Becoming Resilient While Living With Chronic Illness or Addiction

Foreign I'd like to welcome everybody to today's presentation on the emotional aspects of living with a chronic illness or addiction. I'm your host, Dr. Donnelly Snipes. Now today we're really going to talk about how to improve your emotional health. We're not going to spend a lot of time on the distress, except for to really identify what you may be dealing with and how to cope with it. So we'll explore the emotional aspects of living with a chronic illness or addiction and identify strategies to enhance hardiness, resilience, contentment and hope. Chronic illness and addiction often change people's vision of themselves and their rich and meaningful life. If you get diagnosed, or when you get diagnosed with something or you develop a condition that is chronic, it often changes what you are able to do. Now, it may not preclude you from doing what you want to do, but it may require some modifications. I've mentioned to y' all before that I have a heart condition and I am not as comfortable going out, you know, hiking on an eight mile trail anymore as I used to be before I developed the condition. I take more precautions when I go out to work on the farm because I know that if I start to get overheated, it will likely trigger an episode. So can I still do the things that I like? Yes, but I've had to make some modifications to be smart and be safe. Unfortunately, or however you want to look at it, when you have to change that, it changes your vision. And when you change your vision, it involves a grief process. And a lot of people with chronic illness and or addiction struggle with different forms of anger and anxiety. Today we're going to talk about those. One form of anger is grief, and it's anger and depression about the situation. Eventually you want to move toward acceptance. However, we need to allow ourselves to acknowledge the loss, acknowledge our disappointment about the loss, acknowledge our frustration that we not control the loss, and then move toward that place of acceptance where we figure out, okay, now what can I do? How can I address this? Shame and guilt are two other forms of anger. And guilt is anger at yourself for not doing something you shoulda or doing something that you shouldn't. And shame is, is anger at yourself because you don't feel like you are lovable. You feel like you are useless, worthless, unworthy. We may have anger at ourselves for causing or worsening our condition or being too weak to cope. And, and I'm not saying you're weak, what I'm saying is we may perceive that we are too weak or we May perceive that others think we're too weak to handle the pain. They say, you know, just get up and get over it. It's one of the challenges with invisible disabilities that people can't see the, the broken arm, people can't see the exhaustion. They think that we can just, you know, push through it and that is not healthy or helpful. We can also have resentment toward others for not understanding and jealousy toward others for being able to do what we cannot. We can get jealous, we can get angry. And I struggle with this on a little bit, not, not on a grand scale. But I can feel myself getting a little. When I go to the gym and I see these 20 something year olds able to do what I was able to do when I was 20 and I can't do it anymore and I'm like, that's no fair, I don't like that. Why do I feel like that? That's no fair. I don't like it because I feel disempowered and I like to feel empowered. Encouraging ourselves to examine where is this feeling coming from, in what way? Because remember, anger is a response to a perceived threat. In what way does this me make me feel unsafe or powerless and what can I do about it? And anxiety is the other side of that fight and flight reaction. We may have anxiety about rejection, we may have anxiety about worsening of the conditions. Exploring that, accepting that, acknowledging that, and then doing something about it. If you have this anxiety and you just try to ignore it most of the time, it's not just going to go away. It takes energy to suppress. It takes energy to nurture or hold on to some of these feelings. Anger, your flight fight reaction and anxiety, your flight reaction. Help us respond to potential threats doesn't mean there is a threat. Anger and anxiety are felt when the body's flooded with stress hormones. And it takes a lot of energy. When we feel stressed, our body says, hey, you need to be ready to fight or flee. So I'm going to dump all this blood sugar, I'm going to dump all this cortisol and thyroid hormone and all this other stuff that gets us revved up. Now. We may feel angry, we may feel anxious. Depends on the situation, but it's exhausting. It actually is burning a lot of energy. Think of sitting in the car and just floor in the gas with it on park, you ain't going nowhere. Floor in the gas. It takes a lot of energy to rev that engine up. That way when we are chronically stressed, angry, anxious, it increases inflammation, which often worsens Our symptoms, if it's a chronic illness, if it's autoimmune, if it's pain related, if it's sleep related, or even if it's addiction, we see an increase in distress, an increase in a lot of relapse warning signs in people who are chronically angry and anxious. Now, a lot of times I've used the analogy of anger and anxiety are like a smoke alarm. Today we're going to switch it a little bit because maybe that one doesn't stick with you. And we're going to talk about dog poop. And I know you're like, what? Anger and anxiety are like dog poop. It is triggered by a stimulus with the goal of getting you to evaluate the facts in this context at this time to determine if there's a problem. What do I mean by that? You're sitting on the couch and watching TV and all of a sudden you're like, you smell something. Now does that mean that the dog took a dump somewhere in the house? Maybe, or maybe he just passed gas, but we don't know. So you get irritated. It's like, oh, this stinks. What did you do? Do you sit on the couch and nurture that anger at the dog or do you get up and see if you can figure out where the smell's coming from? Hopefully that energy dump motivated you to get off the sofa and see where the smell was coming from. You may determine that the dog actually just passed gas and it's like, okay, no harm, no foul. We'll just, except for maybe a foul odor, we'll just let it go. Based on the facts in this context at this time. Was there a problem? Now if you don't do something about it, it's almost like you're carrying that