Dear Diary,
October brings renewed conversations about mental health.
We share the graphics. We talk about checking on our strong friends. We remind people that asking for help is okay. We encourage one another to talk about the things happening beneath the surface.
Those conversations matter.
But when October ends, people living with chronic illness donât get to pack away the emotional side of being sick along with the awareness ribbons.
Chronic illness doesnât follow an awareness calendar.
And neither does its impact on your mental health.
đ There Is a Mental Side to Being Physically Sick
Living with chronic illness isnât just about symptoms.
It isnât just doctorâs appointments, medications, treatments, procedures, lab work, insurance authorizations, and trying to remember which specialist told you what.
There is an emotional weight attached to all of it.
When you live with Crohnâs Disease and Myasthenia Gravis, you become incredibly aware of your body.
Sometimes too aware.
Is this normal tiredâor MG tired?
Is my stomach upset because I ate something wrongâor is Crohnâs getting ready to start acting up?
Why am I short of breath?
Is it asthma?
Is it MG?
Is my diaphragm struggling?
Should I wait?
Should I call somebody?
Should I go to the ER?
And perhaps the most exhausting question of all:
Am I overreactingâor am I not reacting enough?
That kind of constant internal monitoring does something to you.
Your body may be carrying the illness, but your mind is carrying the responsibility of constantly trying to interpret it.
đ§ When Your Body Has Betrayed You Before
Before chronic illness, âIâll see how I feel tomorrowâ can sound perfectly reasonable.
After your body has taught you that seemingly small symptoms can become something serious, those words hit differently.
You remember the times something wasnât right.
You remember the appointments.
You remember not being heard.
You remember knowing something was wrong before anyone could tell you exactly what it was.
So when something changes in your body, part of your brain immediately starts paying attention.
Thatâs not something you simply switch off because youâre trying to âstay positive.â
Sometimes youâre not being negative.
Sometimes experience has simply taught you to pay attention.
đ There Is Grief Here, Too
I think one of the least discussed parts of chronic illness is grief.
Not necessarily grief for a person.
Sometimes youâre grieving yourself.
The version of you who could make plans without first wondering how much energy they would require.
The version who didnât have to calculate bathrooms, medications, temperatures, walking distances, treatment schedules, or recovery time.
The version who could wake up tired and assume she simply needed more sleep.
There are days when I genuinely enjoy my life.
There are days when I laugh until my stomach hurts.
I travel. I work. I spend time with my family. I go to Disney. I bake. I write. I make plans.
I live.
And there are still moments when I miss the woman who didnât have to think this hard about simply existing.
Those two things can be true at the same time.
Gratitude doesnât erase grief.
Being thankful for the life I have doesnât mean Iâm never allowed to mourn the things chronic illness changed.
đŽ And Then There Is the Uncertainty
Sometimes the mental weight isnât about whatâs happening today.
Itâs wondering about tomorrow.
What happens if my symptoms get worse?
What happens if a treatment stops working?
What will the next flare look like?
Will my body allow me to do the things Iâm planning?
Will I always be able to work the way I do now?
Will something else change?
Chronic illness has a way of introducing you to questions nobody can answer with certainty.
And Iâve learned that I canât spend every good day worrying about whether a bad one is coming.
Iâm still working on that one.
Because when youâve experienced enough unexpected plot twists courtesy of your own body, trusting the next chapter can be a little difficult. đ
But I also donât want fear of what might happen to steal what is happening.
Today deserves to be lived, too.
đŽâđ¨ Then There Is the Exhaustion Nobody Sees
Sometimes the exhaustion isnât physical.
Sometimes Iâm simply tired of being a patient.
Tired of appointments.
Tired of explaining.
Tired of fighting insurance companies.
Tired of prior authorizations.
Tired of phone calls.
Tired of waiting months to see specialists.
Tired of wondering whether a medication will be approved.
Tired of having to proveâagainâthat something my body needs is medically necessary.
Tired of knowing more medical terminology than I ever wanted to know.
And yes, sometimes Iâm even tired of talking about being sick.
Which is ironic considering I created an entire blog about it. đ
But thatâs the reality.
Advocacy can be empowering while simultaneously being exhausting.
Sometimes I want to advocate.
Sometimes I want someone else to make the phone calls, fight the insurance company, schedule the appointments, and explain my medical history for the 937th time.
Preferably while I take a nap. đ
đ âBut You Look Fineâ
Chronic illness creates another strange emotional experience.
You can look completely fine while your body is fighting a battle nobody around you can see.
So you learn how to function while uncomfortable.
You learn how to smile while exhausted.
You learn how to participate while calculating how much energy you have left.
You learn how to answer, âIâm okay,â when the real answer would require a PowerPoint presentation, three specialists, and approximately 45 minutes. đ
And sometimes being good at functioning becomes its own problem.
Because people see what you can still do and donât always understand what it costs you to do it.
They see the trip.
The dinner.
The workday.
The Disney picture.
