Living with chronic illness can significantly impact your confidence levels and change how you look at yourself. It’s common to feel as though your body has ‘let you down’ or ‘is broken’. These beliefs understandably make you feel less confident within yourself.
How chronic illness can affect your confidence
When you aren’t able to do everything you used to be able to do, for example not being able to work, go out with loved ones or keep up with hobbies, it can make you doubt who you are as a person. When you feel as though the things that made you who you were and gave you purpose are taken away, it can lead to a confused sense of self.
Needing to ask for help can be a big hit to self esteem, especially if you were a particularly independent person before you became chronically ill. It can be frustrating not to be able to do everything you want to do, to say the least.
It can be so easy to blame yourself when you have a flare in symptoms or when you can’t complete a task. Even though logically we may know that it’s not our fault and that we’re trying our best, sometimes it’s hard to actually feel that way.
Using mobility aids or having other equipment you need to use regularly to manage your chronic illness can feel frustrating (even embarrassing at times) and change how you view your body.
This 2017 study on how those with chronic illness adjust to their new reality explains that, “The presence of a chronic illness alters an individual’s sense of self, as the previously held healthy identity is replaced by an illness identity that includes physical impairments, emotional reactions to physical symptoms, and cognitive constructions of the illness.”
Stigma means that we may experience poor treatment from others. As much as this shouldn’t be the case, unfortunately it’s still a possibility: this can be really gut-wrenching and reduce confidence levels. Other people not understanding (even when they try to and mean well) can be really hard to cope with.
When you’re unsure about what the future holds and which goals you are, or are not, going to be able to reach, this can be nerve-wracking and reduce self-esteem. It can feel as though you aren’t in control of your own life. For all these reasons and more, confidence can be a hard thing to rebuild and maintain when you live with chronic illness.
Negative perceptions can worsen chronic pain
Unfortunately these negative perceptions can actually worsen chronic pain symptoms, and make the experience of living with chronic illness even more difficult. When we have negative perceptions of ourselves and our illness, we’re less likely to actively keep up with adaptive (meaning helpful and productive) self management strategies and to engage with treatments effectively. Understandably, when symptoms are not well-managed they can worsen.
Lack of confidence can even mean that those with chronic illness don’t reach out for help when they need it, or try to hide their struggles. This can be detrimental to their recovery journey.
A lack of confidence can contribute to a decline in mental health. Depression and anxiety are common comorbid conditions with chronic illness and can worsen chronic symptoms. As well as contributing to the lack of motivation for self-management, the areas of our brain which regulates our emotions and regulates pain share the same neural pathways! This means they can influence one another. This study explains that, “injury sensory pathways of body pains have been shown to share the same brain regions involved in mood management”.
Stress can cause and worsen chronic pain, creating a cycle known as the stress and pain cycle. A lack of confidence and negative perceptions of yourself can increase stress levels, therefore actively contributing to an increase in symptoms.
For many reasons, isolation and withdrawal from activity are common problems for those who are chronically ill. When you lack confidence, you’re even more likely to withdraw from social interaction and other activities. When we become more inactive, it can lead to deconditioning. Deconditioning means that the muscles and joints become weakened because they aren’t being used. This deconditioning can contribute to pain and other symptoms.
A study from the Journal of Health Psychology investigated how self-esteem affected chronic illness patients and discovered that, “Low self-esteem predicted more negative affect, less positive affect, greater stress severity, and greater symptom severity in daily life.”
How to build confidence
This can all sound a bit worrying, but there are lots of ways you can build your confidence and create a more positive experience for yourself. Let’s take a look at 6 great ways you can get started on your confidence journey:
1. Reframing how you look at your body
Instead of looking at your body in a negative way, for example feeling your body has let you down, reframe those thoughts. It’s time to think of your body as an ally, rather than as the enemy. Your body is fighting chronic illness with you! Despite all of its challenges it’s still fighting and functioning in the best way it can, just like you. Your body is a warrior, and together you can find ways to overcome your chronic illness and live well in spite of it.
2. Replacing negative self talk and negative thoughts
A technique that can be learned through cognitive behavioral therapy (CBT) is replacing negative thoughts (which are unhelpful) with positive ones (which are more productive). This is easier said than done but once you begin to implement it into your daily life, it becomes more natural.
