When living with chronic pain, fibromyalgia, or persistent gut issues like Irritable Bowel Syndrome (IBS), each day can feel like a battle against an invisible foe. Physical pain, fatigue, and digestive problems take their toll not only on the body but on every part of life. But what if the true source of that pain isn’t just the body? What if the mind, especially our thoughts, emotions, and past experiences, plays a powerful role in shaping how we feel physically? 

Pioneers like Dr. Howard Schubiner and Alan Gordon are shedding light on how the mind and body connect deeply, especially in conditions that often seem unexplainable or resistant to standard treatments. Their groundbreaking work brings a hopeful perspective, suggesting that by understanding the mind-body link, we can unlock new ways to manage—and even heal—chronic pain and other long-term symptoms. 

The Mind-Body Connection in Chronic Pain 

Dr. Schubiner, a leader in mind-body medicine, describes how chronic pain isn’t always a result of structural damage in the body. Instead, it can arise when our brain’s neural pathways become wired to interpret sensations as pain. This can occur due to past traumas, stress, or unprocessed emotions, which keep our nervous system in a constant state of high alert. Over time, our brain becomes accustomed to generating pain signals even when there’s no physical damage. 

Alan Gordon, another visionary in chronic pain recovery, elaborates on this concept through his work in Pain Reprocessing Therapy (PRT). He explains how the brain can become “stuck” in a loop where it misinterprets harmless signals as threats, perpetuating chronic pain. By retraining the brain to recognize these signals as safe, we can begin to break the pain cycle. Gordon’s approach emphasizes the power of understanding that while pain is real, it may not mean our bodies are truly injured. 

Fibromyalgia: A Perfect Example of Mind-Body Complexity 

Fibromyalgia, often defined by widespread pain and fatigue, is a classic example of a mind-body syndrome. Medical professionals often can’t pinpoint a clear, physical cause for fibromyalgia pain, which can be frustrating and confusing for those who suffer from it. But by viewing fibromyalgia through a mind-body lens, as Dr. Schubiner does, we can begin to see that it’s not “all in your head”—but it is deeply connected to how our mind and body interact. 

Fibromyalgia can develop from a combination of stress, trauma, and prolonged tension in the nervous system, which leads the brain to stay in a “pain-ready” mode. Dr. Schubiner emphasizes the importance of acknowledging past stressors, traumas, and even our personalities, as factors that shape how we respond to physical sensations. By bringing these factors into awareness and using therapeutic tools, individuals with fibromyalgia can help their brains learn to unwind from this cycle, decreasing sensitivity to pain. 

IBS and the Gut-Brain-Pain Connection: When Stress Affects Digestion 

For people with Irritable Bowel Syndrome (IBS), the gut-brain connection offers valuable insights into a condition that can otherwise feel like a mystery. IBS, characterized by bloating, stomach pain, constipation, and diarrhea, is a condition often worsened by stress, anxiety, and emotions. This is because the gut and brain communicate directly through the gut-brain axis, a pathway that transmits signals back and forth between the digestive system and the central nervous system. When we experience stress, our gut can physically react, creating discomfort or even debilitating symptoms. 

For years, treating IBS primarily involved changes in diet or medication, but Dr. Schubiner and Alan Gordon’s work demonstrates that addressing the emotional component is just as crucial. Dr. Schubiner’s approach considers the role of past emotional stress or trauma in IBS symptoms. If we think of the gut as an emotional “second brain,” it makes sense that feelings, thoughts, and past experiences can lead the digestive system to stay in a state of tension, contributing to symptoms. Gordon’s techniques in Pain Reprocessing Therapy also help people recognize when they’re feeling anxious or fearful, teaching them how to reframe those feelings to bring the gut back into balance. 

A Path Forward: Healing Through Mind-Body Awareness 

Healing doesn’t mean that the pain or discomfort is “imaginary.” Rather, it acknowledges that our brains and bodies can adapt and sometimes, adapt in ways that no longer serve us. This approach invites people to engage in mind-body therapies such as Pain Reprocessing Therapy, Somatic Experiencing, or other forms of trauma-informed therapy. By working through stored emotions, fear, and stress, individuals can help their nervous systems recalibrate, reducing pain, fatigue, and digestive issues. 

