Guide · Chronic illness

Healthy, proven ways to live well with chronic illness

Methods from therapies studied with people living with pain, fatigue, and long-term conditions, with steps to try at your own pace.

What the research supports

Methods with real evidence behind them

Each of these comes from a therapy that has been tested in clinical research. You can borrow pieces of them on your own; a therapist can help you use them fully.

Method 1 of 4

Make room and move toward what matters (ACT)

Acceptance and Commitment Therapy doesn't ask you to like your condition. It helps you stop fighting what you can't change, so more energy goes to the things you care about.

The evidence
The American Psychological Association's Society of Clinical Psychology lists ACT as having strong research support for chronic pain.
Source: APA Society of Clinical Psychology ↗

Try this

1.Notice a painful thought, like "I'm useless now."
2.Rephrase it: "I'm having the thought that I'm useless."
3.Ask: what matters to me today?
4.Take one small step toward that, alongside the discomfort.

Method 2 of 4

Pace your activity

On good days it's tempting to do everything, then crash for days afterwards (the boom-and-bust cycle). Pacing spreads activity out to stay within your energy limits.

The evidence
Pacing is widely used in pain and fatigue rehabilitation, and the CDC describes it as one of the best ways to prevent symptom crashes in ME/CFS.
Source: Centers for Disease Control and Prevention ↗

Try this

1.For one week, note activities and how you feel afterwards.
2.Find a level you can manage on bad days too.
3.Break big tasks into chunks with rest between.
4.Stop before you're exhausted, not after.

Method 3 of 4

Fix your sleep (CBT for insomnia)

Pain, worry, and medications often disrupt sleep, which makes symptoms feel worse. CBT-I retrains sleep habits without relying on medication.

The evidence
The American College of Physicians recommends CBT-I as the first treatment for chronic insomnia in adults.
Source: Qaseem et al., Annals of Internal Medicine, 2016 ↗

Try this

1.Keep the same wake-up time every day.
2.Use your bed for sleep and intimacy only.
3.If you can't sleep after about 20 minutes, get up and do something calm, then return.
4.Avoid long daytime naps where possible.

Method 4 of 4

Practice mindfulness (MBSR)

Mindfulness-Based Stress Reduction was created by Jon Kabat-Zinn for patients with chronic pain and illness. It teaches noticing sensations with curiosity rather than alarm.

The evidence
Studies of MBSR have found reductions in stress, anxiety, and depression, and improved quality of life, in people with a range of chronic conditions.
Source: NCCIH: Meditation and Mindfulness ↗

Try this

1.Lie or sit comfortably for five minutes.
2.Move your attention slowly from your feet to your head.
3.Notice sensations, including discomfort, without trying to change them.
4.Return to the breath whenever your mind wanders.

Tool

Find your values compass

ACT starts by asking what matters most to you. Pick your values to get small steps you can take even on low-energy days.

Choose up to three that matter most to you, illness or not.

Your small, doable steps will appear here.

Everyday tips

Small habits that add up

Plan around energy. Each morning, choose one or two priorities. Rest is part of the plan.

Prepare for appointments. Write your top three questions beforehand, and bring someone when you can.

Make specific asks. "Can you pick up groceries Thursday?" is easier to say yes to than "Let me know if you need anything."

Find people who get it. Peer support groups for your condition can ease isolation.

Name the losses. Grief that's named is easier to carry. Let yourself feel it.

Keep a symptom journal. Tracking sleep, activity, and symptoms helps you and your doctors spot patterns.

Resources

Trusted organizations and reading

NIMH: Chronic Illness and Mental Health ↗: How chronic illness and depression affect each other, and how depression is treated.
Association for Contextual Behavioral Science ↗: Learn about ACT and find trained therapists.
Family Caregiver Alliance ↗: Guides and support for caregivers. Call 800-445-8106.
Cancer Support Community Helpline ↗: Free emotional support. Call 888-793-9355.

Books worth reading

How to Be Sick, Toni Bernhard
Full Catastrophe Living, Jon Kabat-Zinn
Living Beyond Your Pain, JoAnne Dahl and Tobias Lundgren

Back to chronic illness support →

Ready when you are.

The first conversation is free, and there's no pressure.

Book your free consultation