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    Adjusting to a Illness or Chronic Illness

    There are many adjustments when you have had an ongoing illness possibly including couples issues.  Any chronic illness means there are new adjustments in life. Some chronic illnesses directly increase risk for depression. For example, diabetes doubles the risk of depression although the exact cause is unknown.

    Fibromyalgia (FM) treatment includes the relationship between thoughts, beliefs, emotions and behavior to treat or prevent depression from pain. (This is not just positive thinking but a restructuring of your thinking process to more realistic and helpful thoughts. For the faith-based person treatment can also help them use their faith as a support during this time.) Chronic pain due to back or spinal conditions is another example.

    Treatment can help you manage the stress of an illness so that the hopelessness and helplessness of depression is prevented. Treatment can also help with anxiety about the decisions you may need to make: taking a medication, changing arrangements with your family or friends due to illness or needing to ask questions of your medical provider.

     Counseling also means you more likely to follow medical treatment procedures and have better physical health (medical family therapy is an emerging field). In the Rogue Valley treatment for chronic llness does not include couples issues including changes in sexual desire.

    When you have a chronic illness your families’ response is very important. Understanding the following will be a huge asset:

    1. Spouses and other relatives have their own experiences associated with chronic illness.

    2. Stress reactions , free-floating anxiety and fear are often experienced by family members. For example, having another family member who had a chronic illness that did not adjust well can cause a spouse to be discouraged about treatment. This means the support of the patient is possibly affected. Couples counseling can be helpful in sorting through these issues.

    3. Basic facts about illness and what contributes to changes in condition. Each time I have worked with families they have needed facts to understand an illness.

    4. That despite “recovery” or better time periods in the illness, you can at risk for future recurrences. “It won’t happen again” is a false belief. Chronic diseases continue.

    5. The extremely important role of medication in the treatment and the need for continuing medication to prevent recurrences. “Being on medication” is a huge adjustment as well as the number of medications that may be needed. The feelings about medication as well as the education about medications need to be discussed. Since going off medication is often a concern, family members can remind and reinforce medication issues appropriately.

    6. The difference between ongoing aspects of personality and the illness in the patient. Overgeneralizing (“it is all the illness”) creates resentment if the persons valid concerns are not heard. Under identifying (“none of it  is the illness”) the chronic illness issues means relapse prevention does not occur effectively.

    7. More effective ways of identifying and managing external stressors that “trigger” recurrences of the illness. Stressors such as going on a family trip, changing work hours, taking children for a more extended time, etc. can be managed differently (postponed, held at a less stressful time, having another person for support there, etc.) if they are known.

    8. How to maintain a positive, cooperative emotional tone in a couple relationship, by employing effective strategies for direct communication and conflict management. Often family members are stressed and attempt to use criticism or overprotectiveness as tools to manage the episodes and behaviors they see (number 1). When an ill person is depressed family may become worn out when no support seems enough and become angry.

    Problem solving and communication skills must be expanded to face issues most people have not learned. Techniques can be gained from books and other recourses. Applying and communicating well in the coaching of a couples or family session helps during adjustment periods for family members.

    Do you have feedback or comments about the article? Email Barbara at

    Feel free to email this article to anyone that needs help with adjusting to an illness or a chronic illness.

    Barbara Massey Licensed Marriage and Family Therapist

    Medford Oregon