So, how do you get started? Here are a few steps inspired by Dr. Schubiner and Alan Gordon’s approaches: 

1. Educate Yourself About Pain: Understand that chronic pain, while real, doesn’t always mean physical harm. It may reflect your brain’s heightened alertness to potential threats. Knowing this can take the fear out of pain, which is essential for healing. 
2. Challenge Painful Thoughts and Fears: Pain Reprocessing Therapy encourages noticing thoughts or fears related to pain. These thoughts can keep your brain in a pain-sensitive state. By gently challenging and reframing them, you reduce pain’s power over you. 
3. Practice Somatic Awareness: Recognize your body’s sensations without immediately labeling them as harmful. This can involve mindful breathing, noticing areas of tension, and allowing yourself to feel grounded and safe. 
4. Process Unresolved Emotions: Emotions like anger, sadness, or fear—especially those suppressed or unaddressed—can contribute to chronic pain. Therapy or journaling can help release these emotions, allowing the nervous system to relax. 
5. Focus on Reassurance and Safety: Reassure yourself that your body can handle sensations, that the pain is not necessarily a sign of injury, and that you are safe. This helps reprogram the brain’s reaction to pain, reducing its intensity. 

The journey of understanding the mind-body connection is deeply personal and often transformational. While it may not be a quick fix, learning to connect the dots between our mind, emotions, and body can help reduce suffering and create a life filled with more peace, resilience, and hope. 

Healing is possible. And with approaches like Dr. Schubiner’s and Alan Gordon’s, we are beginning to see just how powerful our minds are in shaping our paths to well-being. 

 

Do you have a friend who is diagnosed with a chronic illness? Having a chronic illness can present any number of challenges for the person who has been diagnosed. Some of these challenges may be realized by the loved ones of the person with the illness. At times, these issues also may have some impact on the lives of the people close to the person with the illness.

If you are close to someone who has a chronic illness, you may be very aware of the above. You might also, despite knowing none of these difficulties are the person’s fault, become frustrated with them from time to time.

If you do, it’s okay to admit it. You are not alone in your feelings.

Let me tell you about my good friend Sarah. We met three years ago working at a coffee shop. She is outgoing, intelligent, and driven, and we immediately hit it off. However, Sarah was diagnosed with both fibromyalgia and chronic migraines. Her symptoms flare up unpredictably, and as a result, she has trouble holding a full-time job. In fact, she lost the job at the coffee shop because she couldn’t keep up with her scheduled shifts. When she was fired for absenteeism, I felt bad for her, but to be honest, I was also relieved. Since she called in sick so frequently, coworkers, myself included, were asked to fill in for her, which disrupted our own personal schedules. Needless to say, that was difficult for all of us. [fat_widget_right]

Sarah also battles depression and anxiety related to her diagnoses. I personally can’t imagine what it’s like to live with chronic illness, but I can see how it can be depressing not being able to meet the goals you set, or frequently needing to change plans at a moment’s notice to deal with a flare-up of illness. Sometimes Sarah is too sad to get out of bed and cancels our plans. At other times she’s so anxious it makes her physically sick. Often she’s stuck in her head and doesn’t ask about how I’m doing. While I understand coping with all of the things she experiences must be difficult, it’s very frustrating when she cancels plans at the last minute or spends most of the time, when we do get to spend time together, discussing the physical difficulties she’s currently experiencing.

We show our friends we love them by offering support and our care, but we can’t forget to show love to ourselves by taking care of ourselves at the same time.

I want to support my friend, both in general and through her struggles. Our friendship is too important for me to give up. But I do also want to feel heard and encouraged by her. So as awkward as it was, I initiated a frank and open conversation. Together, we decided the following guidelines could help us both cope with her chronic illness:

1. Be a good listener. While I’m willing to listen and give Sarah support when she faces challenges, I also want to share my thoughts and feelings and be heard by her. Sometimes I just need to ask bluntly for her ear, but she appreciates it when I do and admits that listening to my problems helps take her mind off hers.
2. Be flexible. This is a tough one sometimes, especially if Sarah cancels plans at the last minute. I’ve learned that’s it’s all right to admit I’m disappointed. But it was also important for her to know that canceling plans is not a friendship-breaker. It’s important that we reschedule any canceled dates, but I also follow through with our original plans, even if it means going alone. This helps me not feel resentful about not being able to do what we had planned.
3. Be informed. Before meeting Sarah, I had no idea what fibromyalgia really was. To be completely honest, I thought it was a made-up disease. But after reading clinical articles about it and attending a medical appointment with Sarah, I was better able to better understand how this “invisible illness” affects her life. It helped me learn not to blame her when she canceled our plans.
4. Be mindful. We carefully word the questions we ask each other, using open-ended questions rather than ones that can be answered with a “Yes” or “No.” By doing so, we keep the lines of communication between us open and can get a better understanding of our situations in the moment. I also make sure to remain mindful of how I’m feeling. When I am having a rough day or week and communicate that, I feel better about being able to focus on my own needs.
5. Be honest. Honesty is always the best policy. If Sarah doesn’t feel up to walking around a museum for several hours, then I want her to tell me that. Otherwise, neither one of us will enjoy the date. Likewise, I need to be open with her if I’m feeling frustrated or unheard by her. It isn’t easy to have these kinds of conversations with anyone, but Sarah and I have found that doing so helps us maintain a healthy friendship.