When you have a negative thought or are talking negatively about yourself, for example thinking “I can’t do anything!”, stop it in its tracks. Sometimes it can be helpful to think the word ‘STOP’ or even say it out loud. Actively replace that thought with something positive. In our example this could be, “I am doing my best, and look at all the things I can do even though it’s hard.”
This 2019 study on self-compassion in those with chronic illness explains that, “self-compassion is proposed to facilitate adaptive emotional responding to the inevitable setbacks that occur when trying to change health behaviors, by promoting self-kind versus self-blaming responses”.
It’s all about appreciating yourself and focusing on the positives about yourself, even when things don’t go to plan. Treat yourself as you would treat a loved one. We’re often so good at being there for others and building them up. It’s time to start doing that for yourself.
Mindfulness can help us to gain greater control over our emotions and to control anxiety. Through regular mindfulness practice we can introduce mindfulness into our day to day lives. As with the CBT techniques, this can become a positive habit. By centering yourself in the present and letting go of worries, negative thoughts and feelings can drift away and instead you can learn to feel more in control and more positive.
A study from the Journal of Clinical Psychology discovered that “Participants with higher levels of mindful awareness and self compassion presented lower levels of pain intensity and depressive symptoms, and higher levels of AE (meaning activity engagement).”
4. Listing 3 positive things
Listing three positive things about yourself at the end of each day can be really helpful in viewing yourself in a more positive light. These three positives can be something you achieved during the day or something you felt good about (maybe you had a good hair day, you liked your outfit, or maybe you made someone smile).
You could choose to simply think of these three things and list them in your head or you could write them down. Jotting them down in a journal means you can look back at them when you’re struggling and remind yourself of just how wonderful you are! By doing this every night, you go to bed thinking positively about yourself, and you start to gradually shift your mindset towards actively looking for the positives within yourself.
5. Surrounding yourself with positive people
Who you surround yourself with in your life can markedly influence your self esteem. Ensure that you are surrounding yourself with people who encourage you, who are there for you and who help you to build your confidence. If there are people in your life who are taking away from your confidence, consider distancing yourself from them as much as is realistic for you.
Don’t be afraid to set boundaries with those in your life, even those you love. You have a right to express your feelings, to ask for what you need and to set clear boundaries with others for the benefit of your own mental and physical health. Being firm and clear but respectful can be hard, but with practice you can start to prioritize your wellbeing.
6. Finding purpose
Sometimes it can be tough to find purpose when you’re chronically ill, especially if you’re not working or are in a job that you don’t feel passionately about. Whether it’s a hobby you love, a personal goal or a professional endeavor, find something you really care about and want to throw yourself into. Finding purpose can provide motivation, excitement and hope, and build confidence!
We all deserve to feel good about ourselves. Each one of us deserves to be able to see just how amazing we are. We’re all worthy of self-love and self-compassion. Most importantly, it is possible to get to a place of confidence within yourself despite chronic illness.
Vicki S. Helgeson, Melissa Zajdel, (2017), “Adjusting to Chronic Health Conditions”. Annual Review of Psychology, Vol. 68:545-571
Sheng, J., Liu, S., Wang, Y., Cui, R., & Zhang, X. (2017). “The Link between Depression and Chronic Pain: Neural Mechanisms in the Brain.” Neural plasticity, 2017, 9724371.
Vanessa Juth, Joshua M. Smyth, Alecia M. Santuzzi, (2008), “How Do You Feel?: Self-esteem Predicts Affect, Stress, Social Interaction, and Symptom Severity during Daily Life in Patients with Chronic Illness”. Journal of Health Psychology, Volume: 13 issue: 7, page(s): 884-894
Sirois, F.M., Hirsch, J.K. (2019), “Self-Compassion and Adherence in Five Medical Samples: the Role of Stress.” Mindfulness 10, 46–54 .
Sérgio A. Carvalho David Gillanders Lara Palmeira José Pinto‐Gouveia Paula Castilho, (2018), “Mindfulness, self compassion, and depressive symptoms in chronic pain: The role of pain acceptance”. Journal of Clinical Psychology, Volume 74, Issue 12, December 2018, Pages 2094-2106