The initial diagnosis of a chronic illness, in my case Rheumatoid arthritis, can be frightening. It feels like a form of bereavement, as if part of you is irrevocably lost. Coming to terms with such life changing news is a long process and we need to give ourselves time and space to accept the new reality. As I began reading around the subject to gain some perspective, I was struck by the similarities between the Kubler-Ross grief cycle and the emotions I was feeling. You begin with denial, avoidance, confusion and fear. Anger, frustration, irritation and anxiety soon follow. There is a struggle to find meaning and a growing desire to tell your story. Unfortunately depression often ensues. It is estimated that over a third of people with a chronic illness experience mental health issues.
In my experience traditional western health systems tend to treat the symptoms rather than the person. Dr Gabor Mate, in a podcast with Tami Simon (2023), makes the point that doctors don’t often ask questions about a patient’s childhood and how trauma is often the precursor to chronic disease. Thus we often leave an appointment with a consultant without having checked in on our mental health. So, if we are essentially alone with our feelings, what can we actively do to promote our own well-being?
Firstly, we can work on our mindset. Carol Dweck (2006) differentiated between a fixed and a growth mindset. There is little or nothing about us that is fixed and we should adopt a growth model where we constantly adapt to our environment and are open to learning new ways to tackle new situations. I am an advocate of a proactive, positive approach. What can I do to improve my well-being? What can I focus on that is within my control?
Secondly, it is vitally important to be able to talk about your feelings openly and freely. Families and friends are obviously the first port of call but it is good to interact with others who can offer an objective rather than a subjective point of view. People who also have a chronic illness will have more of an innate understanding of issues that you mutually encounter. Support groups can be invaluable as long as they are positive, with an emphasis on developing strategies to cope with a chronic illness.
Thirdly, explore life choices, be self-reflective and practice meditation. It is important to take some time out each day to clear the mind. There are also a number of other ways to improve well-being. As a consequence of my diagnosis I have adopted a vegan diet and avoid processed foods. This led to a weight loss which lowered the stress on painful feet and ankles. Also, look for as many different ways of moving as possible. Prior to having RA I was still playing contact sports but was unable to continue, rather than sit on the couch I looked for a non-weight bearing sport to keep me moving. Cycling has proved to be an absolute godsend. Yoga, whether bikram or chair, is also hugely beneficial. Any form of stretching is good. Whilst appreciating that some people will be more restricted in their options, it is important to move as much as possible. If it is a gentle walk, that’s marvellous. Whilst it is important to take things easy, remember that if you rest too much you rust! Getting out and connecting with nature is therapeutic and life-affirming. Take a step forward and have a look at some positive principles below.
M move
I interact
N never live the label
D discuss
S smile
E evolve
T take control