I have found having a friend with a chronic illness to be both a blessing and a challenge. Chronic illness will affect Sarah forever, so as long as we’re friends, I’ll be affected too. Sarah has opened my mind to diagnoses I didn’t know existed, and that has helped me be more understanding of the many challenging situations other people might also be experiencing. My friendship with Sarah has also helped me learn to more effectively identify and understand my own needs. I have also come to better understand just how important it is to maintain open communication and focus on self-care.

We show our friends we love them by offering support and our care, but we can’t forget to show love to ourselves by taking care of ourselves at the same time. If you would like help exploring ways to prioritize self-care or work on communication, a qualified and compassionate therapist or counselor is always a good resource.

References:

1. Metzger, C. (2016, July 22). Have a friend with chronic illness? Here are 10 ways you can help. Huffington Post. Retrieved from https://www.huffingtonpost.com/entry/have-a-friend-whos-chronically-ill-here-are-10-ways_us_57866e23e4b0e7c8734f4804
2. Renee, B. (2017, November 10). 9 ways to better support someone with chronic illness. The Mighty. Retrieved from https://themighty.com/2017/11/supporting-friends-with-chronic-illnesses

It is a simple question, but one that can cause more inner turmoil than most of us realize.

“How are you feeling?”

For countless people living with a longer-term or chronic illness, that seemingly innocent question can be loaded with emotions.

As a psychotherapist specializing in living with chronic conditions, I hear countless people wonder aloud if people really want the truth. Or they worry that the truth, some variation of “not so good,” will be followed by awkward silence or unwanted advice.

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Part of the issue can also be that when you do not feel well, the people who love you are not “okay.” In that sense, if you are the one struggling with a condition, then you are also in the position of providing reassurance to loved ones that you are okay and therefore they are too.

These kinds of stressors are not helpful.

Many people with health conditions would rather scrap the topic altogether, so they grit their teeth into a forced smile and say, “I feel good! Fine!” Then everyone can get on to a different topic.

If you are living with a chronic condition, how do you respond to people who ask how you are feeling?

One of the most important things you can learn when you are experiencing a chronic condition is how to communicate about it. Deciding on a couple of go-to tools, phrases, and responses to questions can go a long way to helping you manage your stress around the condition.

1. When people ask how you are feeling, offer up a number on a scale of 1 to 10.

For instance, you can say, “Today I’m a 4. Hopefully tomorrow will be better.” And leave it at that.

In doing this, you are letting people know you are not feeling great, which can be helpful information for them. It also protects you from having to divulge specific symptoms.

2. Draw clear boundaries around how much information you will give ahead of time.

If it is someone with whom you are in regular contact, you can let them know of some general symptoms you experience such as pain, fatigue, headaches, etc. But you can decide you are not going to discuss particulars.

Having the conversation sooner rather than later, and preferably at a time when you are feeling relatively okay, will go a long way to fending off a tendency to respond in an aggressive or possibly hurtful way when you are having symptoms.

3. Cut unwanted advice off at the pass.

When you are experiencing a persistent condition, you will inevitably encounter people who know someone (who knew someone) who had just what you have, and they will know exactly what you should do.

Listen carefully for the beginnings of advice coming your way, and if it is not something you are interested in, kindly let that person know with some variation of, “Thank you for the idea, but I’ve got all the help I need right now.”

After all, people just want to help. And the truth is, if you don’t feel well, others may feel uncomfortable too, and they may feel compelled to help you “fix” it.

Of course, some people will be interested in hearing any kind of new ideas to try. But what I hear most often from the people I work with is they are already engaged with physicians, specialists, and very likely some integrative or complementary practitioners. They don’t want any more advice.

Listen carefully for the beginnings of advice coming your way, and if it is not something you are interested in, kindly let that person know with some variation of, “Thank you for the idea, but I’ve got all the help I need right now.” If they continue with their advice, just repeat.

4. Ask for you what you need, and be clear about what you do not need.

This is important for everyone with chronic conditions, and especially necessary when your condition is not visible. The people who care about you are not mind-readers. You may look like you feel great when you are buckling under pain, fear, and discomfort.

Make informing those around you of your needs a priority, especially if you are feeling symptomatic. If you need to, reschedule the dinner party, plan a date night that does not require too much energy, or send the kids to a friend’s house for a few hours.

Maybe you do not need an elaborate meal, a bouquet of flowers, or a great show of affection. Simple whole foods and a bath before bed might be all you require. The trick is to pay attention to your instincts and let those around you in on the plan.

Ask yourself what information you are willing to share and what you are willing to accept. Have some answers to the familiar and often-asked questions ready so you can get on with your day and not get mired in the details.