smell around with you and staying angry about it. It doesn't make the smell go away, it just drains your energy. So getting up and taking proactive steps is definitely helpful. We experience feelings to help us survive. We don't want to get rid of our feelings. We want to identify them, acknowledge them, and act or react based on what that feeling is telling us. Does it? Is that feeling telling? Telling us there might be a threat that we need to evaluate if there's a threat and if so, we need to get away from. Is that feeling telling us, hey, that was good, I won't do that again? So feelings are there to be our non verbal guide, so to speak, to help us explore the environment. Feelings are based on our prior learning experiences and they help us anticipate or expect what's going to happen? Feelings are not thought facts. Feelings are not based necessarily on what's going on in this context at this time. Which is why it's so important to step back and acknowledge your feeling. Downregulate and then evaluate what is going on and what do I need to do? So the goal is not to get rid of feelings, but to recognize them as a source of motivation for a behavior. And we can all think of our happy feelings. I want to do that again. Our sad feelings yet? No, rather not. Stress in any piece of your life will trigger changes to your hormones and neurotransmitters. We've talked about this a lot in other videos. When those hormones and neurotransmitters change into or alter into their fight or flight balance, their stress balance, it increases hypervigilance and it increases your scanning. It inc. Decreases how safe you feel. It increases your attention to the negative and decreases your attention to the positive. It increases, go figure. Unpleasant emotions. If you're scanning and you're noticing more of the negative and less of the positive, yeah. You're going to feel less safe, more disempowered, more hopeless potentially. And it can decrease distress tolerance. As we become progressively stressed, we have more difficulty activating that rest and digest that parasympathetic nervous system that can help us down regulate, that can help us tolerate that distress. We develop dirty discomfort when we've got chronic illnesses. We can wake up in the morning and we may recognize, oh, I feel depressed today. I just, I don't want to get out of bed, I have no motivation. And then we get angry. We get angry that this is another day that I am feeling depressed. We may have anger about being in pain again. You wake up and you're like, oh, it's this, it's not happening today. And then you get angry because you had plans for things that you wanted to do that day. Or you get angry because it's frustrating that you can't control your own pain. And you may have guilt about being irritable because you were in pain. So how many layers of distress are you adding? I woke up, I was in pain. That was stressful, distressful. And then I got angry because I was in pain and then I got irritable or then I then I got felt guilty because I was irritable with people because I was angry because I was in pain. How much energy is that taking? Oh my gosh. Dirty discomfort turns up the intensity of distress and the amount of energy burn. It's like carrying multiple Backpacks. If you wake up and you're depressed or you're in pain or you're having cravings, it's like carrying a 50 pound rucksack. It's not easy. It's. You're going to have to deal with feeling dragged down until you address the issue. But if you are having those issues and then you start feeling guilty and angry on top of it, you're just adding more rucksacks, more backpacks, eventually it's just gonna drop you. You're not going to be able to function because you are being dragged down by so much negativity. So let's talk about grief. As I mentioned, that's one of the first things. When we recognize that our vision of the perfect, rich and meaningful life, it ain't gonna be. We're going to have to make some modifications. There's a grieving process, there's a grieving process to realizing that we don't have total control and that we're not invincible. Grief has denial. We're assuming you've gotten past that anger, depression and acceptance. So the first stage is anger, or second, if you count denial. We get angry because we feel like there's a threat. Makes sense. You notice that you get diagnosed with chronic fatigue syndrome or Lyme disease, or lupus or depression or addiction. You get this diagnosis and it's like, this is not freaking fair. You get angry. I should be able to handle this. Well, apparently not. You get angry and it's important to recognize all of the things that are triggering your anger about that situation that often revolve around your powerlessness and potentially your sense of unsafeness. I have this now. What does that mean? I have this chronic illness. Is it going to get worse? Is it terminal? I have an addiction. I. Does that mean that I'm going to relapse? Does that mean that I'm destined to be in and out of treatment for the rest of my life? You know, we can start jumping to conclusions and expecting the worst possible outcome. Catastrophizing when we get that diagnosis. And that's natural. That's what our brain does, unfortunately. It says, oh, let me tell you what could happen. So we need to come back and check the facts so our interventions recognize in what way does this situation feel threatening to yourself, your self concept and your vision of your rich and meaningful life? I have feel in italics and bold because feelings are not facts. Now there it may, it probably will require you make some adjustments. But not every feeling you have is going to be accurate in this context. So once you identify what feels threatening, using the facts in this context at this time, identify what the actual threats and losses are versus the threats and losses you assume might happen, that you may be catastrophizing. Could they happen? Anything could happen. But we want to look at probability, not possibility. It's also important when we're grieving, when we're in distress to have those distress tolerance skills and the ability to just sit with it. If I'm grieving, if I'm angry, if I'm anxious, whatever that distressful feeling, the ability to acknowledge that feeling and say, yeah, this sucks, I don't have to make it go away right now, I can sit with it for a minute. And when I'm ready, then I can take steps to address the situation. Distress tolerance helps us realize that we are more empowered than we often give ourselves credit for. We are more empowered, more able to handle