Does my disease cause all my problems or do other things come into play?
When you have a chronic illness, many other things can make problems worse or cause new problems. Kate Lorig, developer of the Chronic Disease Self-Management Workshops, writes about the symptom cycle in Living a Healthy Life with Chronic Conditions. The disease, which is at the center, can cause a variety of other symptoms like depression, anxiety, fear, pain, fatigue, muscle tension, and poor breathing. Each of those symptoms can lead to others in the cycle. For example, constant pain may lead to anxiety and fear which in turn lead to muscle tension, which causes even more pain.
In order to manage your symptoms, it is helpful to realize that not all of the symptoms come directly from the disease. And any one of the symptoms can make the disease worse. As a person with a chronic illness, you are the only one who can identify what is going on with you and this symptom cycle. And to complicate matters even more, once you break the cycle, it will repair itself. It's your job to be aware and to take the steps necessary to break the cycle each time.
Poor nutrition is another problem. When you are sick, you are not as inclined to eat what is best for you. Instead, you may reach for the food that comforts you. You probably don't have a lot of energy to spend on food preparation, so prepared food that is loaded with blood pressure-raising sodium, refined carbohydrates, and artery[1] -clogging fat may be the norm. Without good nutrition, your body has an even harder time coping with disease. Poor nutrition is likely to lead to obesity, making your body work harder to do even the simplest things. Lack of exercise leads to fatigue, more pain, muscle tension, and sleep problems, while also contributing to obesity.
Is denial a bad thing?
Denial is a normal part of adjusting to the diagnosis of a chronic illness. In the denial stage, we feel numb. We feel as if we have been transported into some stranger's life or that we are strangers observing our own lives from outside. At first, denial is good. Denial protects us from thinking about the unthinkable. Denial gives us time to adjust, to come to terms with the diagnosis. Healthy people may perceive this period of denial as a flaw and judge us. Each person has to accept his own diagnosis in his own time and his own way.
The denial that says, "I don't have it; they are wrong," is a denial that can only last a few days or weeks at most. After that, denial takes subtle destructive forms.
Let denial be the short-term buffer it is meant to be, and then move on to learn to manage your disease.
Wanting a second opinion may be wise. Wanting a tenth opinion when the first nine doctors all agree could be denial (and pretty expensive denial at that). Not following a treatment regimen can be denial. We get tired of reminders of illness, and conveniently forgetting to take medication or self-manage our illness can be denial. Pushing yourself beyond your limits is another way of pretending your limitations do not exist. Denial may speak in the words, "What difference does it make anyway?"
Let denial be the short-term buffer it is meant to be, and then move on to learn to manage your disease. Accepting the fact that you have a chronic condition is not resignation and it is not giving in or giving up. Norman Cousins, a journalist who suffered from ankylosing spondylitis[2], said, "Never deny a diagnosis, but do deny the negative verdict that comes with it."
