Coping with Chronic Illness

An emotional reaction to a diagnosis of chronic illness is quite natural.  Many people feel "strange" or unlike themselves.  They find the diagnosis to be traumatic and react in a manner common to individuals faced with a life-threatening event.  Individuals tend to re-experience the trauma through dreams or nightmares, intrusive thoughts, and increased arousal when faced with reminders of the illness.  In an effort to cope, many people engage in avoidance behaviours.  They may refrain from talking about the illness, deny it, or experience emotional numbing.  Reduced interest in usual activities may also be noted.  The anxiety prompted by the diagnosis may be experienced both physically and emotionally with individuals reporting sleep disturbance, stomach upset, headaches, shakiness, agitation, irritability, rage, and impatience with the mundane.  Symptoms of depression may also be reported.  Emotional reactions may be delayed and may be compounded by life changes that ensue.  The most common reactions to traumatic events are:

• Anxiety about the future.

• A generalized increase in concerns about safety.

• A sense of foreboding (doom and gloom).

• Emotional distress caused by events or objects that remind you of the illness.

• Intrusive thoughts about the illness.

• A wish or active attempts to avoid thinking or speaking about the illness.

• Self-blame and feelings of injustice.

• Confusion, concentration difficulties or memory problems.

• Temporary mood swings or changes in temperament.

• Shortness of temper, angry feelings, or a lack of patience with yourself or others.

• A feeling of numbness, lack of emotional responsiveness.

• Feeling depressed or detached or estranged from others.

• Sleep problems and/or nightmares.

• A change of eating patterns.

• Diminished interest in significant activities (work, social, or family).

• A reprioritizing of the relative importance of events.

• Feelings of shame and stigmatization.

Individuals may experience some or all of these symptoms.  It is important to realize that they are common and reflect the mind's attempt to resolve the trauma of the diagnosis.

When faced with a diagnosis of a chronic illness many people experience anger and a sense of injustice.  They may grieve personal losses, both present and future.  There may also be a shattering of basic assumptions about the world and life.  There is a loss of the sense of invulnerability; the world may no longer feel like a safe place.  Individuals question why this has happened to them.  If good things happen to good people and bad things happen to bad people, how can bad things happen to a good person?  It seems unjust and individuals may search for a reason, often blaming themselves.  They may also engage in victim thinking, feeling helpless and vulnerable.  Increases in dependency on others may be noted, even when this is not warranted by the illness.

Individuals may find that they are also faced with further hurts once they have received a diagnosis of a chronic illness.  Comments and actions of others, referred to a secondary wounding, may increase feelings of distress and estrangement of others.  Others may deny the illness or minimize it, blame the individual, stigmatize them, or deny needed assistance.  Frustration and resentment can also develop as a result of an inability to meet perceived expectations and from feelings of being misunderstood.  Depression may ensue as individuals grieve their losses and experience feelings of helplessness/powerlessness, hopelessness, self-blame, lowered self-esteem and guilt.

In order to cope with the trauma of a diagnosis of chronic illness it is important for individuals to discuss and acknowledge their feelings.  Rather than avoiding the issues, they must be actively confronted and emotionally processed.  The reality of the diagnosis must be accepted along with the ensuing limitations.  Adjustments must be made to accommodate the illness.  Losses need to be grieved and meaningful and fulfilling activities sought out and pursued.  The anger needs to be addressed and overcome.  Changing self-talk and thought patterns, as well as learning means of relaxation can assist in dealing with the anger.

In managing one’s illness it is important to obtain education about the illness for one’s self and for family members.  It is necessary to communicate about limitations and adjust responsibilities accordingly.  Development of a fighting spirit (optimism in the face of realistic appraisal) improves outcome.  Active participation in one’s treatment helps to provide a sense of control and avoid victim thinking.

It is also important to understand that family members have also been traumatized and they are dealing with their own feelings and adjustments.  They require personal outlets, supports, and good stress management as well. 

Copyright © 2004 Dr. A. Maura Beattie

Registered Psychologist, CPBC #1068