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 Rx: How to Live Well with Chronic Disease 
 
The following is one in an ongoing series of columns entitled Mind Body Health by . View all columns in series

Managing Daily Activities
Life doesn't end if you have chronic illness. There are still chores to do, jobs to perform, and relationships to maintain. Things you once took for granted can become much more complicated, but you can learn new skills to maintain your daily activities and continue to enjoy life.

Break the Cycle
Chronic disease often brings fatigue, pain, shortness of breath or other symptoms that support a "vicious cycle" of physical inactivity. You can't sleep and your energy drops. You become weak and deconditioned. Deconditioning leads to feeling helpless, which in turn discourages physical activity. And so on. The solution is to break the cycle with gentle, gradual physical activity. As your physical activity increases, your strength and stamina grow, your mood improves, and soon you'll be carrying out your normal daily activities.

One Step at a Time
When living with chronic disease, it's easy to focus on limitations and disabilities rather than potential. The tendency is to overemphasize the risk of exertion. There are safe limits within which people with chronic disease can live a vital and fulfilling life.

Identify a specific action you would like to take. Break it down into small steps. If you want to walk a mile to the park, start by walking a block. Each successful step brings satisfaction, boosts your mood and enhances your confidence.

Managing Your Emotions
When you are diagnosed with a chronic illness, your life changes. The future looks different. Your familiar routine is altered. Life plans may be thwarted. The resulting emotional shift can magnify your symptoms and disabilities. Watch for the following common feelings:

Anger: "Why me - it's not fair. I am frustrated that I can't do what I used to do."
Anxiety: "I'm afraid of what might happen to me. The future is so uncertain."
Depression: "I can't do anything anymore. What's the use of trying."
Isolation: "No one understands. No one wants to be around someone who is sick."

Learn the skills to manage these negative, limiting emotions.

Explore Your Feelings
Learning you have a disabling chronic disease can be a profound shock to your sense of self. It changes your perceptions of who you are, who you were and who you will become. Suddenly you discover that you are not invulnerable after all. "These things" don't always happen to other people. These traumatic feelings can hit hard so give yourself the time and space to come to terms with them. Like bereavement, chronic illness can bring with it powerful feelings of loss: loss of aspirations, plans, or physical abilities.

People often go through various stages of feelings when diagnosed; Denial: Denying or not believing the diagnosis; Anger about being ill and blaming others; Bargaining or guilt: Attempts to reverse the diagnosis by offering something in exchange; "I'll give up smoking if you'll take away the disease." Depression: Feelings of helplessness and loss of control; Acceptance: "I don't like being sick, but I can live with it."

These stages are all normal responses. Express your feelings. Pent-up anger or unvoiced sadness can undermine important efforts to manage your illness. Take time to learn the proven skills for managing angry feelings and depression.

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 About The Author
David S. Sobel, M.D., M.P.H., is a practicing physician in adult medicine and Medical Director of Patient Education and Health Promotion for Kaiser Permanente Northern California. He is physician lead for the......moreDavid Sobel MD
 
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