emotions. Emotions are not going to consume us and, and that's where distress tolerance really comes in handy. The next phase I usually skip over bargaining is depression. And when you're angry for a while, it's exhausting. So you move into depression where you're exhausted, you may feel hopeless and helpless that you can't completely change the situation. You may feel helpless to completely control this situation. So you can't change it, you can't control it. It's like, ah, I don't like this feeling. People often bounce back and forth between anger and depression for quite a while until they decide that they are ready to figure out what to do next. Interventions help people explore what aspects they can control. As I mentioned, with my heart condition, I stay hydrated. I don't go on 8 mile hikes anymore, at least not 8 miles out. I can do loops, I can do multiple loops, but I try to stay a little bit closer to home. I don't go out when it's super hot because I know if I get overheated I'm going to trigger myself. So what aspects of this condition can you control? Identify areas of the chronic illness or addiction that will not significantly impact your life. I can have this condition and what the stuff that I do in the house very rarely triggers it. It's not going to impact my relationship with my kids. It's not going to impact my ability to love on my animals. It's not going to impact my ability to crochet. You know, that's my carpal tunnel. That's a whole different issue. But recognizing that just because I have this condition doesn't mean that my entire Life is over. It means I've got to make modifications, and then that comes to compromise. What modifications? What compromises can I make? My daughter, we've talked about her in multiple videos, whether she likes it or not, has pots, and we had to work with her. She was diagnosed when she was very young. So, you know, she was still listening to mom at that point. And we had to work together to try to find compromises for what is it that you can do? And instead of saying, you need to, okay, no, you don't. You can't do that. That's fine. What can you do instead? You can't drive right now. All right? And she just recently got to the point where she could drive for 15 or 20 minutes without having significant problems from her pots. And that's beautiful. I am so grateful for that. But there was a while there where when she was younger, we had to transport her, and once she got married, her husband had to drive her because she couldn't drive. Was it frustrating? Oh, yeah, I'm sure it was. And she just accepted that, hey, this is the way it is right now. It sucks, but getting angry about it is just going to make me feel worse. And then monitor your progress and your setbacks. Every little movement forward, if you're able. With pots, if you're able to stay sitting up for more than 15 or 20 minutes, that's progress. You know, note how. How long you were able to sit upright before having to lay back down. If you are having chronic pain, maybe you've got Crohn's disease or colitis, you're having a lot of pain, but yesterday was a six. On a scale of one to ten, today's a five. Well, that's progress. It's not as much progress as you want, but it's progress. And monitor your setbacks. If Yesterday was a 6 and today's an 8, then you need to look and say, what was different? What changed? What might I be able to do to prevent that flare? Because generally, there's some underlying issue that contributed to the flare, and it may not have been something you did or didn't do. I have fought with doctors for years when they've said, you don't have more pain in your arthritis when the. The pressure changes, when there's a temperature change. And I'm like, oh, yes, I do. I can tell you when it's fixing to rain. And, you know, every older person that I've ever talked with has said, oh, yeah, honey, you're right. And every doctor I've talked to has said there's absolutely no clinical evidence that says that's true. But I recognize my arthritis is going to be worse when rain's coming, when a cold front's coming in. So that setback, that day that I wake up and my pain's worse, it's not anything I did. It's the weather. Accepting that, all right, so what am I going to do about it? What am I going to do instead? I have gloves that I can wear that warm my joints, making sure not to blame myself or take responsibility for something that was wholly out of my control. People with addictions, especially in the first two years of recovery or if they go through significant weight loss, may experience resurgences of symptoms as the drugs that have been stored in their fat cells are released into the body. And we call that protracted withdrawal. But that can feel exasperating because they're like, why am I feeling this way? I haven't used. I. I haven't even wanted to use. And now, you know, I'm having these cravings that seem to have come from out of the blue. And it may just be the body's reaction. Now, that doesn't mean you don't address it. But taking. Not taking responsibility and saying, what did I do yesterday? Or what did I do today that caused this? You may not have done anything now. Shame, guilt, and regret. Shame is the feeling that you are unlovable or not good enough. I have this condition. I am not 100% perfect, therefore I'm not lovable. And we really need to explore where we got that message and if we believe that message. A lot of times I'll ask people, what makes someone or something worthy of love. Let's think about a dog or a cat or, heck, even a snake, if you like snakes. What makes them worthy of love? And obviously, they can't actually give you anything, but their presence is there. And. And a lot of us have this feeling towards our pets that. And towards animals in general. I love cows. I love. Even little jumping spiders love them. You know, I think they're the cutest thing in the world. Infants. Infants are born, and infants are a lot of freaking work. They cry. They wake you up all the time. You know, they don't pop out and suddenly make this glorious life that, you know, where they're providing all this unconditional love. They're very needy, but we love them. We love them with all their heart. The minute we see them, it's like this. This child, this person is deserving of love. Not because what they can do for us, but because. Because they are. I also ask people do differences or even mistakes. So do differences between people or even mistakes that somebody makes them make someone or something less lovable? If I am pretty book smart, you know, I. I'm really good with books. But my husband used to laugh and say I had the common sense of an 8 year old because I'm very gullible and I can't find my way out of paper bag. He was in the army, he's good at navigation, got a lot of common sense. He was in law enforcement and we're just very different. He is not the type of person that wants to pour hours into reading articles on PubMed. Does my lack of direction and gullibility make me less lovable? No, it just makes me different and you know, vice versa. Does his lack of love of, you know, getting steeped in research articles make him less lovable? No. And then I ask people to judge themselves like they would judge their best friend, their child or their grandparent. If you went over to Mima's house and she's 87 years old and she can't go hiking with you or rock climbing or maybe she can't even walk around the mall for three hours because she's 87 years old, are you going to love her less? Are you going to judge her harshly for that? I don't think so. When your child starts melting down at 4 o' clock in the afternoon in the middle of the grocery store, is it embarrassing? Yes. Is the behavior frustrating? Yes. Do you love them any less because they've reached their threshold and they're melting down? No. You don't love the behavior, but you do love them now. Guilt and regret and a lot of people confuse shame. I'm not good enough with guilt and regret. Guilt and regret have to do with behaviors causing or worsening the situation. Sometimes people have guilt or regret over causing their condition. Both of my parents died of cancer. Both of my parents were heavy drinkers and heavy smokers. And did that potentially contribute to them developing cancer? Yes. Did they have guilt and regret over that? Probably. I didn't ask. Do people who develop diabetes poor self care, they don't manage their stress, they don't manage their blood sugar. They end up becoming insulin resistant and developing diabetes. Did they potentially contribute to the development of that issue? Possibly. So there is guilt and regret, but holding on to that guilt and regret is not effective. It's just going to drain your energy. Staying angry and continuing to beat yourself up for something that's done it can't be changed is not a good use of energy. You're stealing energy from the things that are important in your rich and meaningful life and giving them to the old you. So strategies for handling guilt and regret. Examine the situation. Was this actually your fault and wholly your fault? Generally you can't say it was wholly your fault. There was some. There were something or some things that also contributed. And sometimes it just is. They have no idea why. I developed a heart condition. I was an avid runner, ran 10 miles a day for years, decades even. And maybe my heart just got tired, I don't know. But was it actually my fault? No. Does it tick me the heck off? Yes. But there's nothing for me to feel guilty about. What was the function or meaning of your behavior if you contributed to it somehow? Smoking, drinking, not controlling stress, poor dietary habits, whatever it was that contributed, why did you make that choice? And people engage in behaviors that are rewarding, and it may have been the only tool you had to survive until now. Understanding that behavior is communication and behavior serves a purpose can be helpful. And we can look back and say, did I have any other tools to deal with that at that time? And you may be able to say, no, I didn't. Now I do, but then I didn't. What are the benefits and drawbacks of continuing to burn energy on something that cannot be changed? You can't change the past. You can change how you deal with your condition in the present. You can change your behaviors. Henceforth, you can't change the fact that you got it. Whatever the chronic illness is, it's there. Depression, anxiety, schizophrenia, for the mental health ones, addiction or autoimmune disorders. There's a lot of stuff that's chronic. Okay, well, it is what it is. What are the benefits to continuing to be angry about that? And how does that help you use your energy to move toward your rich and meaningful life? And what can you do if you decide that it's not worth continuing to be angry? What can you do? Or to address that guilt and regret so you can free up that energy? More about being Guilt and regret. Guilt and regret are also anger. Is also anger about a behavior you did or didn't do? Being too weak to cope is one of the things I. I hear repeatedly, I should be able to do this, or I shouldn't have to take breaks every two hours or, you know, lots of shoulds and shouldn't. Get rid of those words. Those words are not helpful. Should and shouldn't. So strategies, more strategies for guilt and regret. What will you do? Not what can you do? Not what should you do? What should I do? That's very ambiguous, ambivalent. Well, I should get up and go to the gym. But yeah, maybe, maybe not. Can is very similar. I can go to the gym today, but I may or I may not. So identifying what you will do, it's a semantic change, but it helps a lot. What will I do or not do in the future? Stop comparing yourself to others. Just stop it. When you notice that you're doing it, stop right there and recognize that you are doing the best you can with the tools you have at this time. And you may also explore who says what you should be able to do. Who says that you should be able to do what that person is doing. Is that coming from your own head? Is that coming from somebody in your past whose approval you're trying to get? Is that. Where's it coming from? And is it accurate? Work toward being the best version of you that you can be on that particular day. And maybe it's not better than yesterday, maybe it's. But it's the best that you can do for you that day. Be flexible and compromise. Sometimes you just have to take a break or you need to recognize that you need assistance, for example, and then unhook yourself. Please unhook yourself from the behavior. I made a bad choice. I didn't do this. Instead of saying that I am a bad person, I was awful for doing that. Say, I made a bad choice when I did that. I'm lovable. I made a bad choice. I made a bad decision. Resentment is another one of those anger feelings. And we can have resentment toward others for not understanding what we're going through or even for pulling away. But it's important that we don't mind read because there are a lot of reasons people either don't understand or pull away. You can choose to use your energy to see, then silence and be resentful, or recognize that their lack of compassion and understanding may mean a lot of different things. And it's important, if you value that relationship, to figure out what it is. They may be trying to wish you out of pain and feel guilty that they cannot make it better. And this may come across as toxic positivity, saying, you know, you just need to get up and try. Come on, you just need to come out and go for a walk with me and. And you'll feel a lot better. And the person's sitting there going, nah, not gonna happen. Okay. The person is trying to help you feel better. The person has your best interests at heart. They really want to see you not hurt. And it's important to acknowledge that and say, I. I see that you want to help me feel better, and that's just not something I can do right now. Ideally, propose an alternative. I can't go out on a walk with you right now. It's too hot. I just don't have it in me. How about if we play a game of checkers? I don't know. They may not want to understand because it's scary. Whatever you're going with, dealing with may be something that they don't understand, and it's scary. They think that it is a death sentence. HIV is one of those things, and we've come so far in understanding HIV that there's a lot that people need to be educated on. But they get scared. They hear cancer, they hear hiv. They hear. Well, those are two of the big ones, multiple sclerosis. They. They get scared and they're like, I don't want to hear. I don't want to hear about it because that's really scary. I don't want to think about what you're going through, and I don't want to think about what I would go through if you were. If I were in your position. And yeah, we do that. We. We juxtapose ourselves and think, well, if it happened to them, it could happen to me. Facts in this context, at this time, the person may be defending their own behaviors. Maybe you have celiac disease or Crohn's disease and you can't eat gluten. And they eat gluten. So they're going to say, well, gluten intolerance is not real because they're defending themselves. They don't understand it, and they want a reason to defend their behaviors. Being around alcohol for somebody who has an alcohol addiction, just not smart. But somebody who doesn't have an addiction can be around alcohol until the cows come home. And it doesn't bother them. They don't understand. So they think because they can do it, you should be able to do it too. Same thing for not getting enough sleep. Some people can run on four hours of sleep and be just fine. The rest of us, we need our eight hours or more in order to feel good, in order to get rid of the brain fog, and in order to avoid a relapse. They may be self absorbed. Let's just say it. And I didn't say narcissistic because I don't like that word because it gets overused. But they may be too self absorbed and just not wanting to exert the energy to understand or spend time with you if you don't want to do what they want to do when they want to do it. In that case, you may want to evaluate how useful that friendship is. And finally, it may trigger prior similar trauma memories like when their mom got sick. And if you're diagnosed with cancer and they say it's early stages, we can treat it, you know, no problem, you know, chemo sucks, it doesn't matter who you are. And your friends who've gone through cancer with other people before may pull away not because they don't love you, but because it's too traumatic to watch you go through it. Same thing with other diseases or conditions. Addiction is the same way. If they had a loved one who struggled with addiction and they see you struggling with addiction and recovery, then they may pull away some because they are afraid and it brings up those old very painful memories. Jealousy is another one. And jealousy toward others for being able to do what you cannot. Jealousy often represents a sense of hopelessness or powerlessness. As I mentioned earlier, I go to the gym and I see these people that can run seven and a half minute miles and lift all kinds of weight and I'm like, oh, I remember when I used to be able to do 240 on leg press and now at about 160 my knees say, nope, that's enough, we're not doing anymore. And it's frustrating because I don't feel any older than I did back then. And when my body doesn't cooperate, it makes me a little angry. And I see other people around me and I'm like, oh, to have the body of a 20 year old again. But it's not going to happen. I can't turn back the clock of aging. Being angry, being jealous is not a good use of my energy. Instead of focusing on what you don't have or what you can't do, identify what you do have and what you can do. And, and I had to kind of adjust my thinking and compare myself to my cohort compared to other middle aged people. How am I doing if I'm going to compare myself? But I do, I know I said you shouldn't compare yourself to other people. And I tried to remind myself that I won't compare myself to other people, but I find myself lapsing. But focusing on what you do have, what you can do is really important. How can you use your energy to move closer to what's important in your rich and meaningful Life. Being angry that somebody has something that you don't have, maybe they've ascended to the rank of CEO at work, but you haven't. Being jealous over that, even though it has nothing to do with your illness, probably that drains your energy. Maybe you're jealous of the fact that they've promoted, but you haven't because you've been out a lot. You've had to take multiple leaves of absence. Well, it happens. And being angry at them for not having to take leaves of absence, is it their fault? And examining that anger, that jealousy, in what way is this threatening? To me, anxiety is fear about the condition getting worse, relapse or rejection. And for anxiety, we're going to use a lot of the same tools, but recognizing when I start fearing that my condition is going to get worse, or I fear that it could get worse. Facts in this context at this time, what can I do to slow the progression of this condition? Or what can I do to prevent relapse? Looking at the facts in this context at this time, I fear that others will reject me if I can't do everything I did when I was 20 or before this diagnosis. But is that really the case with people with addictions? Sometimes they have to change people, places and things. Other times they have supporters in their social network that are not going to reject them because they can't be around alcohol or can't be around, you know, can't go to certain parties or something. Those people acknowledge it and say, that's fine, I'd rather be your friend and I'm not rejecting you because of your sickness, because of your condition. And based also on facts in this context at this time, probability versus possibility. Could the condition get worse? Sure, there's always a possibility. Could there be something worse going on? Sure, there's always a possibility. But based on the facts that you know right now, what's the probability that the worst case scenario is going to happen? Other strategies Emotional awareness. This is really important if you're going to improve your emotional health and become resilient. We need to be aware of the function and symptoms of various emotions. For us, anger and anxiety, their responses to perceived threats. Okay, that's the function. What does anger feel like for you? It may feel different for you than it feels for me. So what does it feel like in your body when you start to get angry? What is anxiety feel like for you? You know, anxiety for me is either in the pit of my stomach or right in the center of my chest. Those are early warning signs. You know, shakiness of course that comes too, but I know what that those symptoms may mean. So when I start experiencing those symptoms, I can say, hey, I'm feeling anxious. All right, what do I do about it? I and the mnemonic is idea. Identify your feeling. Feeling angry, feeling anxious, feeling jealous, resentful, whatever. The word is down regulate. It's going to be virtually impossible to evaluate the situation and decide what you need to do. If you're in fight or flight, you need to get into your wise mind. So downregulate, explore the cause or trigger or triggers for that feeling in context. Why am I suddenly feeling anxious or angry? What happened? And then decide, is it an issue? You can, as I mentioned earlier, smoke alarm can go off, that can trigger anxiety. And you get up and you start looking around for it, you may start smelling poop and it triggers irritation or something and it gets you to get up and see, you know, if the sewer backed up or whatever the case is. But we're exploring what caused me to start feeling this feeling. Is it a threat right now? And what can I do to address it? If it's not a threat, I can let it go. If it is a threat, what do I need to do next? Define your rich and meaningful life. And I know we've talked about that throughout the whole presentation, but it's worth restating. Define what that looks like, what people things and experiences are important. And in the morning, each morning, review your rich and meaningful life. That's why I love having people do a rich and meaningful life vision board, because it's just right there and they can look at it and it's very visual and they can envision all of the things that are important and they can notice all of the things that are going well. It's there. Instead of having to think of it, think about when you were taking a test, which was easier. The fill in the blank questions where you had to come up with the answer all on your own, or the multiple choice questions where you had options, you didn't have to try to think of everything. Vision boards work the same way. Instead of trying to have to think about what's important and in my rich and meaningful life every day and come up with that list every day. If you have it on the vision board, you can look at it and you can go, yeah, got that. So in the morning, review and decide what's worthy of the energy you have that day. If your gas tank, physically gas tank is 60%, you don't have as much energy. So what is worthy of that partially charged battery today. If you feel fully charged, great. You've got more energy to disseminate among the things that are important in your rich and meaningful life. You may have to engage in mental rehearsal. If you know you've got to go to a meeting with that's stressful for some reason, and you know you don't want to waste a lot of energy getting stressed out in that meeting, then mentally rehearse sitting in that meeting, going through it without getting overly stressed. One of my favorite sayings, and my husband hears me say it a lot, is not my circus, not my monkeys. And I say it so much, I've actually shortened it down to just circus monkeys. Because when you're part of the team or living in a community where there's other beings around, you can't control everything. And people may be doing things that you think are really not smart moves or you think are not the right choice, but you can't control it. You can't fix it. You can't make them do something that they don't want to do. Not my circus, not my monkeys. I gave my two cents. If they don't want to take my opinions, fine. If they want to do something that seems disrespectful, I'm going to set my boundaries. I don't need to chase them for their approval. So mental rehearsal can be very helpful. But just remember, circus monkeys, what are you actually responsible for in the evening, Reflect on how you effectively used your energy. Look back and say, how did I use my energy toward the things that are important? Well, awesome for me, you know, I actually did nurture those things and I did take positive steps. Learn from your challenges. Most of us don't get through an entire day using our energy only for things that are important. In our rich and meaningful life, we get sidetracked with a little bit of irritability or frustration that we hang on to for a little bit too long. We can look back over that and say, hmm, what can I learn from that so I don't waste my energy on that again. And in the evening again, take stock of everything in your rich and meaningful life. Go through that vision board and go, yeah, I am grateful that that's in my life. I am grateful that I've got that. That's going well. That's going well. That maybe not going so well, but, you know, that's 20% of the puzzle. 