How to Handle Stress When Living with Chronic Illness

It is a fact of life that stress is part of all of our lives. But for people managing a chronic rheumatic or orthopedic condition, the pain, fatigue and unpredictable symptoms and flares you may experience can elevate stress levels sky high. Stress may also contribute to flares that cause even more stress!

“At the same time, it is important to remember that there are many soothing strategies you can employ proactively to keep excessive stress at bay,” says Joan Westreich, LCSW-R, Social Work Coordinator of the Early Arthritis Initiative at HSS.

What is stress?

Acute stress can occur when you’re faced with tasks that need completing on a timeline or when you’re running late, dealing with a minor illness or having an argument. Chronic stress, on the other hand, occurs over a period of time. Some examples include family pressures, financial concerns or long-term health issues.

A certain amount of stress is beneficial and can help us focus on a task (think studying for a test). Stress also helps protect the body from harm. The stress hormones cortisol, adrenaline and norepinephrine released during the flight, fight or freeze response help us prepare for a perceived acute threat. But the experience of physical, emotional and mental stress over an extended period of time can be overwhelming. The resulting prolonged exposure to these hormones has a negative impact on one’s health, including issues involving blood pressure and the immune system.

What can you do about stress?

Understanding what causes your stress, as well as identifying your personal stress triggers, is a first step. Next, you can develop strategies and tools to de-stress and maintain greater calm. You may not be able to control the course of your illness, but you can have some control over the way you handle illness-related stress. Start with the techniques below and see what works for you.

Look for your triggers

Of course, some triggers are related to your illness. If your disease flares or makes you feel unwell, you’re likely to feel stressed in response. Often, though, stress triggers are related to things surrounding the disease, rather than the disease itself.

For example, you may have a friend who seems insensitive to your feelings or who trivializes your illness. Sometimes, being around that person may make you feel stressed out or depressed. Some ways to help lessen your stress: focus conversations on subjects other than your illness or, perhaps, spend time with that person engaged in activities you both enjoy and look to other friends when you need an empathic ear. It’s also important to identify the triggers that you can control or avoid versus those you cannot.

Practice self-compassion

Self-compassion, or treating yourself with the same kindness and care as you do your friends and loved ones, goes a long way in coping with the stress of chronic illness. You may not always feel up to joining in activities, or you may need to withdraw from commitments to look after your health. Give yourself permission to do so without judgment, just as you would with someone else you care about.

Seek support from others

It can be frustrating and angering when the people in your life don’t understand what you are going through. Living with a chronic illness has an impact on you and your relationships with others. It can also influence changes in your role in various areas of life, as well as your need for help from one day to the next.

Often these changes are not easy for others to understand. If you’re looking to friends or loved ones to help you deal with your illness, give some thought to these questions to help you better identify and potentially receive what you need:

• How can you best communicate your experience to others?
• How can you ask for the support you need? What would be most helpful to you, just an ear to listen or someone to help with tasks?
• What are your barriers to asking for the support you want?

Practice self care in many ways

• Be aware of your patterns of thinking and the ways in which you may, for instance, tend to attack or criticize yourself.
• Spend time with supportive family and friends.
• Get adequate rest and sleep.
• Carefully choose what you eat and drink.
• Reduce stress through exercise, breath work, meditation, spiritual practice and/or various types of yoga.
• Participate in activities that bring you joy or increase your creative expression, such as listening to music, dancing, creating art or writing in a journal.

Stress-relief techniques

Conscious yawning exercise

You may recognize that when you are anxious, you yawn more. Conscious yawning increases the oxygen content in your body and can reduce stress, increase relaxation and promote alertness and cognitive awareness. Can’t yawn? Try faking it five or six times. You can do this both standing up or sitting down.

Another no-cost, portable de-stressing tool is 4-7-8 breathing, which is a form of the ancient yoga practice of "pranayama," or breath control.

4-7-8 breathing

1. Place your tongue on the roof of your mouth, behind your teeth and exhale.
2. Inhale for a count of four.
3. Hold your breath for a count of seven (set your own pace).
4. Exhale to a count of eight.
5. Inhale again.
6. Repeat steps 1 to 5 three more times.

“Over time, by practicing some of the strategies outlined above, you may become more confident about your ability to minimize and manage your health-related stress,” says Westreich.