Face It: How You Cope Actually Impacts Your Health
Arielle Radin, Director of Clinical Research at Gali Health
One of the worst aspects of having a chronic illness is the “chronic” part. When so much of our time and energy is spent dealing with an illness every day, it can feel as if our chronic condition begins to define us. But the last thing we want is to become our diagnosis and forget about all the other things that make us who we are, beyond being a “patient” or “disabled.”
Naturally, it’s tempting to want to escape reality and pretend like our illness doesn’t exist, especially when we are in remission and the hours spent in agonizing pain seem like distant memories. However, there’s a growing body of evidence that says we should actively confront our illnesses, even when it’s hard or seems unnecessary. We do now know that the way we cope with an illness does in fact influence not just our psychological well-being, but also our physical health.
For over 30 years researchers have been trying to figure out how the different ways we cope with health-related stressors affect the outcome. An early dichotomy distinguished between “problem-” and “emotion-focused” coping strategies¹, favoring approaches that emphasized solving problems the stressor created rather than addressing the emotions it elicited. But subsequent research found that emotions do indeed play a large part, based on studies that looked into “approach-oriented” and “avoidance-oriented” coping strategies²,³.
The former can be described as a conscious effort to manage health-related stressors, along with the emotions they elicit, in some positive way, mainly through mobilizing and using your inner resources. This includes acceptance, planning, positive reappraisal (trying to re-frame stressful events in a positive light) and seeking social support, both instrumental (identifying people or social networks that can provide you with practical help and advice, like when weighing therapeutic options) and emotional (finding support systems that allow you to process and express how you feel).
An important recent addition to the approach-oriented set of coping strategies is the study of “emotional processing” (active attempts to acknowledge, explore and understand your emotional experience) and “emotional expression” (verbal or nonverbal efforts to communicate it).⁴ One study found that men with prostate cancer who engaged in emotional approach coping exhibited lower levels of inflammation four months later.⁵
Ultimately, all of these strategies involve approaching the stressor and dealing with it either through activities or mental processes. Avoidance-oriented strategies, on the other hand, explicitly try not to. These include mental and behavioral disengagement, like choosing to give up thinking about the illness or watching TV to take your mind off of it, as well as denial — refusing to believe that you have the illness or pretending that your diagnosis never took place. One might argue that thinking about your disease and participating in illness-related activities just causes more stress, but avoidant strategies are more like quick fixes — they might make you feel better in the moment, but prevent you from actually managing your illness and processing your emotions. Think short term gains at the expense of long-term consequences.
Clinical studies back this up: approach-oriented coping strategies have been linked with positive outcomes.⁶ For example, in the first year after treatment, people who chose an approach-oriented strategy when first diagnosed with breast cancer were more likely to think positive and feel less depressed and less afraid of the cancer returning than those who preferred avoidance‐oriented coping.⁷ Avoidant coping strategies have been associated with psychological consequences across various illnesses, including being one of the strongest predictors of depressive symptoms in breast cancer survivorship. In terms of physical health, avoidant coping has been linked with treatment non-adherence as well as poor health outcomes in diabetes, HIV and cancer patients.
But while it would be easy to dub approach and avoidant coping strategies “adaptive” and “maladaptive,” it’s important to remember that whether a strategy is effective depends on the context and the person employing it. For example, avoidant coping can help to mitigate short-term anxiety in acute situations, like while waiting for test results.⁸ However, when it comes to managing a chronic illness, using approach-oriented strategies will buy you better psychological and physical well-being in the long run and provide you with the freedom to live your life outside of your diagnosis to the fullest, both psychologically and physically.
It’s essential to find a balance between approaching the stress and emotions that come with a chronic illness and allowing yourself to live a life not defined by your disease. More importantly, coping with a chronic illness does not need to occur in isolation: social support has been tightly linked with health outcomes in various patient populations.⁹ Identifying either in-person or digital sources of social support to help process and express your emotions can definitely help you cope.
Chances are, you already engage in digital forms of social support by connecting with friends and family through social networks. You might even belong to patient groups that are geared toward sharing experiences and advice with others, or frequent specialized websites for chronic illnesses and message boards spanning topics related to symptoms, treatments and dealing with health-related stress. However, there are two important issues to keep in mind: oftentimes patient support groups can feature disproportionately negative content that drowns out the positive, and it is difficult to sift through the vast amount of knowledge out there for information that is actually relevant to you and the way you experience your illness.
The ideal form of digital social support would balance positive experiences with the negative, tailor support to your unique needs and integrate both emotional and problem-solving based approach-oriented coping activities. Gali is the first community-powered digital health assistant who not only encourages you to proactively manage your health by giving you the relevant and timely information you need to approach health-related stressors thoughtfully and strategically, but also to share your experiences and knowledge with others.
Based on the extensive research on coping with chronic diseases, actively confronting your illness will help to improve both your physical and mental health. Gali helps to optimize the time you spend caring for your health in a friendly, convenient, stress-free way, so you never feel lost, powerless or alone when dealing with your illness. Gali’s ultimate goal is to empower you to spend more of your time feeling healthy and living your life, because you are, in fact, so much more than your disease.
To learn more about Gali, please visit https://galihealth.com/.
Arielle Radin, M.A., is the director of clinical research at Gali Health and a Ph.D. student in health psychology at the University of California, Los Angeles. Her research focuses on mind-body interactions in chronic illness and cancer, specifically how the immune system, namely inflammation, impacts psychological functioning and influences quality of life in disease populations.
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