Acute and Chronic Illness: Challenges and Insights

Over the many years I have been a psychotherapist I have had the honor to work with people who were dealing with acute and chronic illness.

When the HIV/AIDS epidemic was in full swing and prior to the advent of life saving medications, many of my patients were facing certain death. They of course all reacted in their own particular ways; however there seemed to be a stream of typical thoughts such as “How do I face the fact that I am actually mortal?” It is true that we all know this but when a person is not dealing with acute or chronic illness it is easy to put on our familiar blinders and carry on as if there were unlimited number of days before us.

There is an internal push to seize the moments and make them count when one is facing a not-so- elusive-death. However this push is never without the angst of confusing emotions.  Typically there is a “why me” and paralyzing fear as well as deep concern for loved ones that will be left behind.

A popular TV show on HBO followed the life of a woman dealing with cancer. She was fighting hard to live and she was also storing birthday, graduation and Christmas presents for her husband and children in a storage unit for all the events to come that she would miss.

Receiving a diagnosis of HIV, cancer, multiple sclerosis, Parkinson’s, Alzheimer’s and more is traumatic. I have worked with patients who smoked cigarettes for 20 years, yet came to my therapy room in complete and utter shock that they were diagnosed with lung cancer.

As a species we often live lives with moments of mindfulness and huge blocks of over thinking, anxiety, planning and all the other chatter that keeps our lives afloat. I have been told that the moment the doctor says: “You are ill and this may not be able to be managed” the mind stops. Everything is in slow motion and one feels as if they are suspended and untethered.

This is a good time to turn to a therapist to help traverse the many ins and outs of this journey. Some people are facing imminent death and the rush to do better, fix everything and leave a legacy are overwhelming and in need of a gentle yet firm coach to help put everything in perspective without losing precious time.

The other side of an acute and untreatable illness is a chronic illness that needs to be meticulously managed with lifestyle changes, medications, doctors’ visits and more. Everyone who receives the aforementioned diagnosis wish for years to manage their illness rather than months. However, there is fatigue and uncertainty that follows a long-term managed chronic illness.

Those with HIV/AIDS who used to die within months of their diagnosis are now living to experience advanced age but it is not without consequence. My patients usually start this conversation with: “I am so lucky, or so blessed that there are medications to keep me alive and I don’t want to complain and seem ungrateful. I would never tell anyone else this but this is hard and I am constantly aware that if I miss a dose of medication I may die.”

These concerns are challenges. But, there always seems to be some insights, some push to be better, stronger, more mindful and less lost in the chatter. There seems to be a need to fix relationships and not get caught up in petty drama. And while all of this is time consuming and tough the betterment of self in this context is exhilarating and there is a feeling of immense accomplishment.

Remember that if you or a loved one are facing acute and/or chronic illness you can reach out. We are here to help and join in your journey.