Coping With Chronic Illness

Source: Katie Willard-Virant

The singer/songwriter Ani DiFranco has a song lyric that reads: “Buildings and bridges/Are made to bend in the wind/To withstand the world/That’s what it takes.” I’ve always liked this lyric, as it reminds me that flexibility rather than brute force is essential in coping with challenges. This month’s post will analyze that flexibility as foundational to coping with chronic illness. A new research article titled "Stress-coping-adaptation trilogy in chronic illness management: A new perspective from the granular interaction thinking theory" (Sari & Nguyen, 2026) does a great job of digging into the nuts and bolts of flexible coping. I will present its findings here.

Chronic illness stress

Sari and Nguyen describe stress as “informational entropy.” That is, stress generates signals received by our mind. These signals originate from both inside (e.g., body symptoms, emotions, memories) and outside (e.g., medical advice, family support, social messaging).

Let’s illustrate this with a fictional example: Amelia lives with an autoimmune disorder. She breaks out in a rash on her torso. Some of the many signals hitting her mind include the following:

• “This itches and burns.”
• “This looks terrible.”
• “Am I flaring?”
• “Will this spread?”
• “Did my medication cause this?”
• “What will I do if I have to switch medications?”
• “I remember when I broke out in a rash six years ago from a medication reaction. That was so painful!”
• “I am feeling fragile and angry. I hate that I cannot rely on my body.”
• “Maybe the doctor can’t see me today. I wonder when she can see me.”
• “I’ve read some stories about rashes that can get pretty bad. I hope that doesn’t happen to me.”
• “Who’s going to pick the kids up from school if the only time my doctor can see me is in the afternoon?”
• “I need to finish that work project today. I don’t have time for this!”
• “My illness puts stress on my spouse, too. I wonder if he can take some of the load with the kids today. I hate to ask.”

Look at all of the thoughts and feelings hitting Amelia at once. These stressors cause an uptick in anxiety and dread. Amelia’s body is likely responding to this onslaught of informational signals with shallow breathing, tightened muscles, and impaired thinking.

Coping

Sari and Nguyen describe coping as the response to the informational signals of stress. That is, coping can be defined as managing the information flow created by stress. Information management consists of identifying and prioritizing (selecting, discarding, and weighing) information signals. Let’s come back to Amelia. Successful coping might look like this:

“A lot is coming at me right now. I’m aware that the stress is impeding my ability to think clearly. I’m going to take some deep breaths, consciously relax my muscles, and bring my nervous system back to a place where my brain can problem-solve effectively.” (Amelia is recognizing that she needs to step back from the onslaught of information and focus on calming down. She’s practiced nervous system regulation as part of her chronic illness treatment, so she knows the processes that work for her and puts them into practice.)

“Okay, I feel better able to think this through. I know that I have a lot of feelings right now. I’m scared and angry and worried. Some bad memories are coming up for me, too, as I’ve dealt with this illness for a long time. Right now, I need to think about what is happening in the moment: this rash. My emotions are important and I can return to them once I have solved the immediate problem, but right now I need to put them on the back burner.” (Amelia acknowledges and accepts her emotions about her illness. She does not dismiss them; rather, she tells herself that she will process them after making a plan for what to do about the rash. She also practices self-compassion as part of her chronic illness treatment, so she is able to put her hands on her heart and say to herself, “I will come back to these feelings and feel them at a time when they can be processed.”)

“As much as I would like to ignore this rash, I know that I need to call my doctor. I don’t know when I will be able to be seen, so I should call now and find that out. My appointment may or may not interfere with tasks I need to accomplish today, but I won’t know that until I call, so I’m going to table these scheduling worries until I have accurate information.” (Amelia realizes it’s not productive to worry about scheduling now. It’s more productive to make the call to the doctor to see what she is dealing with, rather than anticipating problems that haven’t yet arisen.)

“I’m picking up the phone and dialing my doctor’s office. That is the most important action I can take at this time.” (Amelia went through a process of sifting through informational signals until she identified the action step that was crucial: calling her doctor for advice.)

Note that Amelia will continue to utilize coping skills throughout the duration of this flare-up. When her doctor’s office provides her with an appointment time, she will have to navigate managing the appointment with work and family responsibilities. At that time, she will prioritize scheduling issues and make an action plan. When her medical team evaluates her rash and comes up with a treatment plan, she will prioritize understanding and implementing treatment. As the rash is managed, Amelia will prioritize the feelings that couldn’t be fully processed during the acute crisis. She may journal; she may cry; she may talk through her feelings with her spouse or a friend. She’s aware that this step is important in her coping process.

Adaptation

Sari and Nguyen describe adaptation as “the individual’s ability to integrate stressors and responses into sustainable functioning.” Adaptation, then, is the integration of successful coping. As Amelia continues to manage her chronic illness, she can draw upon all of the times she has successfully coped. She can conceptualize herself as a person who copes well with chronic illness stress, which will in turn enhance her ability to cope.

Chronic Illness Essential Reads

A Reflection on Illness, Safety, and Adaptation

How to Support Clients With Chronic Illness in Therapy

Conclusion

Remember that coping is a learned skill (Booth & Neill, 2017). Therapists are trained to coach you in improving coping skills. Do not hesitate to seek assistance in shoring up your ability to “bend in the wind” and face challenges with resilience.

To find a therapist, visit the Psychology Today Therapy Directory.