A chronic disease or health condition is one that lasts at least 3 months or more, that requires ongoing medical attention, and/or limits your ability to complete your usual daily activities. Many conditions are or can become chronic, such as (but not limited to) heart disease, arthritis, anxiety, depression, hearing loss, autoimmune conditions, cancer, endometriosis, adenomyosis, asthma, IBS, Crohn's disease…the list goes on and on and on. Symptoms can sometimes fluctuate, especially in the case of autoimmune conditions and mental health conditions like anxiety and depression.

If you've ever had the misfortune of experiencing a chronic health condition, you'll likely be familiar with some of the psychological impacts. Some of the challenges of living with a chronic condition include:

· Dealing with the physical symptoms of the condition. Anyone who has felt unwell or been in pain for weeks or months (or even years) on end has likely been in the pit of despair more than once, wondering how they can possibly get through another day feeling like this. I've worked with plenty of people in absolute despair due to the level of pain or other symptoms they experience on a daily basis.

· Coming to terms with the reality of the condition being chronic. Generally, unpleasant symptoms are tolerable if you know that they will eventually end and you just have to "get through it," particularly if there are medications that are helpful for your condition. Once it becomes clear that there may not be an end to the symptoms, depression and anxiety can set in. This can also occur if there are no effective treatments for your condition and/or if medications do not help with symptom relief.

· Anxiety about triggering symptoms or being in public and having the onset of difficult symptoms. This can lead to people not leaving their house or ending up with a severely limited life. For example, people with Crohn's disease can end up with a severely limited diet due to worry about triggering a flare-up. People with chronic digestive issues might also find themselves limiting social interactions to places where they know for sure that a bathroom will be available.

· Impact of treatment. Treatment for chronic conditions can be very expensive, even in a place like NZ with a public healthcare system. For some people, treatment might not be available in the public system or may be so delayed that they resort to private treatment. For some chronic conditions, medications may be needed that are not funded by Pharmac, and can reach into the hundreds of thousands of dollars, or take years to access. Then there is the time required to attend various appointments. People who receive a diagnosis of cancer, for example, often find that attending appointments and treatments becomes almost a full-time job, at least initially.

· Loss and grief associated with changes in the ability to do things that you used to be able to do or had anticipated doing in the future. This can be especially acute when there are impacts to fertility, mobility, or the ability to complete work tasks or tasks that are particularly important to a person, e.g. playing a musical instrument, making art, etc.

· Dealing with other people's responses to your chronic condition. A lot of chronic conditions are "invisible" in the sense that a person may look relatively well whilst feeling terrible. This can result in a person feeling invalidated or starting to second-guess their own experience. People who don't have experience with having a chronic condition can find it hard to understand and make sense of the idea that their friend or loved one is not "better" and may not "get better" in the future.

· There is often a significant impact on relationships when someone has a chronic condition. There may be changes in relationship roles, for example going from equal partners to a caregiver/patient relationship. There may be frustration from both sides regarding changes in functioning and ability, and it can take some time to settle into a new normal. Some relationships don't survive, and this can result in significant loss and grief. The financial pressures of one person having a chronic condition can cause stress within the family unit. Career stress and crisis can also be a significant issue, particularly if a person has been very unwell for a long time.

I'm sure there are other impacts that people reading this may identify in their own lives, this is just a list of the most common.

So, what can you do to help yourself with the mental load of living with a chronic condition?

The first and arguably most important step if you have a chronic condition is to find a treating team that you trust. The most important part of that team is your GP, as they are the clinician who has the power to make referrals and fight for you if you are having trouble getting specialist treatment.

If there are medications or treatments that can help with your symptoms and you have access to them, then use them. This is especially important if you experience chronic pain, as the only way to break the chronic pain cycle is to give your body a break from the pain (if possible). Even if a medication or treatment isn't feasible in the long term, either due to side effects or financial cost, giving yourself a break from chronic symptoms can help you to cope mentally over the long run.

If you have the ability, see a psychologist or therapist to help you develop coping skills; this can be really helpful. Again, if you don't have the financial capacity for long-term therapy, even a few sessions with an experienced therapist can give you a set of strategies that you can use for a lifetime. This is particularly important if you are experiencing depression or anxiety that is limiting your ability to function and engage in your day-to-day life.

Talk to your loved ones. It can feel like a tough balance to avoid your illness becoming the only topic of conversation but helping them to understand what you are going through can be the difference between feeling alone and feeling supported. Your treating team should also be able to help with this, particularly your specialist doctors. Sometimes a loved one just needs to hear the information from an expert - even if you've been saying the same thing yourself!

Connect with people who get it. These days this will most likely be an online group or community of some sort - like The Cyclist! The important thing is to ensure you don't spend too much time in online groups, as they can tend to be echo chambers, and if not well moderated can end up being quite toxic.

Give yourself the space to grieve the things that you have lost and move gently towards acceptance. The saying "you need to feel it to heal it" tends to be true. Acceptance doesn't mean being okay with your chronic condition; it means accepting that this is your reality right now and letting go (as much as possible) of the emotional struggle with it. The book Radical Acceptance by Tara Brach is a great place to start if you don't have the ability to see a therapist.

Finally, take care of yourself and give yourself grace and compassion. Living with a chronic condition is one of the hardest things you can do.

Want support but don't know where to look?

Check out our practitioner directory under resources for trusted, vetted health professionals who truly understand chronic conditions.