Therapy for Chronic Illness in Teens
Therapy for chronic illness can help with one important layer of living with chronic sickness or chronic pain. Think of chronic illness as having several layers. At the bottom is the underlying medical condition causing the illness, such as POTS or cancer. The second layer is the physical symptoms, which may include dizziness, joint pain, exhaustion, and more. The top layer is where therapy can be especially helpful. This includes the stress, fear, isolation, and emotional struggles that can come from living with a chronic illness.
Your teenager may feel isolated or depressed because their illness has changed what they can do and how they live. They may also become afraid of causing a flare-up or making their symptoms worse by being more active. These emotional parts of chronic illness and chronic pain can take a toll on your teen’s relationships and overall quality of life.
Counseling can be very helpful with this top layer. So, why should you consider therapy if your teen has a chronic illness or pain? Therapy can help reduce isolation, work through fears about relapse or flare-ups, and help your teen stay as active as they safely can. It can also help them find purpose and joy, even when life doesn’t look the way they hoped it would. In other words, some form of counseling or support for chronically ill teens can make a meaningful difference.
An Example Case: Therapy for a Teen with POTS
When someone has a condition like POTS (Postural Orthostatic Tachycardia Syndrome), they may spend a lot of time feeling dizzy. Some people also experience fainting. This can happen when they get too hot, go from lying down to standing, or sometimes without much warning at all. Knowing that you could faint unexpectedly or suddenly feel very dizzy can create a lot of fear.
Several years ago, I saw my first client with POTS. I’m honestly surprised she came to me because at the time I had no experience with chronic illness. In fact, I hadn’t received my own lupus diagnosis (an autoimmune disorder) yet, although I was already not feeling well on a regular basis.
This sweet, gentle, and kind teenager was living with constant anxiety. As we worked together, it became clear that she was extremely afraid of getting dizzy. When she had been at her sickest, the room spun so badly that she didn’t even want to open her eyes. She spent days, and eventually months, in bed.
So, how did therapy for chronic illness help her? She was originally referred to me because I had experience using cognitive behavioral therapy with teenagers. As we worked together, it became clear that she had already done much of the medical work necessary to manage her POTS. What remained was another layer of suffering caused by the fear and anxiety surrounding her symptoms.
Layering for the Teen with POTS
At the root of this particular teen’s struggles was POTS. The second layer was her physical symptoms. She experienced significant brain fog, dizziness, nausea, and occasional fainting. The top layer was her fear of fainting unexpectedly. Over time, that fear grew into a fear of dizziness because, to her, dizziness meant that fainting might be coming next. She developed a great deal of anxiety.
In an effort to avoid fainting, she spent hours lying in bed each day. Over time, she became physically weaker and more socially isolated, which only increased her anxiety. The problem was that anxiety itself causes brain fog and dizziness when it’s intense enough. So how was she supposed to tell which symptoms were caused by POTS and which were caused by anxiety? After attending the Mayo Clinic PRC in Rochester, MN, she came home with a better understanding of how to manage many of her physical symptoms—the middle layer.
She still experienced some dizziness and brain fog related to anxiety. This is where therapy for chronic illness made a significant difference. Using cognitive behavioral therapy methods, she learned to face her fear of dizziness and challenge the anxiety surrounding it. In her case, the Mayo Clinic doctors explained that there wasn’t a direct cure for the underlying condition, POTS, but that it could be managed. Through a lot of hard work, her life improved enough for her to return to school and begin socializing again.
Counseling for Chronic Illness
So, how does therapy help with chronic illness? Counseling isn’t medical healthcare, so it doesn’t treat the root cause of your child’s illness. It also has limited impact on the middle layer—the physical symptoms that you and your teen work to manage through medical care.
However, counseling for chronically ill teens can be very helpful with the top layer. It can help your teen understand when their discomfort may be connected to their physical illness and when stress or anxiety may be making their experience worse. By reducing stress, anxiety, loneliness, and depression, therapy for chronic illness can help bring the overall intensity of suffering down a notch or two.
Support for the Family
The counseling process can also help families who are living alongside someone with chronic pain or illness. As a parent, you have to walk a difficult line. You want to help your teen when they truly need you, but you also don’t want to do things for them that they are capable of doing themselves. If you do too much, your teen may begin to lose confidence in what they can handle. On the other hand, if you expect too much, you may push them beyond what their body can manage.
It can be incredibly difficult to know where that line is. You don’t want to seem unsympathetic, but you also don’t want to unintentionally prevent your teenager from living as fully as possible. Therapy can help you figure out the balance of flexibility, support, and encouragement your chronically ill adolescent needs from you.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT