Chronic illnesses – conditions that are permanent or that may wax and wane over the course of a lifetime – can touch every aspect of a person’s life. They may require you to adjust to changes in how you feel, how you see yourself, what you can and can’t eat, what you can and can’t do, the shape your relationships take, the shape you may have hoped and dreamed that your life would take.
All that adjusting can be a lot of work, physically and emotionally. It can be draining, frustrating, overwhelming, and lonely living with a chronic illness. Learning how to manage the emotional aspects – especially the distress that might come up – can make a big difference to your long-term quality of life.
Let’s look at a few ways you can do that.1. Acknowledge and validate your feelings
Navigating the emotional aspects of chronic illness starts with acknowledging and making space for how you’re feeling. Check-in with yourself about what you’re feeling, even if it’s uncomfortable or painful, rather than avoiding or ignoring it. Trying to fight or avoid our feelings is usually a losing battle in the long term, one that leaves us tired and robs us of the ability to choose how we deal with our feelings and show ourselves that we can deal with them.
Ask yourself: What’s going on with me right now? What am I feeling? Where could that feeling be coming from?
Then, validate how you’re feeling – which just means telling yourself that it’s okay to feel how you feel, that it probably makes sense that you’re feeling that way. Our feelings always come from somewhere, whether from something that’s actually happening in the moment, or from something in the past that’s being triggered by what’s happening in the moment.
- Figure out what you can and can’t change
Once you have a sense of what you’re feeling and what might be leading you to feel that way, think about whether it’s something that’s within your control, something that you can change or need to act on. For example, if you’re distressed because of physical symptoms of your condition that can be improved by medication, exercise, rest, etc., it’s important to recognize that and take the appropriate action.
On the other hand, there are very likely going to be things that you can’t change. For example, if you’re experiencing distress because of physical symptoms of your condition that actually can’t be improved, it’s important to recognize that, too, because it will require a different strategy – learning how to ride out and tolerate distress.
- Practice distress tolerance
Distress tolerance was originally developed by a psychologist named Marsha Linehan and refers to a set of skills that are meant to help you ride out and get through intense emotions without doing things that might make the situation worse. These skills rely on what we know about the physiology of emotions: that they come up, peak, and then come down, usually within minutes. We’re not biologically wired to sustain intense emotions for long periods of time – if we don’t feed them, for example by thinking about whatever’s causing them over and over, they will pass.
Distress tolerance skills can be helpful for dealing with chronic illness in two ways: first, they can help you get through tough moments when you’re experiencing intense emotions about things that you can’t change. And second, even when it’s something you can change, the emotions can be so intense that it’s hard to take the actions that you need to take. Distress tolerance skills can help you ride out those emotions until they’re low enough that you can do what you need to do to take care of yourself.
An example of distress tolerance
One of my favorite distress tolerance skills involves hacking your physiology with cold water. Hold your breath and put your face in a bowl of cold water or put a Ziplock or cold pack of water on your eyes and cheeks for 30 seconds. This makes your brain think that you’re diving underwater and starts the “dive response” – slowing your heart rate and calming your body. A calmer body can lead to a calmer mind. For more examples of distress tolerance skills, check out the additional resources below.
If you find yourself struggling with the emotional aspects of chronic illness, reach out to someone you trust or check out our Guided CBT Program for coping with chronic illness. You can access the program by visiting our Virtual Mental Health Therapy Clinic. If you are part of our Workplace Mental Health Program, please visit your company page for access to services covered by your workplace.
- McKay, M., Wood, J. C., & Brantley, J. (2019). The dialectical behavior therapy skills workbook: Practical DBT exercises for learning mindfulness, interpersonal effectiveness, emotion regulation, and distress tolerance. New Harbinger Publications.