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Coping with chronic conditions

Published in Behavioral Health Services, For the Health of It Author: Toni Mahowald, PsyD, MAPP

Stress can have a powerful impact on health (read "Can stress really impact your health" or view this YouTube video from AsapScience for additional information). When our health is the source of stress, such as when we are diagnosed with chronic conditions like heart disease, diabetes or COPD, we may need to find new ways of coping. One concept that can be helpful in managing your diagnosis is that of the “new normal.” The new normal means developing an understanding of how our diagnosis changes our capacity, relationships and bodies, and adjusting to lifestyle modifications such as regularly testing blood sugar, weighing ourselves daily, taking medications or managing side effects.

When we are able to accept our new normal, we are more likely to feel that we are living rather than just existing. One way to think about this process is to use a framework of stages. The caveat to this is that people rarely move through stages in an orderly way — it is often much more like a rollercoaster than a staircase.

Developing the new normal often requires going through the following stages:

  1. Shock
  2. Denial
  3. Anger/depression
  4. Adjustment/acceptance

See more information from for more on these stages.

Acceptance often involves finding new ways to engage in the activities you enjoy. For instance, if you enjoyed writing letters in the past, but can no longer hold a pen, you may choose to dictate your letters, or call someone on the phone, or see them in person. These adaptations allow for continued social connection while adjusting to a change in physical capacity.

Ways that you can help yourself to develop your new normal include:

  1. Develop or maintain a solid foundation. We are more vulnerable to negative emotional states when we are out of balance in the following areas. It is very important to understand how each of these areas impacts your emotions as different people may be more or less sensitive to any of the following:
    • Physical illness
      • Follow treatment recommendations
      • Use medications as prescribed
    • Balance eating
    • Avoid mood-altering substances
    • Balance sleep
    • Get exercise (as you are able)
  2. Practice mindfulness. Mindfulness is a practice that helps us to be in the present moment in a non-judgmental way. Programs such asMindfulness Based Stress Reduction are based on the idea that greater awareness will reduce negative affect and improve vitality and coping, and have been successful in helping people with chronic pain, heart disease, cancer, depression and anxiety.
  3. Engage in active coping. When we engage in active coping for the management of chronic conditions, we are more likely to notice:
    • Improved physical activity levels
    • Higher levels of social interaction
    • Lower levels of depression
    • Shifting focus to aspects in your control
    • Adaptive thinking

    In order to be effective, it is essential to remember to

    • Set aside time for breaks and relaxation
    • Don’t over exert yourself
  4. Seek support. People with chronic conditions often feel that they suffer alone. Seeking support from prior networks (e.g., community, family, or faith-based) or new networks (e.g., condition specific support groups, health care providers) can help to manage the distress associated with your diagnosis and with the adaptations it may require.
  5. Be an active member of your treatment team. Learning about your condition, and about treatment options can be empowering. Ask your treatment team for recommendations for information or support either in your community or online.

While a new diagnosis may require significant changes in your daily life, they do not mean the end of fulfillment, enjoyment or engagement. This list, which is by no means comprehensive, provides some ideas to help you on your journey to developing your new normal.