Living Well with a Chronic Health Problem

Living Well with a Chronic Health Problem
Gail Brenner, Ph.D.

This article provides some concrete, practical recommendations for daily coping when you have a chronic health condition.

For virtually all of us, at some point in our lives, we are faced with living with a health problem.  Whether it’s a nagging sports injury that takes months to heal or an illness such as diabetes or heart disease, we find that we cannot maintain our familiar level of daily functioning.  Chronic health problems are pervasive.  In fact, more than 80 percent of people over the age of 70 have been diagnosed with a chronic disease. Chronic illnesses may last for life and are characterized by symptoms that tend to vary from day to day.  Medical treatment is aimed at effectively managing symptoms if the problem is seen as incurable.

Although a chronic disease is a medical problem, anyone living with a chronic condition knows that virtually all areas of one’s life can be affected, including daily activities, relationships, and physical and emotional well-being. There is often a pervasive sense of loss – loss of control over our physical bodies, loss of independence, loss of ability to engage in activities we enjoy, loss of important roles that have defined who we are.

In the face of these challenges, the good news is that effective coping with chronic disease is within everyone’s reach by learning and implementing useful skills. Successful coping requires moving through denial and accepting what can and cannot be controlled. We usually cannot control the fact that we have a chronic health problem, but we can control how we relate to having the disease. We can resist and struggle and wish things were different or we can be realistic and practical about what is actually happening.

In the river of chronic disease, we can fight to paddle against the current, or we can skillfully navigate downstream following the river’s natural flow.

Good coping skills are fundamental to living successfully with a chronic illness
. By cultivating an array of coping skills, as suggested below, those with chronic health problems will discover the very real possibility of sustaining a good quality of life with satisfying relationships and meaningful experiences.

Pace your activity level each day.

  • Fatigue is often an issue for people with chronic disease. If you are exhausting yourself by trying to do too much, see if you can adjust your expectations for how much you can accomplish.
  • Set your priorities, and do only those things that are essential.  You might benefit from taking short periods of rest throughout the day.
  • In addition, it is useful to learn how to politely say “no” when you are asked to do more than you are able to.

Your attitude is essential to successful coping.

  • Although you may not have control over your physical symptoms, you do have control over where you focus your attention. Attention is like nourishment – what you feed is what will grow. If you pay attention to what you can do and what functioning remains, you will develop a positive attitude and good quality of life. However, if you feed the losses with your attention, you are likely to live in sorrow and negativity.  When you notice that you are feeling sad or frustrated, relax, take a breath, and gently shift your attention to what is healthy, whole, and alive in you.
  • Find a balance regarding the expectations you have for yourself.  Be realistic.  Do as much as you can, and keep yourself encouraged about maintaining your activity level.  However, if you expect more than what is possible, you are setting yourself up for disappointment.
  • Gratitude is a wonderful antidote to negative thinking. There is always something to be grateful for – the love of family, the kindness of a stranger, the beauty of nature.
  • Identify someone you know who is wise and effective in dealing with life’s challenges.  Use that person as a role model and inspiration.
  • Do at least one thing every day that gives you pleasure, and really enjoy it. Examples include: taking a bath, seeing the sunset, watching children playing, having a good laugh.

Keep yourself as healthy as possible.

  • Discover what is working in your body and focus on these strengths.  Exercise 30 minutes 3-5 times a week or as much as your condition allows.
  • Eat a balanced, healthy diet.
  • Drink alcohol in moderation.
  • If you need to stop smoking, find the support that will help you.
  • Get enough sleep.  If you are having difficulty sleeping, find resources to help with insomnia.  You can start with a guided relaxation that you can listen to at night before sleeping.

Minimize stress in your life.

Chronic health conditions can be aggravated by stress.  Below are a few effective ways to bring greater peace and relaxation into your life.  Experiment to find what works best for you.  Identifying stress in your life and making real changes can be challenging to accomplish on your own.  Please feel free to seek professional help to guide you.

