How can my mind help manage my chronic illness?

In western cultures we tend to see the mind and body as two separate entities. You already know that what is going on in your body with your chronic illness affects your mind and emotions in many ways. You might experience trouble thinking and remembering. Unpleasant emotions like anger, fear, sadness, hopelessness, and helplessness can become constant companions. These are examples of how the sickness in the body affects the mind.

The mind can also affect the body. This is not the Pollyanna notion that you can simply think away your condition. It takes work. What you think causes what you feel. What you feel affects how your body functions. If you change the way you think, then you change your feelings and change what happens in your body. For example, if you think someone or someone is threatening, you will feel stressed and defensive. It doesn't have to be a real threat. Your perception is all that matters. When you feel stressed and defensive your body releases extra adrenaline, raises blood sugar, raises blood pressure, and activates the immune system. All of this happens just because you thought. You thought you were threatened.

You are not a victim of your thoughts unless you choose to be one.

As with so many other things, awareness is the beginning of change. What are you telling yourself? For one day, pay attention to your thoughts and your self-talk. Write down what you are telling yourself. Take any negative or stress-producing thoughts and challenge them. For example, you could be telling yourself that this is as good as it gets and the only way to go is down. Really? How do you know? What proof do you have? Does anyone else agree with you? Challenge your thinking to see whether or not it is rational. Now write a positive statement to replace the negative and irrational one. You might say, "I am having a rough period right now, but experience has shown me that I have ups and downs with this disease. I am going to do the things I know help me feel better." You have control over what you think. You are not a victim of your thoughts unless you choose to be one. As you examine and challenge what you tell yourself, you will gradually change your thinking, which will change your feelings, which will make your body function the best it can.

What can I do to get a good night's sleep?

First, it's important to figure out what is at the root of your sleep problems. Are you in pain? Have you been sleeping a lot during the day? Are you depressed? Are you anxious and worried because of your disease? Are you getting any exercise? Do any of your medications (such as prednisone) impact your ability to sleep? Are your expectations of how long you should sleep reasonable? How much caffeine, alcohol, or tobacco do you consume each day, and what time of day do you consume it? Are you watching television or on the computer until late at night? Keep a journal of your sleep habits and what you do during each day. It doesn't have to be too terribly detailed, just enough to get a good picture of what's going on in your life. You may be able to pinpoint the reason for your sleep issues just from reviewing your writing. Do have a discussion with your doctor, but make sure you have done some homework first. Armed with this information you will be able to help the doctor come to a quicker understanding of your sleep issues and help you find a solution. Your journal may give you some clues about things that you can change and thereby improve your sleep habits.

Consider your sleep environment. Is the temperature right for you? Are your pajamas comfortable? Does your pillow support your head properly? How is your mattress? These seem like such simple solutions, but are often overlooked. It is not a good idea to sleep with the television on. The flickering light will trick your mind and body into thinking it is daytime!

Daily physical exercise helps you sleep better. If you have been avoiding exercise, you might want to give it a try. Of course, always check with your doctor first. Exercising right before bed will have the opposite effect. Your exercise should be several hours before you plan to go to sleep. Gentle stretching exercises help release tension. Some yoga postures are especially good for quieting the body and mind for sleep.

You may not realize that you are carrying tension in your body when you get into bed. Think about surrendering your body to the mattress. Personally, I use the image of being a small child cradled in my mother's lap, leaning against her chest, and feeling totally safe. Find an image that works for you.

Progressive relaxation is another wonderful tool to help you fall asleep. Once in bed, flex the muscles in different parts of the body, hold for a full minute (you can count to 60 slowly), and then release. A typical sequence would be feet and legs, then abdomen, chest, arms and hands, neck and shoulders, and finally the face.

Any adult who has cared for young children learns quickly that a regular bedtime routine helps the little ones settle down and fall asleep. It really isn't that much different with us. The first thing to do is to keep a consistent schedule of bedtime and getting up. Your body actually "learns" this schedule. A couple of hours before your intended sleep time, start to wind down. This is not a time to exercise, solve major problems, or get overstimulated by violence or horror on the television (or the news, for that matter!) This is a time to prepare yourself for deep, restorative sleep. Take a warm bath. Have a snack. Quiet your mind. Before you begin your bedtime ritual, you might want to jot down anything you want to remember for the next day. Once you have a written reminder, you won't have to listen to the mental reminders that keep you awake. Play a recording of ambient, relaxing music as you go to sleep. Soon the evening bedtime ritual will trigger sleep. It almost goes without saying that if you sleep until noon, you will not be ready to sleep at 9:00 p.m. Consistent waking times are important if you want to have a consistent sleeping time.

If you try all of these techniques and still can't sleep, have an honest discussion with your doctor. There are prescription sleep aids available that carry a very limited chance of causing dependency.

Frances R.'s comment:

It's so confusing. I was newly diagnosed. The doctor didn't really explain what I could expect. So there I was, sitting in his waiting room. I struck up a conversation with another patient. When she found out what I had, she went on to describe, in great detail, how a friend of hers had the same disease and how she died a slow, lingering death as one by one her organs failed. One of my co-workers told me I might as well quit working now because my disease would make me too tired. A neighbor told me about somebody else who cured themselves just by changing their diet. They can't all be telling the truth. I just don't know what to believe.