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.
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.
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.
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.
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.
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:
Practice self care in many ways
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.
“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.
Joan Westreich, LCSW-R, Social Work Coordinator of the Early Arthritis Initiative at HSS.