress, and your emotions follow. You cannot take a break from illness like taking a vacation from a stressful job. The illness lingers, like a guest overstaying their welcome, until you want to scream at the top of your lungs, “Get out!”
When you are sick and suffer from a disorder everything else you learn about coping depends on your ability to face the fact that you are sick. Often, in my work with others, I hear people report about various long-term symptoms or diagnoses and then sort of brush it off and act like they do not exist. I can certainly understand why. These illnesses are not welcomed. Who wants to be sick? Who wants a diagnosis predicting long-term illness or recovery? Still, I work with my clients to face the fact that their symptoms are a reality because when we can be honest about this, we can then take the steps needed to cope and maybe even heal.
Prioritizing self-care may seem obvious. Nevertheless, it is often overlooked.
What do you need when you are sick? I need lots of extra sleep, quiet downtime and restful activities, food prepared and ready-to-go, and a clear calendar with as few obligations as possible. Yet, people often try to power through when sick, adhering to the same schedule and ignoring that their needs are now different. When dealing with a chronic illness, coping is not as simple as “powering through” until you feel better. In fact, often, this approach can work to your disadvantage.
As mentioned, if you have a cold or flu, you know it will pass. However, when a chronic illness takes hold, it can be necessary to accept long-term limitations and changes in your functioning. This is why facing the reality of your illness symptoms is such an essential prerequisite for self-care. To prioritize self-care, you must first be honest with yourself about what your new limitations are and what you need. This means putting aside what you think you “should” be capable of, what others seem to be able to do, and how you wish you were or how you used to be. This means standing naked, and full-frontal accepting and addressing what you need given your life at this moment. And then, of course, being brave enough to give that to yourself.
Self-care when chronically ill may not feel like pampering. In fact, it can mean saying “no” to activities you enjoy, asking for help or modifications, or telling others that you do not feel well and cannot participate as you once did. Facing these truths can feel devastating. Feeling despair is often part of this process. Notice the specification that despair is part of this process, not all. When you face the ways that chronic illness has changed your life, you need to grieve what you have lost. Just as with losing someone or something you love, if you can allow yourself to grieve, you will move through it and be able to move forward. If you are in this stage and feeling emotionally overwhelmed, try listening to my Welcome Emotions Practice to help you move through this stage of loss.
Remember that grief is not forever and does not mean that you are accepting your illness, as it stands today, indefinitely. Rather, you are mourning the changes in your body that you do not want so that you can clear your path and move forward in the wisest, most empowering way. Frequently, when we accept our situation and allow ourselves to grieve, this paves the way to change. You may find a helpful treatment provider you hadn’t previously considered, adopt a new perspective you did not realize was available, or other doors may open to you that you had not noticed were there. Through allowing yourself to face the reality and trusting this process, you can find meaning, fulfillment, and joy in your life.
I know facing your illness and prioritizing the reality of self-care needed now can be difficult, so please be gentle with yourself. Chronic illness is a process. For most, it is a long and winding road. Your needs may change periodically, and your symptoms may fluctuate without notice. As a result, how to best care for yourself can take frequent re-evaluation. Practicing gentle, self-compassion may be the kindest thing you can do. Even gently placing a hand on your heart or using soft, gentle tones with yourself can help ease the difficulty. (Listen to the meditation at the end of this article for a quick and simple practice you can use anywhere.) The tasks you are faced with require fierce bravery. Envelop these courageous steps forward in gentle, loving care, and you will see yourself progress faster and with greater ease.
GENTLE TOUCH PRACTICE
(Adapted from Kristin Neff, Ph.D. and Chris Germer, Ph.D., Mindful Self-Compassion Core Skills Training manual)
An easy way to support ourselves when we are going through a difficult time is to offer self-comforting or a soothing touch.
Start by taking 2-3 nourishing breaths.
Gently place a hand over your heart, simply feeling the gentle pressure and warmth of your hand. If you wish, place both hands over your heart.
Feel the natural rising and falling of your chest as you breathe in and as you breathe out.
Linger with this feeling for as long as you like…
Some people find putting a hand over the heart comforting and this type of touch doesn’t resonate with others. Feel free to explore where on your body a gentle touch is soothing. Let’s try some other possibilities:
Cup you hand over a fist over your heart. Take 2-3 breaths and notice how this feels.
Place one hand over your heart and one on your belly. Again, breath and notice.
Now, place two hands on your belly. With each new position, continuing to breathe and notice how this feels.
Place one hand on your cheek.
Cradle your face in your hands.
Gently stroke your arms.
Cross you arms and give yourself a gentle squeeze.
Gently stroke your chest, back and forth or in small circles. See what feels best.
Allow one hand to tenderly hold the other hand.
Gently cup your hands in your lap.
Take a moment now to notice if there was any one position you liked best, or a gentle touch I didn’t mention that you would like to try. Take the opportunity now to place your hands where they feel most gentle, soothing, and compassionate. Allow your breath to nourish your body as you feel your hands comforting and soothing you.
You can practice this any time you are under stress or use this daily as a reminder to treat yourself with care.