  • Learn what makes you feel stressed.  If you cannot change or avoid the situation, embrace it by saying, “yes” to it.  You may find that you feel relieved when you stop fighting what is actually happening.  As you let go of being at war with people and circumstances and accept them as they are, you are aligned with what is true and are likely to experience greater peace.
  • If you have too much to do, take an honest look at your priorities and let go of what is not essential.
  • “Don’t sweat the small stuff.”  See if you are overreacting unnecessarily to situations that don’t matter that much.  For example, maybe you can let your daughter throw her socks on the floor without getting upset.
  • Take five deep breaths twice a day.
  • Learn yoga or tai chi in a class or by DVD.  These are mind-body practices that offer meditative movement that can be very calming.
  • Take a walk in nature.
  • Listen to a recording of guided relaxation or meditation.
  • Take 5 minutes twice a day to sit in silence.

Allow yourself to accept support.

  • Relationships are key when dealing with a chronic illness, so keep the lines of communication open with family, friends, and caregivers. Talk about your needs and concerns before a problem flares up.  Recognize that one family member’s chronic illness can be stressful for everyone.  See if the experience can bring you closer and encourage you to be more appreciative of one another.
  • It can be difficult to ask for help if you are used to being independent. There is a tremendous wisdom in receiving help when it is needed. Consider asking for what you need, and graciously thanking people for their efforts.
  • Most communities contain a wealth of resources that can support people with chronic disease and their families. Consider contacting the appropriate disease-specific association (for example, Arthritis Foundation) for information, support groups, and additional tips for coping. Local hospitals often offer classes in coping with chronic illness.

Sex and Intimacy

  • Sexuality may be hindered by a chronic health condition due to a variety of factors, including fatigue, pain, body image issues, and limited mobility.  Communication with your partner is at the heart of maintaining sexual intimacy, as needs regarding lovemaking are likely to change.
  • Maintain an open perspective of what might be possible for your sexual relationship.
  • Discuss the possibility of planning intimate time together at the time of day when you feel the best.  Do whatever is needed to feel comfortable prior to your planned time:  take pain medication, indulge in a bath.
  • Allow pleasuring of all kinds to be a part of your sexual experience.  Loving touch can be just as intimate as intercourse.

If you are in pain…

  • Tell your doctor so he or she can prescribe appropriate medication.
  • Try to find a balance between resting and activity.
  • Often we automatically contract our muscles around the site of the pain, which increases the pain level. Try breathing into the pain and relaxing the muscles.
  • Visualization can be very effective. Create a mental picture of yourself in a very serene setting, such as watching waves at a beach or sitting on a mountaintop.  Embellish the scene using all the senses so it becomes very real for you. Go there as often as you like.
  • You can also try using your imagination to change the pain sensations.  If the pain is focused in one place, imagine it diffusing and disappearing.  If it is hot, imagine being in a freezer.  Lie down and allow the pain sensations to float into the space above you.  Experiment to see what helps you.

Be an active participant in the doctor-patient relationship.

  • Being an active partner in your care increases your sense of control. At each doctor’s visit, bring in a written list of your questions and concerns.
  • Follow your doctor’s orders, and let him or her know when this is not possible. Work with your doctor to make your treatment regimen fit your lifestyle.

Learn to cope with your emotions.

  • Emotions such as sadness, anger, and fear are natural. The experience of an emotion is temporary.  It may come frequently, but it doesn’t last forever.  Notice that there are times when you are not feeling these emotions.
  • Be kind and gentle with yourself, treating yourself as you would a loved one (that is what you are!).  Acknowledge difficult feelings when they are present, talk to others for support or write about them, then notice that they dissipate.
  • Emotions often last because we tell ourselves stories that perpetuate them.  For example, if you often remind yourself of all the activities that are not possible for you to do, you will continue to feel sad and frustrated.  Choose to think affirming, supportive thoughts, and you will probably feel better.
  • If you are depressed, anxious, or are having trouble sleeping, tell your doctor or visit a mental health professional.

Experience the goodness of giving.  

  • It is easy to become focused on yourself and your problems.  Even if you are not feeling well, offer your caring and good cheer to those around you.
  • Give others your attention by showing interest in them.
  • Give to out to others what you think you are lacking.
  • Be supremely kind and forgiving toward yourself and others.