by Lauren Goodman | Aug 22, 2026 | Therapy for Chronically Ill Teens
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
by Lauren Goodman | Aug 13, 2026 | Therapy for Chronically Ill Teens
What Do Chronically Ill Teens Experience?
If your teenager is living with a chronic illness, you know they may feel different from their peers. The limitations your teen faces are likely different from those of other teenagers, but what teens with chronic illnesses tend to forget is that there are still many experiences they have in common. Every chronically ill teen we’ve worked with at Teen Therapy OC has struggled with feeling “other” or different from their peers. Every young man and woman wants to do what other teens are doing without limitations. CBT for chronically ill teens can help ease some of this emotional pain and help teens regain their joy.
Chronically ill teens need to find a careful balance between doing as much as they can while also knowing when to slow down. If your son or daughter pushes too hard, they may experience a physical setback, which can make them feel even more isolated. If your teenager spends most of their time worrying about how to prevent a flare-up of physical symptoms, their life can become focused on carefully following rules instead of enjoying the moment. CBT can help them combat this.
How Does Cognitive Behavioral Therapy Help Chronically Ill Teens?
Real Life Examples
Cognitive Behavioral Therapy, usually called CBT, helps your child challenge self-imposed emotional and sometimes physical limitations. One chronically ill teenager I worked with developed POTS and EDS at age 16. Before becoming sick, she had been the life of the party, the most energetic, and one of the most athletic people in her friend group. When she could no longer maintain the energy needed to fill those roles, she completely withdrew from her social circle. We used CBT for chronically ill teens to challenge her belief that she was “only a valuable friend if she can entertain everyone.”
Another young woman was dealing with a physical condition that caused dizziness and fainting. Because of this, she developed a fear of going out in public unless she could be seated. I can completely understand how this fear developed; I would be scared too. She eventually underwent treatment that stopped the fainting, but the dizziness continued. Whenever she felt dizzy, she became afraid that she would faint, to the point that she stopped going out with friends altogether. The resulting social isolation became depressing. We used CBT to help her challenge her fear of feeling dizzy. Once she was able to face that fear, she started socializing more, which helped bring more joy back into her life.
CBT Increases Mental Flexibility in Adolescents
CBT can help increase your chronically ill teenager’s mental flexibility. Oftentimes, teens want to do things the same way they did before they became sick. However, that may no longer be possible. Your teenager may need to learn how to participate in activities as much as they can while also being willing to modify them. We challenge all-or-nothing and black-and-white thinking about what life can look like. Your teen can likely do more than they think. In my experience, I rarely see a chronically ill teen who consistently overdoes it. More often, the effort to control flare-ups and difficult symptoms causes teens to pull back farther than necessary.
For example, instead of no longer seeing friends, why not invite them over to watch a movie? There are many ways to participate in an activity without doing everything exactly as you did before. For your teen, partially participating can do a lot to maintain joy, connection, and mental health. When these areas of life improve, your teen may also be more likely to maintain some level of physical activity. This can support their overall health as well.
Chronic Illness and Chronic Pain Aren’t Easy for Teens
At Teen Therapy OC, we know having a chronically ill teen isn’t easy. We know this isn’t what any of you signed up for or how you expected life to go. We agree that it’s hard, and we wish you weren’t facing this. However, learning to first accept what cannot be changed and then find ways to live life as fully as possible may be the best option your teenager has right now. CBT can help with this. Please feel free to reach out with questions. While we don’t pretend to have all the answers, we may have a few ideas that could improve your teen’s quality of life.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT
by Lauren Goodman | Feb 19, 2024 | Therapy for Chronically Ill Teens
Whether your teen is suffering from POTS, cancer, an autoimmune disease, or one of the many other thousands of things that can go wrong with the human body, living with chronic illness is hard. However, there are some things that can help. These include breathing exercises, regular exercise, better sleep, distraction, and proper emotional support. While none of these steps will cure the chronic condition, they are steps that can ease some of the misery.
Physical Ways to Help Teens With Chronic Illness
Breath Techniques
Breathe in deeply. Hold your breath. Breath out slowly. Breathe in deeply. Hold your breath. Breathe out slowly. Controlling breath is one of the relaxation techniques that is helpful for teens with chronic illness and chronic pain. Slowing the heart rate down through concentration on breath control helps lower anxiety. Lower anxiety means a more relaxed body. This usually translates to a reduction in physical suffering.
Imagine breathing calming, healing breath into the area of pain. Picture the breath filling the lungs, exchanging oxygen for carbon dioxide, and adhering to your red blood cells. Picture it moving through your body into to area(s) of discomfort. Imagine the area of discomfort relaxing. Imagine your red blood cells taking the carbon dioxide away from your pain, exchanging in the lungs, and exhaling from the body. With that, picture some of the pain leaving the body too.
Exercise
People with chronic injuries or illness tend to avoid too much physical activity because they fear causing a setback or that it will hurt while exercising. While this is completely understandable, people who push to continue some form of exercise actually usually find that their pain recedes. In some cases it disappears completely. For this reason, try asking your treating physician for a physical therapy referral whenever appropriate. PT helps me manage my lupus symptoms, and I have attended at least a few sessions per year ever since getting diagnosed. Consistent exercise in line with my doctor’s recommendations has also helped control my pain. I hope it can do the same to help your teen living with chronic pain or chronic illness.
Sleep
Most people already know this. However, it cannot be overstated. Protecting sleep is one of the most important things people with chronic illness can do. My rheumatologist told me right from the outset of my lupus treatment that this was the single most important change to make in my life. She said I must lie down for 8 hours per night so that I at least have the chance to get enough sleep. Simply prioritizing getting enough sleep can help alleviate suffering.
Mental Techniques To Help Teens With Chronic Pain and Chronic Illness
Distraction
My aunt just had knee surgery. She has been in considerable pain for the past 4 weeks since the operation. A couple days ago she said to me, “It’s the weirdest thing. When I get on the phone with someone and start chatting, the pain recedes.” That didn’t seem strange to me. The brain is amazing in the ways it focuses. When we are enjoying relationships and conversation, other things fade. When we have something urgent to focus on, we tend to lose sight of everything else. While extreme pain will always cut through to the forefront of your conscience, dull chronic pain can recede somewhat. So, make an effort to help your teen focus on something challenging that isn’t overwhelming. This can actually relieve pain quite a bit.
Emotional Help for Teen With Chronic Disease
Empathy and Understanding
This is where a support group and/or therapy play a huge role! Sitting with someone who understands the frustrations, need for modification in activities, the sadness, and the fatigue that comes with constant suffering and vigilance against suffering is a big deal. Your teenager often feels like the only teen who is living a less carefree life than his or her peers. It gets lonely. Working with someone who understands the feelings that come with chronic pain/illness helps your teen make better choices. Your teenager is more likely to find purpose in the suffering too. According to the National Institute of Health, people who have support from a counselor or peers who really get chronic conditions have better psychological health, shorter healing times, and better preventative behaviors. I would add that it is easier to find meaning in the suffering when talking to others who also understand.
At Teen Therapy OC we are here to help. You are welcome to call or connect with us if your child is living with a chronic condition. Not only do I live with one, our whole team is happy to listen or pray with you as you navigate this extremely challenging journey.
Helping teens grow and families improve connection,
Lauren Goodman, MS, MFT
