The Chronic, Part One....

Sue Bergeson Health Guide
  • No, not that "Chronic." With all due respect to Dr. Dre, what I've been thinking about affects more of us than those who enjoyed his classic 1992 album. Depending on which numbers you go by, as many as 25 million of us in the U.S. live with the chronic conditions of depression or bipolar disorder. If you add up the number of people who live with any chronic condition-arthritis, diabetes, lung disease, chronic pain, heart disease, asthma, irritable bowel syndrome, cancer-the numbers get truly staggering. We all have some things in common, and I actually never thought about that before.

     

    In her book, Living a Healthy Life with Chronic Conditions, Kate Lorig, RN, DrPH, outlines what 19 illnesses have in common and identifies the successful tools all of us are using to cope with them.

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    Let's look at what a "chronic condition" means. Lorig makes the case that illnesses are either "acute" or "chronic." Acute means the illness has a fast onset, an easily diagnosed cause, is treatable and people can be "cured"-that is, the person returns to health after a specific treatment. Heart disease, for example, is not acute because once we're diagnosed with it, we have to really watch our health and behave in different ways-we don't return fully to health after the onset of heart disease. A broken leg is usually acute because, once healed, we can return to normal, "pre-illness" functioning.

     

    "Chronic" illnesses, on the other hand, usually have a gradual onset, may have many causes, are harder to diagnose and take lifelong treatment. You don't stop treating diabetes, for example; it's always present. However, you wouldn't need to keep treating the measles your entire life. Measles are acute. Diabetes is a chronic condition. While Lorig doesn't talk about mental illnesses in her book, many types of depression and all forms of bipolar disorder are considered chronic conditions.

     

    It's interesting to me that we can learn so much from others living with all kinds of chronic conditions. For example, Lorig makes the case that most chronic conditions benefit from some combination of pain management, fatigue management, breathing techniques, relaxation, as well as managing nutrition, exercise and medications. Most of these are techniques many of us are using to move toward recovery. Whether it's heart disease, diabetes, cancer or bipolar disorder, these basic tools make sense. For years, I've been looking at the importance of wellness tools in my own recovery. These new insights put me in good company-the company of millions of others who rely on many of the same techniques I do to get through the day.

     

    See if any of this sounds familiar to you: Lorig writes about self-management skills, saying "What you do about something is largely determined by how you think about it; for example, if you think that having a chronic illness is like falling into a deep pit, you may have a hard time motivating yourself to crawl out, or you may even think the task is impossible. The thoughts you have can greatly determine what happens to you and how you handle your health problems." Remember, Lorig is talking here about things like cancer and heart disease and diabetes-not depression or bipolar disorder.

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    She goes on to say, "Some of the most successful self-managers are people who think of their illness as a path. This path, like any other, goes up and down....To negotiate this path, one has to use many strategies." Remember, Lorig is talking about illnesses like arthritis, asthma, HIV and multiple sclerosis-not depression or bipolar disorder.

     

    Lorig highlights three skills people with chronic illnesses must have in order to negotiate the path:


    1. Skills to deal with the illnesses (like how to communicate with your doctor, remembering to take medications, figuring out how to navigate the health care billing system)
    2. Skills to continue your normal life (how to manage a job, how to interact with family, how to make and keep friends)
    3. Skills to deal with emotions (the grief and anger of having to live with the illnesses, the desire for isolation, the frustration of obstacles that appear because of the illness)

    Does this ring any bells for you? It does for me. When I reframe my illness as having a lot in common with other chronic illnesses that seem to be less stigmatized (from my perspective), I somehow feel better. I also like the notion that the mental health consumer community shares the perspective of working our wellness-by paying attention to diet, exercise, stress management and other techniques-with those who live with many other chronic illnesses.

     

    For more about working toward wellness, check out our brochure, Healthy Lifestyles. And for more on Lorig's Chronic Disease Self-Management Program check out this website.

     

    Had you considered before how much you have in common with people who have cancer, heart disease and MS? Have you done any cross-illness support with others who live with chronic conditions? I would love to hear about it.

Published On: September 05, 2007