80% is going well. In terms of hardiness, commitment, commit yourself to all things that are important in your rich and meaningful life. You're not going to do everything all at once in one day or even in one year, but committing yourself and saying, when I have energy, I am going to devote some of it at various points to these different things that are important. If you have four hobbies, you're not going to do all four hobbies at once. You're going to or for me, I tend to go in spurts. I'll crochet for a while and then I'll garden for a while and then I'll cook. Some part of it depends on the season. Obviously during the winter I'm not doing much gardening so I have more time for crocheting, but I'm not. All of those things are important, but I'm not giving each one of them energy every single day. Control. Use your energy to control or change or do the things you can, accept the things you cannot change. And that's important. Part of control is accepting that you can't control everything. You're acknowledging you're controlling how you use your energy and you're saying, hey, I can't do that. I, I can't, you know, drive up this steep mountain without a four wheel drive and I ain't got it. So I, I'm gonna have to accept it. Instead of trying to figure out how to get my, my little car up that steep mountain and then view problems as obstacles like you would on an obstacle course, or challenges, not barriers. So commitment, control and challenge in recovery. We often say the Serenity prayer. You don't have to turn it into a prayer if you don't want to, but think. Grant me the serenity to accept the things I cannot change, courage to change the things I can, and the wisdom to know the difference. This is huge. Accepting the things I cannot change because most of us don't like to do that part. But you'll find that you're much more at peace when you stop trying to change the unchangeable. So, serenity to accept the things I cannot change, courage to change the things I can, the wisdom to know the difference. Living one day at a time. Oh, that's an important part that we usually leave off. Living one day at a time, not living for the entire year, just taking today as it comes and doing the very best I can, enjoying one moment at a time, being present and acknowledging in the moment what is going well. Yes, we're going to acknowledge what's not going well, but we also want to turn our attention and look at the whole pie. What's going well as well as what's not going well. So enjoying one moment at a time accepting hardships as a pathway to peace. O now what does that mean? Recognizing that when we struggle, when we experience those challenges, we are becoming stronger. We are realizing how much more control and how much more power we, we actually have in our life. And that helps us feel more at peace. We recognize our power. All of this so that I may be reasonably happy in this life doesn't say deliriously, it doesn't say always happy. It says reasonably happy, reasonably pain free, reasonably healthy. And that's what we really want to focus on because very few people have a perfect life in terms of contentment and gratitude. We want to focus proactive mindfulness about what's going right in the moment. I had to have my blood drawn this morning for the second time. And I went in and the doctor stuck me and they couldn't get a vein. And I hate needles. And they, they were just digging around in it and I'm like, oh my gosh, this is awful. However, I recognize that it'd be over in a minute and everything else is going right. You know, I was already ready for class. Everything was going well. It was a beautiful day outside. I just tried to think about what was going well. Being grateful for that, not focusing on the distress of the microsecond and stop trying to be happy. When I'll be happy when this goes into remission. I'll be happy when I haven't haven't had an episode for six months. I'll be happy when. Well, we don't know if when is ever going to come. What's wrong with being happy right now for a moment? And some people feel like if they haven't achieved all of their goals, they don't deserve to be happy. And that's a whole other presentation and a whole other thing to think about. Develop a relationship with your condition. Get to know it. What keeps it stable, what keeps it at bay so you feel like you've got control, you know, what you're waking up to every day, what irritates or triggers it, what causes a flare and what helps calm it down. When you have a flare, what can you do to help yourself heal in? Long time ago. I haven't talked about Lenny for a while. But when I have anxiety. I already told you, I have a heart issue. I have this tightness in my chest and it feels oppressive sometimes. And I named it Lenny because it feels like an elephant sitting on my chest. I've gotten to know it when I start having that feeling, I'm like, okay, well, Lenny's back. This really sucks right now. Getting angry about it's not going to do me any good. So what do I need to do? What caused Lenny to show up again? And by anthropomorporizing it. I can never say that word. By giving it human characteristics for some reason, sometimes it feels easier to deal with and I can recognize that, you know, Lenny's visiting right now and I'll be really happy when he leaves, but it's a mental game. It works for me, works for some people, may not work for you. Hope and optimism both increase the release of dopamine and serotonin, our motivation and feel good chemicals that also are neuroprotective, anti inflammatory and help us get better sleep interventions to increase hope and optimism. Set smart goals. Small, specific, measurable, achievable, relevant, time limited goals. For people with chronic illnesses, I encourage them to set small goals. Maybe it's an hour, maybe it's a day, definitely no longer than a week. But set these small goals so you can track your baby steps, you can track your progress instead of missing things and track your progress. 365 baby steps in a year is still progress. It's still a lot of freaking progress. Maybe you're not taking those giant strides you had hoped for, but you're still a lot further along than you were 365 days ago. And get support or mentors or I don't know what you call it, but somebody who's been through it, somebody who can say, yeah, I remember those early days of recovery and it was grueling. It was grueling. Or I remember before I got my condition under control, when I'd have a flare, you know, I'd feel like I couldn't get out of bed and this is what I did, or you know, this too shall pass. But it provides hope. If you can see somebody who is living their rich and meaningful life with the same condition you have, it can be very inspiring and empowering. Chronic illness and addiction can both add a lot of distress to life. Ongoing distress will worsen the condition and negatively impact each piece of life. Physically, it'll negatively impact your sleep, it'll negatively impact your gut, it'll negatively impact your pain levels and neurotransmitters and hormones to boot. Interpersonally, it will negatively impact your self esteem and your relationships with others. Emotionally, distress is generally going to lead to dirty discomfort. So you're going to have distress about your distress which alters how you think about things and