Navigating Christmas with a chronic illness

What defines a chronic illness?

The definition of a chronic illness is quite broad. Chronic illnesses are conditions that last one year or more. They require ongoing medical attention and can limit a person's ability to complete daily activities, and affect their quality of living.

There are lots of illnesses and conditions that fall under the umbrella term of 'chronic health'. These conditions and diseases include:

• Arthritis.

• Asthma.

• Cancer.

• Chronic fatigue syndrome.

• Depression.

• Diabetes.

• Fibromyalgia.

• Heart disease.

• Inflammatory bowel disease, including Crohn's and ulcerative colitis.

• Lupus.

• Osteoporosis.

These conditions can cause a wide range of symptoms including pain, brain fog and overwhelming fatigue. Chronic diseases such as heart disease, cancer and diabetes can lead to death.

How can a chronic condition impact someone's everyday life?

Joanna Burridge is a counsellor working with adults and young people affected by chronic conditions. She also lives with chronic health issues.

"Chronic conditions can lead others to assume that it's easier to live with than an acute condition, which needs to be urgently addressed. Since a chronic condition means 'long-term', that alone makes it incredibly wearing. Imagine waking up every day as exhausted as you felt the night before, dealing with the side effects of a medication for months, or never feeling pain-free. Living with a chronic illness can make planning things very difficult, because we can't predict how we're going to feel on a certain day," she says.

Chronic conditions can lead to:

• Sleeping lots.

• Barely sleeping at all.

• Constant pain that varies in intensity.

• Anxiety around socialising.

• Low mood.

• Stress from a change in routine.

• Over-thinking.

• Feeling pressure to act a certain way.

• Struggling after drinking alcohol or eating differently.

• Difficulty relaxing.

How might someone with a chronic illness struggle at Christmas?

A chronic condition can make both the lead-up to Christmas and the day itself very difficult.

In the lead-up to Christmas
Burridge explains how life with a chronic condition can be very stressful, and the build-up to Christmas is no different.

"Overwhelming panic and stress can cause a flare-up of symptoms. We may experience more pain, for example. We may lose our excitement about the days to come and have anxiety over a to-do list that can keep us awake at night."

Burridge says Christmas preparation can be much more taxing for someone with chronic health issues. Even the little jobs can really take it out of someone.

People with a chronic illness might struggle to pace themselves, staying up until the early hours of the morning to get things done, which can lead to exhaustion.

On Christmas Day
"On the actual day, we might have really high expectations of how we want the day to go, which can affect us in different ways," says Burridge.

Crashing and burning

"We might start off on a high of excitement which pushes us through the day at full pelt. But sadly, after this peak activity, we will crash out the next day, which can cause extreme fatigue, pain and low mood," explains Burridge.

Intense anxiety

Christmas can be a stressful time anyway, but particularly so for those with a chronic health condition. They might start the day feeling anxious and over-thinking about all the worst-case scenarios that could possibly happen. This stands in their way of enjoying Christmas.

Exhaustion from socialising

"Socialising can be really tiring," admits Burridge.

"Especially if we're meeting up with people we don't see often, it can feel like a big deal. Those meetings then come with further obstacles, such as comments being made about our health, saying we 'look well', despite feeling exhausted on the inside. It can be difficult to keep a mask on sometimes, smiling just to keep the mood up."

Disturbed routine

Routine seems to fly out the window over Christmas so we can unwind and celebrate, but this can have a real impact on those with chronic illnesses. The festive season tends to be a time for eating differently, drinking alcohol more, sleeping and waking at different times. Doing things beyond the norm can take a physical and mental toll.

Worrying and stressing

"We might worry that we are letting people down if we cancel plans or don't have the energy to be lively. We also feel conscious of making a fuss over what we need, even if other people don't feel inconvenienced by it at all," says Burridge.

Feeling the pressure

After spending Christmas 2020 in lockdown, there's likely to be pressure on us all this Christmas to have the biggest celebrations and make up for what we missed. However, Burridge says this pressure to have a 'perfect' Christmas can particularly burden those with chronic illnesses.

"We need to remind ourselves that there's no such thing as a 'perfect' Christmas and this time of year is different for everyone, as it should be because we all have different needs. As someone with a chronic condition, I often feel pressure to create the most memorable experience, and it takes a lot to ask for help and learn to delegate," she shares.

Patient picks for Chronic conditions

Senior health

Living with a long-term condition

A long-term condition cannot be cured but its symptoms and complications can usually be controlled with treatment. Examples are arthritis, asthma, diabetes, epilepsy and high blood pressure. Long-term conditions can have an effect on your role within the family, your job, your accommodation, your education and your finances. However, there are many sources of support you can access, including health and social services, the government and voluntary organisations.

by Dr Colin Tidy, MRCGP

How can someone with a chronic illness cope over Christmas?

What can loved ones do to be supportive?

When you don't live with a chronic condition, it can be difficult to understand the best approach to take when offering support. You might be fearful of offering a helping hand in case someone feels insulted. Likewise, you don't want them to think you don't care. Burridge highlights the importance of being there for your loved ones at what is already a chaotic time of year.

• Be supportive and listen.

• Don't assume someone is fine just because they're smiling.

• Don't wait to be asked for help, because your loved one might find it hard to do that.

• Try not to get frustrated or take it personally if someone cancels plans.

Where can you find support if you struggle with a chronic illness?

"If you are wondering whether you have a chronic illness or condition, you should make a GP appointment and go from there. Conditions can be tricky to diagnose so be prepared to have blood tests and other assessments. If you get a diagnosis from your GP, or have a sense of what condition you might have, there are lots of charities and online resources available that can help. These often offer online or face-to-face support groups. This might help you to find some useful coping strategies," says Burridge.

It's also important to look after your mental health alongside your physical health, so consult your GP if you are struggling with your mood. They might prescribe antidepressants or anti-anxiety medication, or refer you for therapy.

Burridge stresses that what people with chronic health issues need differs from person-to-person.

"You might want to engage in some physical activities, or you might want a massage to ease your pain and calm your mind. Either way, there are plenty of options out there and counsellors and therapists who understand your struggles and want to work with you to create a plan of action for managing your condition."