Whether out of obligation or out of a caring heart, more than 65 million adults in the United States take care of an elderly, chronically ill, or disabled loved one. Most of these ailing adults want to continue living at home as they age and their health declines, rather than in an assisted living situation like a nursing home. Because resources are more abundant now for in-home care, “aging in place” has become more common.

If you’re a caregiver in this situation, chances are you’re prioritizing care of another person over your own needs. You might be losing sleep and feeling fatigued or distracted. It could be you find yourself losing your temper easily. There’s even a possibility you have lost friends or are facing new financial struggles because of your caregiver role. All of this might leave you experiencing overwhelm.

Is it possible to care too much?

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The answer is yes. This “caring too much” can be described as “compassion fatigue.” Compassion fatigue, a stress condition marked by a gradual decline in compassion and empathy toward others, often affects people in professional health care positions. But it can also happen at home when a well-intentioned caregiver overexerts in helping a person with a chronic illness or disability.

Compassion fatigue is different than burnout. When a caregiver is experiencing burnout, they have all but lost the ability to empathize or give care to others. Compassion fatigue happens when we help others who are in stressful situations, and burnout originates from occupational stress and being overworked.

Signs and Symptoms of Compassion Fatigue

Caregivers tend to experience compassion fatigue rather than burnout, although in severe cases, caregivers can experience burnout too. Some signs of compassion fatigue include:

• Apathy
• Increased anxiety
• Changes in sleep (too much or too little)
• Difficulty concentrating
• Physical ailments such as headaches, stomachaches, etc.
• Withdrawal from others
• Reducing or stopping pleasurable activities
• Neglecting one’s own self-care
• Lowered resistance to illness
• Feeling impatient or irritable

Because people in caregiver situations often feel compelled to continue this role, they could be at risk for compassion fatigue. Learning to recognize and manage the signs and symptoms above effectively is imperative if you want to continue caregiving for your loved one. If ignored, these emotions and symptoms can intensify, and can eventually lead to more serious mental and physical issues.

5 Tips for Fighting Off Compassion Fatigue

If you believe you are at risk for compassion fatigue, it is not too late to stop the progression. Here are five tips for self-healing:

1. Get enough sleep: You will likely have more energy and sharper thinking when your body is well-rested. This might mean engaging home health care services or a sitter to be with your loved one through the night while you rest. It may help you recharge and feel ready to take on a new day.
2. Eat nutritious food: When we’re in a hurry, we tend to eat whatever is easy, and those choices aren’t typically wholesome. Unhealthy food (including drugs and alcohol) can leave us feeling sluggish and bloated, making it a challenge to be active and effective. Meal planning for the week can be a helpful way to stick to a healthier diet. Skipping alcohol and choosing water will likely help cleanse and rejuvenate your body.
3. Get moving: While it may seem selfish to take time out of caregiving to exercise, the fact is exercise can boost your immune system, increase the “feel-good” chemicals in your brain to fight off depression, and relieve physical stress. Sparing even 20 minutes a day can be beneficial both physically and mentally.
4. Enlist the help of others: Solo caregiving is asking for trouble. It is nearly impossible to care for another person 24/7 without aid. Asking a family member or close friend to take your place for a few hours, or enlisting home health care may give you some respite time to care for yourself. Your support system is crucial to your survival!
5. Practice boundary-setting: Know when caregiving is too much and when you need to ask for help. Even if your loved one prefers your care to someone else’s, be aware of your limits and say no when needed. Express your own needs and concerns with others.

If you are on the downward spiral of compassion fatigue, seek the support of a licensed therapist and start caring for yourself, too. As American author and teacher in American Theravada Buddhism Jack Kornfield wrote, “If your compassion does not include yourself, it is incomplete.”

References:

1. Signs of caregiver burnout and how to prevent it. (n.d.). Retrieved from https://www.vitas.com/resources/caregiving/signs-of-caregiver-burnout
2. What is compassion fatigue? (2013). Retrieved from http://www.compassionfatigue.org/pages/compassionfatigue.html

What are your core values? Can you state them without thought?

A better place to begin might be, What are core values?

A core value can be considered a life direction, an internal compass that serves to guides us throughout our lifetime. Our values mold who we are and help point us in the direction we want to take in life. According to Russ Harris, therapist and author of The Happiness Trap: How to Stop Struggling and Start Living, values are what we want our lives to be about, deep in our hearts. Values—which vary from person to person and may change over time—include ideals like trust, love, success, wealth, freedom, health, and adventure.