whether you're pessimistic or optimistic. And it can even alter your environment, who you want to spend time around, or even whether you can afford to keep a roof over your head because you can't go to work. You know, if you have to call out a lot because your condition is flaring because of this ongoing distress or partly because of it, you know, those are all negative impacts of ongoing distress. Define your rich and meaningful life so you're aware of what's important for you to spend your energy on. And finally, embrace the dialectics. Embrace the good with the bad. Embrace the ways you're. You are safe in addition to the ways you may be unsafe right now or not. Completely controlled. Embrace what you have and acknowledge what you don't have and embrace what you can control in addition to acknowledging what you cannot control. And it's hard. It's hard to say, I can't control that. Once we do, once we acknowledge it and sometimes say it out loud, that's not something I can control. Circus monkeys. It can help lift a weight because you stop trying to change the unchangeable either. Doesn't say always happy. It says reasonably happy, reasonably pain free, reasonably healthy. And that's what we really want to focus on. Because very few people have a perfect life in terms of contentment and gratitude. We want to focus proactive mindfulness about what's going right in the moment. I had to have my blood drawn this morning for the second time. And I went in and the doctor stuck me and they couldn't get a vein. And I hate needles. And they, they were just digging around in it, and I'm like, oh, my gosh, this is awful. However, I recognize that it'd be over in a minute and everything else is going right. You know, I was already ready for class. Everything was going well. It was a beautiful day outside. I just tried to think about what was going on. Well, being grateful for that, not focusing on the distress of the microsecond, and stop trying to be happy. When I'll be happy when this goes into remission. I'll be happy when I haven't. Haven't had an episode for six months. I'll be happy when. Well, we don't know if when is ever going to come. What's wrong with being happy right now for a moment? And some people feel like if they haven't achieved all of their goals, they don't deserve to be happy. And that's a whole other presentation and a whole other thing to think about. Develop A relationship with your condition, get to know it. What keeps it stable, what keeps it at bay so you feel like you've got control, you know, what you're waking up to every day, what irritates or triggers it, what causes a flare and what helps calm it down. When you have a flare, what can you do to help yourself heal in. Long time ago. I haven't talked about Lenny for a while, but when I have anxiety. I already told you, I have a heart issue. I have this tightness in my chest and it feels oppressive sometimes. And I named it Lenny because it feels like an elephant sitting on my chest. I've gotten to know it. When I start having that feeling, I'm like, okay, well, Lenny's back. This really sucks right now. Getting angry about it's not going to do me any good. So what do I need to do? What caused Lenny to show up again? And by anthro fizing it, I can never say that word. By giving it human characteristics for some reason, sometimes it feels easier to deal with and I can recognize that, you know, Lenny's visiting right now and I'll be really happy when he leaves, but it's a mental game. It works for me, works for some people, may not work for you. Hope and optimism both increase the release of dopamine and serotonin, our motivation and feel good chemicals that also are neuroprotective, anti inflammatory and help us get better sleep interventions to increase hope and optimism. Set smart goals. Small, specific, measurable, achievable, relevant, time limited goals. For people with chronic illnesses, I encourage them to set small goals. Maybe it's an hour, maybe it's a day, definitely no longer than a week. But set these small goals so you can track your baby steps, you can track your progress instead of missing things and track your progress. 365 baby steps in a year is still progress. It's still a lot of freaking progress. Maybe you're not taking those giant strides you had hoped for, but you're still a lot further along than you were 365 days ago and get support or mentors or I don't know what you call it, but somebody who's been through it, somebody who can say, yeah, I remember those early days of recovery and it was grueling. It was grueling. Or I remember before I got my condition under control, when I'd have a flare, you know, I'd feel like I couldn't get out of bed and this is what I did, or, you know, this too shall pass. But it provides hope. If you can see somebody who is living their rich and meaningful life with the same condition you have, it can be very inspiring and empowering. Chronic illness and addiction can both add a lot of distress to life. Ongoing distress will worsen the condition and negatively impact each piece of life. Physically, it'll negatively impact your sleep, it'll negatively impact your gut, it'll negatively impact your pain levels and neurotransmitters and hormones to boot. Interpersonally, it will negatively impact your self esteem and your relationships with others. Emotionally, distress is generally going to lead to dirty discomfort. So you're going to have distress about your distress, which alters how you think about things and whether you're pessimistic or optimistic. And it can even alter your environment, who you want to spend time around, or even whether you can afford to keep a roof over your head because you can't go to work. You know, if you have to call out a lot because your condition is flaring because of this ongoing distress, or partly because of it, you know those are all negative impacts of ongoing distress. Define your rich and meaningful life so you're aware of what's important for you to spend your energy on. And finally, embrace the dialectics. Embrace the good with the bad. Embrace the ways you're you are safe in addition to the ways you may be unsafe right now or not completely controlled. Embrace what you have and acknowledge what you don't have and embrace what you can control in addition to acknowledging what you cannot control. And it's hard, it's hard to say, I can't control that. Once we do, once we acknowledge it and sometimes say it out loud, that's not something I can control. Circus monkeys. It can help lift a weight because you stop trying to change the unchangeable. Are there.