The laughter.
They donât necessarily see the recovery afterward.
Both versions are real.
đ The Guilt Nobody Asked For
Then thereâs guilt.
Guilt when you cancel.
Guilt when you need help.
Guilt when someone else has to adjust because your body decided it had other plans.
Guilt when youâre not productive.
And somehow, guilt when you are productive because maybe you should have been resting.
Chronic illness will really have you negotiating with yourself like youâre both management and the employee requesting the accommodation. đ
Eventually, Iâm learning that taking care of myself isnât something that requires an apology.
My body has limitations.
Acknowledging them isnât weakness.
Itâs information.
And I donât owe anyone an apology for responding to what my body is telling me.
đą Mental Health Support Is Part of Chronic Illness Care
We talk so much about treating the body.
What medication are you taking?
What are your numbers?
How are your symptoms?
When is your next infusion?
When is your next appointment?
But somewhere in all those conversations, someone also needs to ask:
How are you doing with all of this?
Not your Crohnâs.
Not your MG.
Not your lab results.
You.
Because there is a human being underneath every diagnosis trying to process what it means to live in a body that can sometimes feel unpredictable.
Mental health support shouldnât be reserved for the moment someone reaches a breaking point.
Support can look different for different peopleâtherapy, a support group, family, friends, community, faith, journaling, or simply having someone you trust enough to tell the truth when they ask how youâre doing.
Sometimes you simply need somewhere safe to say:
This is hard.
Without someone immediately trying to fix it.
Without being told someone else has it worse.
Without being handed another version of âjust stay positive.â
Sometimes acknowledging that something is hard isnât negativity.
Itâs honesty.
đŚ I Can Be Strong and Still Struggle
Thatâs one of the biggest lessons chronic illness continues teaching me.
Strength and struggle are not opposites.
I can be resilient and exhausted.
I can be grateful and frustrated.
I can love my life and miss who I used to be.
I can laugh about my two autoimmune âroommatesâ while occasionally wishing somebody would come evict both of them. đ
I can advocate for myself and sometimes get tired of fighting.
I can have a good day and still have chronic illnesses.
And I can struggle emotionally without that struggle erasing all the progress Iâve made.
Human beings are complicated like that.
Chronic illness didnât take away my ability to experience joy.
But experiencing joy doesnât take away my right to admit when chronic illness is hard.
There is room for both.
đľ Music PlayingâŚ
âHumanâ â Christina Perri
Because maybe the goal isnât to be strong every second of every day.
Maybe sometimes the healthiest thing we can do is remember that underneath the diagnoses, appointments, responsibilities, advocacy, and expectations, weâre still human.
And humans get tired.
Humans get scared.
Humans need help.
Humans need rest.
And humans arenât required to handle everything perfectly.
đ Reflection Corner
Iâve spent years learning how to recognize what my body needs.
Iâm still learning how to give my mind that same attention.
Not every difficult emotion needs to be fixed.
Sometimes it needs to be acknowledged.
Sometimes I donât need someone to remind me how strong I am.
Sometimes I need permission to say:
Iâm tired. This is hard. And today, I donât particularly feel like being inspirational.
Tomorrow I may put my cape back on.
Today?
The cape is in the laundry. đđ
And thatâs okay.
âLiving with chronic illness requires caring for more than the body carrying the diagnosis. The mind carrying the weight deserves care, too.â
đ Mental Health Awareness Doesnât End With October
When October ends and some of the mental-health conversations quiet down, millions of people will still wake up managing bodiesâand mindsâthat require more from them than most people realize.
The emotional impact doesnât disappear on November 1.
Neither should the conversation.
Check on the people who are always âhandling it.â
Check on the caregivers.
Check on the advocates.
Check on the people who make jokes about their illnesses because humor is sometimes how we carry things that would otherwise feel impossibly heavy.
And if youâre the person living it?
Check on you, too.
Your mental health matters when youâre struggling.
It matters when youâre thriving.
It matters during the flare.
It matters during remission.
It matters when youâre scared.
And it matters when everything is going beautifully.
Not for a month.
Not because a calendar told us to talk about it.
365 days a year.
đŹ Your Turn
If you live with chronic illness, what part of the emotional experience do you wish people understood better?
And when was the last time someone asked how you were doingânot your diagnosis, not your symptoms, but you?
Letâs keep having the conversations that donât always fit neatly inside an awareness month. đ
đ Until Next TimeâŚ
If today is a strong day, embrace it.
If today is a hard day, honor that too.
You are more than your diagnoses.
You are more than your symptoms.
And caring for your mental health is part of caring for your whole self.
Keep advocating. Keep learning. Keep listening to your body. And most importantly, keep giving yourself grace. đđŚ
With love, honesty, advocacy, and a little humor,
Kia Lorice
Founder ⢠Author ⢠Advocate ⢠Future Wellness Coach
The Dual Diagnosis Diaries
Where chronic illness meets honesty, resilience, advocacy, and real life.
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