Some of us may have identified our core values but experience challenges or barriers of some sort in moving forward with them. For many, chronic illness may be one of these barriers. Many of the people I work with in my practice who have a chronic illness experience an internal battle between their core values and what their bodies will allow as they attempt to work to establish these values in their lives. [fat_widget_right]

Allison,* for example, is in her early twenties. She recently married, and she and her husband had planned on having children soon after their wedding, but instead Allison received a cancer diagnosis. Without hesitation, she went through the necessary therapies to treat the cancer, but unfortunately these treatments left her unable to conceive. “I want to have children, but I can’t because of my illness,” she sobbed in one session.

Allison values family, but her plan to have children was waylaid by cancer treatment. “I’m so disappointed and sad,” she disclosed, tears streaming down her face. “This isn’t where I thought I would be at this point in my life.”

Allison and I began to address this by first paring down her value list to her top three—love, family, and health— in order to help her come up with some committed action steps to help move her forward. While she cannot become pregnant herself, she can adopt children to start her family. To this end, she and her husband have begun the adoption process by going to informational meetings, saving money, and interviewing different adoption agencies.

Sometimes Allison has to sit with the feelings of sadness and grief, accepting the temporary pain with the knowledge that the feelings will pass. But she also knows that if she continues to move toward her values through committed action, she will indeed find a life filled with love, family, and health.

Determining Our Core Values

How do we determine these values for ourselves? And once we have done so, how do we take action in our lives to implement them? It’s not all that easy to do, but it can be life-changing! There are lists of core values available online, but you can also make a list for yourself.

When you have a list, further whittling it down to the top three values is next. This process, which can be an interesting and insightful one, is important, because it may be too overwhelming to find direction if we have too many core values. Like the old adage says, “The hunter who chases two rabbits catches neither.”

Once we have identified three top core values, we can move forward. Proactive behavior moves us in the direction of our values. If we find we value adventure, making plans to travel someplace new could be a “moving toward” behavior. If health is one of our core values, eating more nutritious food, exercising regularly, and practicing self-care are some committed action steps we might take.

Along the way, we might notice certain distracting behaviors that move us away from our values, rather than moving us forward with them.

Learning to be observant of our behaviors can help us catch ourselves when we’re moving away from our values and get us back on track.

Behaviors that sidetrack us might include:

• Substance use
• Binge-watching television
• Isolating from others
• Sleeping too much
• Overworking
• Excessive spending

When we get caught up in these behaviors, our values are waylaid, and ultimately, we are left feeling unsatisfied. Learning to be observant of our behaviors can help us catch ourselves when we’re moving away from our values and get us back on track. (Any of these behaviors might also be indicative of an underlying concern, though this is not always the case. It can be helpful to raise these concerns, and others that may impact daily life and function, with a mental health professional.)

Sometimes even ordinary illness or fatigue can get in the way or slow down the process of moving toward our core values, and coping with a chronic illness can make a person’s quest to attain their values particularly challenging. However, because our values are ever-present in our lives, we can always commit to some kind of action steps, even if they are small.

What kinds of distracting behaviors are keeping you from moving toward your values? Acceptance and Commitment Therapy (ACT) is one approach that can help us identify our values and make a commitment to taking action steps. I believe that doing so can ultimately help bring meaning to life, even in the midst of chronic illness.

What’s stopping you from living a rich and meaningful life?

Editor’s note: Names in the preceding article were changed to protect confidentiality. 

Reference:

Harris, R. (2008). The Happiness Trap: How to Stop Struggling and Start Living. Boulder, CO: Trumpeter.

I remember the first time I saw all the medication bottles in Mark’s cabinet. We hadn’t been together long, and I was curious to learn more about the medication he was taking. I asked him about them and he said they were for seizures. I didn’t quite understand what he meant by this, but he said “it” was under control, so I didn’t give it much more thought. I thought it was great he was willing to share such sensitive and personal information, considering it was early in our relationship.

Mark began to have seizures in his late 20s that did not respond to medication. Even though they are of the complex partial kind (e.g.,“smaller seizures”), when I witnessed one for the first time, it scared me. He wasn’t able to speak while it was happening, and he made strange sounds in addition to awkward movements with his hands.

Little did I know at that time the impact it would have on our lives. When epilepsy is under control, you don’t think about it. But when it is out of control, causing six or eight seizures a day, you can’t help but think about all the time.

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The Impact of Epilepsy on Our Lives

Gradually, the seizures got worse until it impacted his work, home, and personal life. At work, supervisors did not understand his behavior and, at one point, asked him to take a leave of absence. He missed opportunities for advancement due to his employer knowing he struggled so much with seizures, and because of this his focus was impacted. At one point, I even contacted an attorney who said nothing could be done unless Mark was fired for having seizures.

Mark could no longer drive, meaning I had to do it. This impacted me so profoundly that I became resentful, both with our relationship and with epilepsy. To me, it was the thief that took away my normally laid-back and smiling husband and took away parts of our relationship. He began to withdraw more and played video games for hours at a time, struggled to talk about “it” and his feelings, and lost the ability to focus on our relationship and look forward to our wedding and life after.

