Before I go into the nitty gritty of coping skills, let me say this first: You are not doing anything wrong if you are feeling anxious. Experiencing anxiety while navigating a demanding chronic illness doesn’t make you inadequate. You’re not “failing” at this and neither should you be feeling like you’re not trying hard enough. Managing the ups and downs of IBD is tough and it is not unreasonable to feel anxious. That also doesn’t mean that IBD and anxiety come together as a package deal and that you’re bound to feel anxious. Some strategies might help mitigate the anxiety that can come up as you navigate your diagnosis.
Four tips to help you manage anxiety when going through a Crohn’s or ulcerative colitis flare up
Aurelie Lucette • January 7, 2022
- You often worry about your next flare. Especially if things have been going well for a little while and your symptoms are well-managed
- When you are flaring up, it can feel never-ending and you sometimes struggle to believe that things will ever get better
- In between flare-ups, you feel anxious about the slightest GI symptoms, wondering if it might the beginning of something more
- Navigating flare-ups often feels like an emotional and physical rollercoaster
- Even if things are going well, it feels like you’re always waiting for the other shoe to drop
- You often feel overwhelmed and like you can never catch a real break
Anxiety: A common occurrence when living with Crohn's disease or ulcerative colitis
If you live with Crohn’s disease or ulcerative colitis (also known as inflammatory bowel disease or IBD), you know the dreaded feeling of never being fully able to enjoy the present moment. You sometimes find yourself waiting for your symptoms to improve or, when things seem to be going well, you can’t help but worry about the next flare. And these diagnoses are often unpredictable, although you may have noticed things that seem to worsen its course (e.g., stress, certain foods, skipping your medication).
If you are reading this and nodding your head, know that you are not alone. IBD is significant source of stress. Up to 40% of adults with IBD experience significant anxiety, and these numbers often go much higher during a flare up. A flare-up is broadly described as a resurgence or worsening of symptoms. Depending on your disease, it can be an increase in abdominal pain, fatigue, poor appetite, diarrhea and/or frequent bowel movements, etc. Some flare ups be mild, other may require more thorough medical care or hospitalization to stabilize your symptoms.
From an emotional standpoint, flare ups can be associated with significant anxiety due to the disruption in your day-to-day functioning at home and/or at work, impact on relationships, canceled plans, and the uncertainty of what to expect. Not knowing what’s coming, how long symptoms will last and how severe they will be is often described as an important source of stress and overwhelm.
As a
health psychologist, I want to share 4 ideas that can help you cope with the stress of a Crohn’s or ulcerative colitis flare
1. Reach out for social support
Flare ups are often disruptive and may require some adjustment to your day-to-day schedule, making it difficult to fulfill some of the responsibilities you previously fulfilled. Maybe you’re struggling to get things done at work or can’t quite handle taking care of the kids without feeling exhausted before breakfast even rolls around.
Managing a flare up often requires shifting some of your time and energy to taking care of your health, which might leave less time and energy for the rest of it. Reaching out for instrumental support might be needed to handle day-to-day responsibilities. Looking at your to-do list, what are some of the tasks and activities that you might be able to delegate or get support with? Can a friend drop off groceries over the weekend? Can you partner take over school pick up? Is there someone who can give you a ride to your doctor’s appointment?
Emotional support might also be needed when you are in the midst of a flare up. Who have you turned to in the past who you feel comfortable sharing what you’re going through with? Which of your friends can lend an ear without providing unsolicited advice about your diet or make you feel like only positive thoughts are allowed?
Do you need a hug? Someone to re-watch Ted Lasso with? Do you need to follow up with your doctor to readjust your treatment? Maybe you need someone to take care of the kids for a little while so that you can take a nap or go to an appointment? Knowing what you need, re-assessing often, and communicating it to others is key. And if asking for help feels uncomfortable (let’s be honest, most of us feel like that at some point!) head over to this article for 5 tips on how to ask for the support you need.
2. Pace yourself
If your energy is low and you feel like you’re running on empty from the moment you wake up, it might be helpful to prioritize what you focus on any given day/week. Pacing yourself can also help manage pain.
- Taking a look at your schedule, is there anything that can go altogether? Any plans or meetings that can be canceled or postponed? Things you don’t want to think or worry about right now?
- What is your prime time? What time of day tends to be a bit better in terms of pain, focus, and energy? Can you schedule activities that are more cognitively or physically demanding during this “prime time”?
- Using a timer to limit how much time you spend on any given task can also help!
- Being more intentional about resting can help prevent significant increase in pain and/or fatigue. Can you block some time in your schedule to take a nap or retreat to your bedroom to read or rest? Can you re-organize your to-do’s to spread them out evenly over the course of the week instead of trying to sprint through your list by Monday evening?
- Be clear about how much you can do and when you might need to tighten your boundaries, whether that means taking some time off from work to focus on your health, or asking for additional help because you are feeling overwhelmed and/or drained.
3. Manage stress
There isn’t a one-size-fits-all solution to coping with stress. Learning meditation isn’t beneficial if it feels like another chore on your list. Similarly, yoga won’t do much for you if you dislike it, even if social media advertises it as the number 1 stress-relieving activity of the year.
What has worked for you in the past? Do you feel more relaxed when you’re sitting outside soaking up the sun? Do you enjoy listening to a guided meditation? Could you benefit from seeking therapy to help manage nighttime anxiety? Does your body instantly relax when you snuggle with your pet on the couch?
Whatever you are doing (or not doing!), be gentle with yourself. As you learn to deal with demanding physical and emotional symptoms, some of which might be new or unfamiliar for you, showing yourself kindness and compassion are important aspects of taking care of your emotional needs.
4. Identify helpful coping statements
When going through a flare up, what do you need to hear? What statements are helpful and supportive? What words give you a sense of comfort?
I am not necessarily talking about inspirational quotes from your Instagram feed (you know, the “Look at the silver lining”, “Just focus on the positive”, “You are what you think”) or the pep talk from a stranger with little to no understanding of what you’re going through. I am talking about words that really resonate with you and your own experience at a given moment. Words that make you feel seen and cared for. Words that are gentle and yet provide encouragement as you may be feeling vulnerable, anxious, or overwhelmed.
Below are a few examples, and I encourage you to tweak them as needed or come up with your own as well.
- “Everyday, I am learning to new ways to live and love with my diagnosis.”
- “When I feel overwhelmed, I can take things one moment at a time and ask for support. “
- “I am taking care of my body the way I know best.”
- “I am resilient.”
- “I will give my body the rest it needs.”
In closing, while anxiety and Crohn’s disease often co-occur, it doesn’t have to stay this way! If you feel overwhelmed and feel like you’ve tried everything you could on your own, therapy for anxiety might be a helpful next step to get you unstuck and receive help with stress caused by your diagnosis.
If you are looking for a health psychologist to help you navigate anxiety and stress related to your diagnosis, feel free to reach out!
I am Dr. Aurelie Lucette, a clinical psychologist who provides individual therapy in Miami and online throughout the state of Florida. I can help with issues related to anxiety, stress, sleep, and depression. I also specialize in therapy for adults living with chronic illness and I provide evidence-based treatments such as Cognitive Behavioral Therapy (CBT), CBT for chronic pain, and mindfulness-based practices to help you live with the ups and downs of your diagnosis.
Bonus: I’m fairly fluent in medical jargon and you won’t have to explain all the medical terms related to your treatment or diagnosis!
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