Coping Strategies For Inflammatory Bowel Disease (IBD)

Much of what occurs in the course of living with IBD is not precisely under your control. Try to focus your attention on the things that you can control and use these to your advantage. Your own individual style of relating to yourself and to others may have a big influence on how you experience disease. So, it is helpful to know your behavioral style and how it may affect your experience of IBD.

 

 

One useful way of describing personal style is to look at how you prefer to relate to the people who are closest to you at times of stress. Do you look for the company of your partner or family members to talk things through and to feel supported? Do you depend on others to care for you when you are feeling overwhelmed? Do you find that you want to retreat from others and handle things alone?

 

People differ in the way they use close relationships to feel comfortable and secure at times of stress, and these differences have an impact on medical care. The impact of interpersonal style on medical care has received careful study in the last few years. Bear in mind that many things in addition to interpersonal style determine health outcomes.

 

 

The adaptable style is usually associated with relative ease in using medical resources because people with this style tend to be comfortable with independence and comfortable with depending on others. Adaptable individuals are usually comfortable monitoring their situation independently and making their own health choices. They are also able turn to others for assistance when the situation demands.

 

 

People with the support-seeking style are more comfortable and may function more effectively when the people they count upon for support are near. People with a support-seeking style, who have very supportive people in their life, look and act very similarly to people with an adaptable style. However, without good support from others, a person with a support-seeking style may be troubled by worry and negative feelings.

 

In general, the support-seeking style is associated with reporting more intense symptoms and reporting a greater number of symptoms (including ones that aren't typical for IBD or due to IBD). The support-seeking style is associated with more frequent visits to the doctor, and more tests. This may relate to a greater need for reassurance from others in order to feel comfortable. When IBD is active, the support-seeking style is associated with a higher risk of depression. Doctors of support-seeking patients find it easier to appreciate the significance of the changes in the course of IBD when they have known each other long enough for the doctor to recognize the patient's style of communication. Otherwise, there is a risk of overestimating the current level or severity of disease activity.

 

 

The self-reliant style is characterized by the lowest levels of symptom reporting. Visits to the doctor are infrequent. When it comes to one's health, a self-reliant interpersonal style may be a positive or a negative influence.

 

When managing diseases that require a great deal of collaboration between patients and health-care professionals, a self-reliant style can interfere, especially when patients do not disclose the whole picture of their current state or when a lack of collaboration is frustrating for the patient or the health-care provider. Doctors may need to schedule regular visits or tests rather than wait for a self-reliant patient to decide it is time to check in.

 

 

The cautious style includes a push-and-pull when it comes to dealing with others, which can be tricky to balance in a medical setting. When a level of discomfort in managing things on one's own is combined with cautiousness about being willing to approach others or depend on them for help, a person with the cautious style may sometimes feel stuck.

 

These people are similar to self-reliant people in their relative underutilization of medical resources (preferring, for example, not to go to the doctor if it can be avoided), but are like people with a support-seeking style in their relatively greater experience of symptoms. If the situation calls for trying to overcome cautiousness, many people find it easiest to do this by finding one or two close confidants and relying on them to help with the challenges involved in being ill.

 

 

A second way of understanding your behavioral style is to pay attention to how much information you like to have about your health. There is no right or wrong approach, but there are two main styles of collecting information, known to some psychologists as monitors or blunters. It helps to know your information gathering style because most of the time you will be most comfortable if you stick to your own style. It is also helpful to be aware of the ways in which these styles may lead to trouble if you overdo it.

 

 

Some people feel most comfortable when they know everything. They prefer to monitor small changes in how they are feeling. They like to get opinions about what may be going on and what all the options are to treat their illness. Monitors often spend time on the Internet keeping up on the latest developments and researching all aspects of their medications. Monitors often find that it is comforting to gather more information (even if they don't end up acting on it).

 

 

Other people only want information on a need-to-know basis. Blunters are often content to let their health-care providers recommend choices and don't want to know all of the details behind each choice. They may find that gathering extra information is anxiety-provoking rather than comforting. "Why should I hear about all of the things that might happen in the future? I'd rather just deal with things as they come up" is something that a blunter might say.

 

 

Often people respond to challenges that feel within their grasp through problem-solving and persistence, but respond to circumstances that are beyond their personal resources with emotional distress — feelings of grief, panic, or giving up. These are normal responses to extraordinary circumstances and shouldn't be interpreted as a sign of personal weakness or failure.

 

When stress feels like it is passing beyond your comfort zone, it is time to step back and reassess your options. Review the situation to see if the problem-solving strategies and helpful attitudes that usually work for you might work in this situation as well. Consider new ways of coping. For example, if you are a person who usually perseveres through trouble with a stiff upper lip, maybe now is time to consider allowing yourself a breather and asking for help. In general, when stress crosses beyond the limits of your comfort zone, it is a good idea to consider allowing others to help.

 

 

Often at times of crisis, it is very helpful to call upon the support of others, including family and friends who can offer practical support and can 'be there for you' emotionally as good listeners. Moral support and practical help are usually more valuable than free advice. Professionals may be able to offer treatment and management options that have not been considered, which may also help to move illness challenges back into the realm where they feel manageable again.

 

 

You have many resources to draw upon to help you with the challenges of illness, including your family and friends, healthcare professionals, peer-support groups, and your community. Sometimes you may want to turn to others, but you experience obstacles. Pay attention to these obstacles to see what is within your control. If you feel that you cannot turn to others for support, ask yourself why. Why are you reluctant to depend on someone else? Do you feel guilty burdening them? Were you disappointed in how they responded in the past? Many people face challenges of this kind, especially with partners, close friends, and family. You probably need to identify the type of obstacle you are experiencing before you can overcome it.

 

 

Clear communication is often your most powerful tool. It helps you to sort the real differences in opinion and conflicts that you experience with others from the ones that are based on your assumptions and expectations. Clear communication may also help to change a conflict that feels irremediable ("You always avoid me when I am in pain. I think you are insensitive…") to a problem that can be negotiated ("I want to help you but I don't know how. When you are in pain, you stop talking and I feel powerless to help…").

 

 

 

There are several organizations in North America that, in addition to raising money for research, also provide education and support to patients and families. Two such organizations are the Crohn's and Colitis Foundation of Canada (CCFC) and the Crohn's and Colitis Foundation of America (CCFA). Although the national offices of these organizations may not provide individuals with the type of small group support and personal contact that they are looking for, the local chapters are often a good way to network with other patients and families dealing with IBD.

 

 

The availability of other community support varies from location to location, but many patients and families turn to the Internet, where there are numerous means of communication with other individuals who are in situations similar to your own. However, you should be careful about the quality of the information and support that you might find in places like Internet chat rooms. Typically these are not monitored by someone with the necessary expertise who can put the information and opinions provided into proper perspective or context. If you hear or read something unusual, something disturbing, or something that just doesn't seem right, you should discuss it with your doctor.

 

In addition, remember that, although IBD is considered to be a single group of diseases, its presentation and response to treatment can be completely different from one person to the next. As a result, what one person experienced or a treatment that helped someone may not necessarily apply to you. These Internet sites do provide an opportunity for you to discuss your thoughts, feelings, and hopes with others, particularly if you find it difficult to do so face to face. The responses that you get may not always make you feel better, but, in many cases, people are able to find some comfort in describing their situation and knowing that there are others in similar situations.