It became hard for me to cope. I had few friends and felt no one understood. How could they? No one I knew what I was going through. I didn’t want to go out much with him to social events, as I feared the embarrassing attention a seizure might attract. I hate to say that, but it’s how I felt at the time.

Once we moved out of state, Mark got better medication and his seizures have since been controlled.

Looking back, there is a lot I would have done differently. I waited too long to get Mark support from a therapist for his physical condition and for his emotional well-being, and waited too long to get couples counseling to help us manage the challenging realities of life with epilepsy, for both partners.

Recommendations for Caregivers for People with Epilepsy

I recommend caregivers seek support from as many friends, family, and neighbors as possible and reach out frequently. I wasn’t as willing to reach out to the few friends I had as I should have been, even though I felt isolated and alone.

I also think it’s helpful for caregivers to find some respite through social outings. Going out to dinner, a movie, or bowling can help you feel connected and replenish your emotional reserves.

Pursue local resources that may be available to you as well. For us, a support group for people with epilepsy and their loved ones would have made a world of difference. With the internet at our fingertips, resources including message boards and local support groups are much easier to find and participate in.

The Importance of Self-Care

I recommend caregivers take time for self-care: good eating habits, consistent exercise, plenty of restful sleep. I have learned that the more stressful the experience, the more self-care is needed to maintain good mental health. Find ways to relax through deep breathing, meditation, massage, and stretching. It can also be helpful to find a creative outlet through art, writing, or crafts.

Both people with epilepsy and those who support them can feel overwhelmed, hopeless, and helpless at times.

As a caregiver, it can be easy to allow resentment, guilt, or compassion fatigue to set in, but remind yourself that epilepsy impacts the whole family. It’s no one’s fault, and it’s no one individual’s problem. Like your loved one, you need to be cared for and supported through this difficult journey. The more you take care of yourself and get support, the better the caregiver you are able to be.

Lastly, maintaining a sense of humor through the experience is important. Epilepsy can take over your world like an unwelcome visitor and seemingly become the center of everything. Find what tickles your funny bone and come back to it as needed. Laughing reduces your stress response, relieves tension, improves your mood, and can make it easier to deal with difficult situations (Mayo Clinic Staff, 2016).

In closing, remember to keep the faith. Both people with epilepsy and those who support them can feel overwhelmed, hopeless, and helpless at times. Keep looking for support until you find it—from medical practitioners, from friends, from your community. Remember to support each other as well, because you’re in it together.

Reference:

Mayo Clinic Staff. (2016). Stress relief from laughter? It’s no joke. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456

Jake, who has been seeing me for therapy for some time, is sliding further into depression. He is struggling to get up in the morning, complete daily living tasks, and concentrate at work. Jake needs to take some mental health days off to stabilize his mood, but he’s unsure how his employer will handle his request.

Also working with me in therapy is Sarah, a person with a chronic illness who is unemployed but wants to work part-time to contribute to her family. She experiences unexpected pain and fatigue that can be debilitating, sometimes confining her to bed all day. Sarah isn’t sure if she should tell her potential employer in the interview about her condition, fearing she will not be hired.

Does either of these situations resonate with you due to a mental or physical diagnosis? Are you afraid to tell your employer about your condition out of fear you will be treated unfairly? If so, you are not alone. Many people with chronic conditions face this dilemma.

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Should You Tell Your Employer?

How do you decide whether to tell your employer about your diagnosis? Certainly, there are risks to disclosing; you leave yourself vulnerable to those around you and risk being treated differently or unfairly. But there are dangers to not telling, too. If you don’t disclose your condition’s symptoms to your employer, you run the risk of being seen as incompetent or lazy at your job, which could lead to negative consequences. And if you don’t disclose important information, you may not be protected legally in the event of discrimination.

What are your rights, you ask? The Americans with Disabilities Act (ADA) protects you from any potential consequences and requires employers to make reasonable accommodations for anyone with a condition it defines as a “disability.”

Certainly, there are risks to disclosing; you leave yourself vulnerable to those around you and risk being treated differently or unfairly. But there are dangers to not telling, too.

The term “disability” is defined by the U.S. Department of Labor as:

• A physical or mental impairment that substantially limits one or more major life activities
• A record of a physical or mental impairment that substantially limits one or more major life activities, or
• Being regarded as having a physical or mental impairment that substantially limits one or more major life activities

Likewise, a mental health disability is “a mental impairment that substantially limits a major life activity.” Some common mental health conditions include depression, bipolar, posttraumatic stress (PTSD), obsessive compulsion (OCD), panic, and schizophrenia.

