by Paul Greene, PhD

Living with chronic illness can sometimes feel like an insurmountable challenge. It can be demoralizing, scary, isolating, and frustrating. But there is hope. Read on to learn several helpful strategies to cope with chronic illness.

The Serenity Prayer’s suggestion to “accept the things we cannot change” and to try to “change the things we can” may be helpful—even for those not inclined to prayer—when living with chronic illness. Whether you have multiple sclerosis, diabetes, heart disease, celiac disease, an autoimmune condition, HIV, or another illness, there are usually some aspects of the condition that can be changed and others that cannot. Identifying these things, and acting on them, may bring more peace and a sense of agency back into your daily life.

Changing What You Can

Focusing on changing the things you can is an excellent place to begin. Depending on your illness, this may include things like getting regular exercise, avoiding certain activities or foods, tracking blood glucose levels, regular visits with your doctors, or managing activity levels. For some people with chronic illness, taking these steps may seem futile—like a “drop in the bucket”—in your overall health picture. However, without trying you’ll never know how helpful they could be. It’s worth a shot!

Try being systematic in your application of any changes and be sure to allow enough time to see if they affect how you feel. For example, avoiding certain foods for a few days might not make much of a difference, but after a couple of weeks you might see some improvement. When trying a new strategy, consider keeping a log of your symptoms—that way you can look back on real data to decide if something is working or not. Also, remain open to the possibility that even if a recommended change didn’t help a couple of years ago, it might help now. You’ll never know until you try.

Accepting What You Cannot Change

Accepting what you cannot change about living with chronic illness is easier said than done. This is especially true if you experience a long-lasting decrease in your quality of life—like needing to give up a favorite activity, or having difficulty walking. These are not easy changes to accept! Remember that your doctors are a resource, and consider talking with them about how long a given problem might last.

There’s not one simple way to make yourself accept the more difficult aspects of living with chronic illness. However, many people report that acceptance comes from a combination of three things: recognizing that something cannot be changed, consciously working to adjust expectations, and actively seeking more satisfaction and meaning in the things you can do.

Many people find it useful to understand and adjust to the “new normal” created by the illness. This change in perspective gets us out of the habit of comparing how different your life is now versus when you felt better. This shift helps move your focus from the past to the present.

The Value of Mindfulness

Another approach that may help you accept the difficult aspects of living with chronic illness is mindfulness. Mindfulness helps us become more aware of the moments when we are rejecting the current situation, rather than accepting it. Mindfulness also aids in letting go of unhelpful thought patterns about chronic illness.

In addition to practicing mindfulness, other ways to cope with unhelpful thought patterns include challenging negative self-talk. What you tell yourself plays a significant role in your emotional relationship with your illness. Perhaps you’ve found yourself thinking things like, There’s nothing I can do or This is totally unfair or This is a hopeless disaster. Healthier self-talk could include statements like, It doesn’t feel like it’s helping, but the doctor said I should take a walk once a day, so I owe it to myself to do that. Or, It may not be fair that I have this condition but I want to handle it as best I can to be an example to those around me. Or, Things seem bleak right now, but I know this illness has its ups and downs, and this is just one of the downs. These examples won’t apply in every case, but they illustrate how the messages you tell yourself can help you become more accepting of the impacts an illness has on your life.

The Importance of Social Support

Although it can be difficult, don’t underestimate the power in asking for help from those around you when you’re having a hard time. It’s also important to be willing to accept offers of assistance from others.

For example, if your chronic illness makes it impossible for you to drive, consider asking a friend or family member to give you a ride to the events that boost your quality of life. Sometimes the help we need is practical (like having a friend bring you groceries) and sometimes it’s emotional (like talking through your feelings before a difficult procedure). It’s valuable to share the inner aspects of living with your illness with someone you trust. If you don’t have a person like that in your life, consider finding a support group that is specific to your illness. There are many good resources available for online or in-person support groups for multiple sclerosis, Crohn’s disease, epilepsy, cancer, and many other illnesses.

Anyone who lives with chronic illness knows it isn’t easy. But it’s important to remember that you hold the ability to improve your situation by focusing on changing what you can, accepting what you can’t, and relying on others when you need to.

About the author:

Dr. Paul Greene is the director of the Manhattan Center for Cognitive-Behavioral Therapy in New York City. He received his doctorate in clinical psychology from Boston University and completed postdoctoral training at Memorial Sloan-Kettering Cancer Center and the Mount Sinai School of Medicine. Dr. Greene served as an assistant professor at the Mount Sinai School of Medicine for six years. He is an expert in the treatment of anxiety and related disorders, and the application of mindfulness in cognitive-behavioral clinical interventions.

Judy McNamara Tripp

August 12, 2019

Would love to see an article about Meniere's Disease a debilitating condition of the vestibular system.

“Accept what you can’t change and change what you can” is more than a brilliant strap line.
I have a number of different chronic conditions. There’s nothing that can be done to ‘cure’ any of them and there’s nothing that I can do to completely relieve their symptoms either.
Whenever anyone (health professional or otherwise) has told me that I need to accept the illnesses and the impact that they have on my life (& the lives of my family) if I am to allow myself the help that’s available to me. I have always replied (not necessarily very politely) that if I accept it all, then I am giving in to all the symptoms that I have to live with and I am basically just giving up and that is something I am simply not prepared to do.
BUT I think that I could accept each diagnosis. At the end of the day ‘it is what it is’ and it’s not giving in to anything, nor is it giving up. It would be ACCEPTING WHAT I CANNOT CHANGE.
There are things that I can do to help the symptoms of each condition. That’s where my fight not to give up begins. It’s CHANGING WHAT I CAN CHANGE. Being stubborn and unprepared to accept what I can’t change makes it impossible to reach the point of changing what I can change.
The Serenity Prayer goes on to say “grant me the wisdom to know the difference”. I have discovered that considering the difference between what can and what cannot be changed is a very humbling process, but it has resulted in such a freedom to be me - the ‘me’ that I am now, rather than the impossible ‘me’ that I was before I became ill.
I’ve known the Serenity Prayer since I was a teenager, but it’s only now that I’ve realised how pragmatic and powerful it is as a strap line for life in general.
Thank you for writing this article - I have a feeling that it’s going to turn out to be the catalyst for changing my life around and the beginning of a new adventure.

Hello Sarah, and thanks for your thoughtful comment. You're absolutely right that accepting and "giving in" are two very different things. I have come to believe that when we refuse to accept chronic illnesses and the limitations they impose, we sometimes end up cheating ourselves out of a certain peacefulness that would otherwise be there. What do you think?

And I completely agree with you about the profundity of the serenity prayer. It's hard to go wrong with humility. Being humble about our efforts to determine what can vs. can't be changed sounds like the best idea I've heard all day.

Thank you for a reminder of the Serenity Prayer. Personally, I can usually get through painful days with this Prayer and Gratitude journaling. The trouble I’m having now is the odd tough day is now tough days and sometimes week. How do I get myself to accept my illness’s are progressing?
Thank you

Hello Tammy,

I'm sorry to hear you're having a rough time with your illness. I'm afraid there isn't a magic bullet solution for a problem like that.

However, one thing that's often useful is to change the focus of your efforts at acceptance. Instead of focusing them on the overall situation, focus them on the present moment. Try to accept whatever it is you're feeling *in this moment* rather than anything bigger than that. This is not easy. If you're looking for more help on how to go about this, I recommend looking into mindfulness and the skills taught in dialectical behavior therapy (DBT). In DBT they talk about something called "radical acceptance" which is a useful skill to cultivate. You can read more here:…

I wish you the best and please do reach out if you're looking to connect with some local providers.