Common challenges include:

• Maintaining regular attendance
• Dealing with the change of starting a new job
• Nervousness about interacting with others
• Understanding how to manage time
• Organizing information
• Handling stress and emotions
• Maintaining focus

Ultimately, disclosing your disability to your employer is a personal decision. It might be helpful for you to find support in making this decision. Your choice to tell can change depending upon the situation and the need for an accommodation. If you decide to tell your employer about your condition, do so in a way that feels good for you; share as much as you think is necessary with those who need to know.

Note: To protect confidentiality, names in the preceding article were changed by the author.

References:

1. Tugend, A. (2014, November 14). Deciding whether to disclose mental disorders to the boss. The New York Times. Retrieved from https://www.nytimes.com/2014/11/15/your-money/disclosing-mental-disorders-at-work.html
2. United States Department of Labor. (2016). Entering the World of Work: What Youth with Mental Health Needs Should Know About Accommodations. Retrieved from http://www.dol.gov/odep/pubs/fact/transitioning.htm

Children with disabilities bring a unique set of challenges, and opportunities, to their families. Depending on the nature of the disability, the challenges can be quite significant. At the same time, though, they have the potential to deepen connection between parents as well as the parent-child bond.

Aside from the energy required to manage a child’s physical and emotional needs, there are often huge financial considerations. A child’s disability may require the family to retrofit their home, or obtain housing that is accessible. In addition, equipment, social services, and health care are often pricey and are not always covered by insurance or entitlement programs. Families able to get some or all of these expenses covered often have to advocate for them on their own, and navigating disorganized government programs associated with these benefits can be an extremely taxing process in its own right.

Because it can be quite time consuming to address these issues, many families are forced to give up large portions of their leisure time. Often, one parent takes on a primary caretaking role with the child, while the other parent becomes the primary provider, deeply involved in his or her work in order to help with the finances. Primary caretakers sometimes have to partially or completely forgo any job aspirations of their own.

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If these decisions are not talked about and processed carefully, they can lead to divisions within the family that may become deeply entrenched and long-lasting. Caretakers may feel as if they do an unfair amount of the work for the child, and may feel resentful about having to sacrifice their careers. Providers, meanwhile, may feel isolated within their families, as though everyone is against them, and may come to perceive the bond between the caretaking parent and the child as impenetrable.

The Importance of Communication

To help with this, I suggest that parents openly discuss how caretaking responsibilities are divided. Are there ways to make these responsibilities more evenly managed? What types of feelings does each person have about it? These are important considerations that should be discussed regularly.

Another consideration for parents is the emotional impact of having a child with a disability. Parents sometimes have to adjust their expectations regarding what their child can become, which is frequently experienced as loss and may be accompanied by a mourning process. The process of adjusting expectations to conform to the reality of the circumstances can be challenging and varied depending on the nature of the disability.

Regardless of the specific disability, the family has to come to accept that the child’s life may be limited in some way, and that additional care may be needed for the remainder of the child’s life. This process can be a loaded one and has potential to drive parents apart.

In general, the more ambiguity in the disability, the more difficult it is for the family to adjust. Degenerative diseases, which are less understood than more standard physical disabilities, can be among the most difficult to adjust to. The lack of information about how quickly the disease will develop and impact the child’s life can create enormous anxiety and stress. Cognitive disorders such as mental retardation are also difficult in that parents often cannot tell how much information their children take in.

Regardless of the specific disability, the family has to come to accept that the child’s life may be limited in some way, and that additional care may be needed for the remainder of the child’s life. This process can be a loaded one and has potential to drive parents apart. I suggest that couples set time aside regularly to discuss their feelings about their child’s disability, either in counseling or on their own.

Much is made of accomplishments in Western society, and children are too often measured by what they do instead of who they are. If couples keep an open line of communication and feelings regarding the challenges they face, the experience of parenting a child with a disability can bring them closer together and help them learn to accept and love their child for who they are.

References:

1. Boyse, K. (2009). Siblings of Kids with Special Needs. Retrieved from http://www.med.umich.edu/yourchild/topics/specneed.htm
2. Reichman, N., Corman, H., & Noonan, K. (2008). The Impact of Child Disability on the Family. Retrieved from http://www.medscape.com/viewarticle/581577_2
3. Solomon, A. (2013). Far From the Tree. New York, NY: Scribner.

For most people, the concepts of learning and emotions immediately call to mind images of the brain. However, the central nervous system cannot function without the spinal cord. Doctors already know that the spinal cord can control reflexes without input from the brain. This control of reflexes is what leads you to pull your hand away from a hot stove before the brain registers the pain, for example.

A new study published in PLOS One Biology suggests that the spinal cord does a lot more than control reflexes and send messages from the brain. Using functional MRI (fMRI) scans, researchers found that the spinal cord sometimes learns without the assistance of the brain.

Can the Spinal Cord Learn?

When a person masters a new skill, the process produces measurable changes in the brain. Functional magnetic resonance imaging scans monitor blood flow to brain regions, causing some areas to “light up.” Researchers at the University of Montreal used fMRI machines to simultaneously monitor blood flow in the brain and spinal cord. This process allowed them to witness activity associated with learning in both regions.

[fat_widget_right]The team of scientists simultaneously viewed the brain and cervical spinal cord—a region of the spine that plays a role in hand movement. Researchers asked participants to perform a finger-typing task. As participants mastered this new skill, the brain showed predictable changes in blood flow. Surprisingly, participants also showed independent blood flow to the spinal cord. The results suggest that the spinal cord was learning independently of the brain, and the differences in blood flow suggest that the process is different between the two brain regions.

The researchers argue that their results prove that the spinal cord plays an important role in the early stages of motor learning. If future research verifies this conclusion, it might offer new hope to spinal cord injury victims, who often have impaired connections between the brain and spinal cord.

The National Spinal Cord Injury Statistical Center estimates that more than 270,000 Americans have spinal cord injuries. People with spinal cord injuries may experience mental health issues such as depression, anxiety, and stress in connection with their condition, in addition to difficulties with mobility.

References:

1. Innovative imaging study shows that the spinal cord learns on its own. (2015, June 30). Retrieved from http://www.sciencedaily.com/releases/2015/06/150630151452.htm
2. Psychosocial issues of spinal cord injury. (n.d.). Retrieved from http://www.upmc.com/Services/rehab/rehab-institute/conditions/spinal-cord-injury/education-spinal-injury/Pages/psychological-issues.aspx
3. Spinal cord injury (SPI) facts and figures at a glance [PDF]. (2015, February). Birmingham: National Spinal Cord Injury Statistical Center.

A 28-year-old woman sits across the room from me. Recently diagnosed with bipolar, she is slowly but surely accepting her diagnosis. With a perplexed look, she asks, “But what, exactly, am I supposed to tell guys when we go out? And when should I tell them? And do I even need to tell them at all?”

If you have a chronic illness and are in the dating world, these questions may sound familiar. Whether you have an “invisible” condition (think arthritis, HIV, diabetes) or a chronic mental health diagnosis (think bipolar, obsessive compulsion, major depression), it can be difficult to know when or how to disclose sensitive information about yourself to romantic prospects.

The realm of online dating has brought about fast and efficient ways to meet new people. Online dating can take away some anxiety and stress when meeting others, and it can open up a world of possibility. Online profiles generally allow users to disclose as much or as little as they want. Similarly, users can often make checklists of must-haves and deal-breakers. So you may put it out there that you don’t want to date someone who smokes, but do you want to tell the dating world about your battle with fibromyalgia?

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People who have been rejected by friends and family because of their diagnosis may feel even more anxiety when it comes to sharing it with a date or potential date. It’s a quandary, no doubt! So how do you decide when to tell a prospect about your diagnosis?

Perhaps these guidelines can help you navigate the world of dating with a chronic illness:

1. Inform yourself about your condition and find acceptance. First and foremost, educate yourself about your diagnosis and empower yourself in your treatment. Once you have accepted your condition (at least on most days!), your confidence and self-love will shine through to others. If you need help with this step, find a therapist who can help you move through the stages of grief when it comes to chronic illness.
2. Know what you want and what you need in a partner. You are not looking for a caregiver here. You want a partner who will physically help you when needed, one who will be supportive and understanding, and one who is empathetic to your condition. Don’t settle for someone who can “put up with” you. Look for someone who will accept and love you for who you are. Remember the 80/20 rule of relationships: you get 80% of what you really want. Maybe your new date doesn’t like hiking or going to the movies, but the 80% of things you do have in common is really great.
3. Share your information thoughtfully. In other words, don’t dump out your purse or pockets on your first date. Think about the important facts of your diagnosis and be able to share them in a succinct way. If your new date has questions, answer them accordingly. If not, that’s OK, too—some people need time to process or may not, in fact, have any questions. Allow the other person time to digest the information, and be open to answering questions if he or she wants to talk more about it later.

In my experience, the vast majority of people who follow these guidelines when disclosing their chronic illness are welcomed with open arms. It’s a rare occasion when a new person is turned off by this kind of disclosure, but if it happens, then he or she simply isn’t the right person for you.

Think you want to share your chronic illness with others on dating websites? There are dating sites, such as PositiveSingles.com, NoLongerLonely.com, and Prescription4Love.com, that cater to people with chronic medical and mental health conditions. The idea behind these sites is that you will be in good company and can more openly talk about your experiences with others who understand.