Self Esteem, Body Image, and Chronic Illness – by Ashley Boynes-Shuck


Many of us who live with chronic illness – especially rheumatic and autoimmune illnesses, or conditions that cause chronic pain – can get frustrated at our body at times for seemingly working against us.

However, there are other body issues that can come along with being chronically ill.

Many medications cause appearance-related side effects: skin problems or rashes; hair loss or thinning; puffy face; weight gain; weight loss; and so on.  Additionally, some of these diseases, like rheumatoid arthritis, psoriasis, or lupus, for example, can cause symptoms that are visible to the naked eye and that range from joint deformity and swelling to lesions or skin problems and beyond. (I personally have been really struggling with gaining 20+ lbs from a medication, plus hair thinning, and more. For someone who is admittedly a little vain, these kinds of side effects can be a major downer!)

Additionally, there is a strong link between chronic illness and other conditions such as anxiety, depression, or OCD. Body dysmorphic disorder can come along with these types of conditions, as well.

So, how can we prevent getting down on ourselves? How can we boost our self-esteem, even if we have a love-hate relationship with our body?

Here are a few ideas:

  • Exercise – I know, I know – many of us get sick of hearing about the importance of physical activity, because it does, at times, seem impossible. The truth is, for the majority of people, it’s NOT impossible. It IS hard, though. But, you don’t have to “work out” hardcore — even a short walk or simple stretching will do. Exercise is proven to release “feel good” endorphins and those who work out have better self image than those who do not. It’s a great confidence builder! So, if you’re in a funk — get moving! You may even end up appreciating the physical results of regular exercise, too!
  • Positive self-talk & affirmations – Look in the mirror and tell yourself one thing you love about yourself, each and every day. You can also use this method to practice affirmations. Some examples? “I am not perfect, but nobody is. I accept and love my imperfections” or “I’m beautiful, outside and within. My inner beauty shines through” or simply, “I am grateful, I am loved.” It may seem “crazy” to talk to yourself, but by repeating these important mantras on a daily basis, you can really drive your point home — and your self-esteem will soar!
  • Dress for success – Clothes aren’t everything; and neither are looks. But, even if you don’t work or are at home all day long, there’s no need to spend your entire day in pajamas. Sure, we’re all entitled to those kinds of days, but, you should “get dressed” more often than not. Getting out of “schlumpadinka” mode will help you feel better about yourself — and others, even if it is your kids or spouse — will see your confidence shine through. A shower, some lip gloss, or even just changing your clothes will do – you want to send a message that YOU care about you. If you don’t, who will?
  • Good Posture – Sounds silly, right? But, the way a person carries herself tells a story. By practicing good posture, you’ll automatically feel more confident and powerful. Stand up straight, keep your head up, and make eye contact. You’ll make a positive impression on others and maybe even feel more alert. Granted, conditions like RA can take a toll on our posture, and some can’t help but slouch. But, like anything, it’s about doing the best YOU personally can. It may not look like someone else’s version of “sitting up straight” but good posture — or, your best posture — will send a good message about your self-value AND is vital for back and neck health!
  • Practice Gratitude! – Keep a daily gratitude journal. Or, if that is too much, start small and try it weekly. When you focus too much on what you want, the mind creates reasons why you can’t have it. This leads you to dwell on your weaknesses and shortcomings. So, the best way to avoid this is consciously focusing on gratitude. Be thankful for what you DO have instead of just focusing on what you don’t have, or all the things you want. By listing what you are grateful for in life, you’ll be realize how much you have going for you, even in spite of being chronically ill.
  • Give! – Donate your time or your money. Volunteer or get behind a cause. Practice small acts of kindly daily. Too often we focus too much on ourselves and not enough on the needs of other people. If you stop thinking about yourself all the time, you won’t worry as much about you own flaws.
  • Eat Healthfully – Eat for your health, don’t eat just to eat. Put good, real food into your body. Eschew processed junk and overly sugary foods. Love your body, and be mindful of what you put into it. It is just one more way to be kind to yourself — and you may even feel better, too!
  • Identify the Problem – The Mayo Clinic says that many self-esteem issues and self-image problems arise from a certain catalyst or troubling situation. Is it an illness? Or was it something from your past that led you to feel poorly about yourself? The first step to solving a problem is identifying the root of the problem.
In fact, Mayo Clinic has a great list of even more ways to combat poor self-image, below.

Pay attention to these thought patterns that lead to low self esteem and poor body image:

  • All-or-nothing thinking. You see things as either all good or all bad. For example, “If I don’t succeed in this task, I’m a total failure.” (Another one that I see a lot? “I’m sick, so I can’t be happy.” NOT TRUE!)
  • Mental filtering. You see only negatives and dwell on them, distorting your view of a person or situation. For example, “I made a mistake on that report and now everyone will realize I’m not up to this job.”
  • Converting positives into negatives. You reject your achievements and other positive experiences by insisting that they don’t count. For example, “I only did well on that test because it was so easy.”
  • Jumping to negative conclusions. You reach a negative conclusion when little or no evidence supports it. For example, “My friend hasn’t replied to my email, so I must have done something to make her angry.” (This type of thinking can lead to social anxiety and even eventually paranoia!)
  • Mistaking feelings for facts. You confuse feelings or beliefs with facts. For example, “I feel like a failure, so I must be a failure.”
  • Self put-downs. You undervalue yourself, put yourself down or use self-deprecating humor. This can result from overreacting to a situation, such as making a mistake. For example, “I don’t deserve anything better.”
Now, Mayo Clinic says, replace these negative or inaccurate thoughts with accurate, constructive thoughts. Try these strategies:
  • Use hopeful statements. Treat yourself with kindness and encouragement. Pessimism can be a self-fulfilling prophecy. For example, if you think your presentation isn’t going to go well, you might indeed stumble through it. Try telling yourself things such as, “Even though it’s tough, I can handle this situation.”
  • Forgive yourself. Everyone makes mistakes or has flaws — and mistakes  aren’t permanent reflections on you as a person. They’re isolated moments in time. Tell yourself, “I made a mistake, but that doesn’t make me a bad person.”
  • Avoid ‘should’ and ‘must’ statements. If you find that your thoughts are full of these words, you might be putting unreasonable demands on yourself — or on others. Removing these words from your thoughts can lead to more realistic expectations.
  • Focus on the positive. Think about the good parts of your life. Remind yourself of things that have gone well recently. Consider the skills you’ve used to cope with challenging situations.
  • Relabel upsetting thoughts. You don’t need to react negatively to negative thoughts. Instead, think of negative thoughts as signals to try new, healthy patterns. Ask yourself, “What can I think and do to make this less stressful?”
  • Encourage yourself. Give yourself credit for making positive changes. For example, “My presentation might not have been perfect, but my colleagues asked questions and remained engaged — which means that I accomplished my goal.”  (Or, “My life is harder than some people’s because I am chronically ill, but I do pretty well given the cards I’ve been dealt!”)

These steps might seem awkward at first, but they’ll get easier with practice.

It sure is hard at times to love a body that at time seems to hate us — and it sure can get ugly (pardon the pun!) dealing with side effects from medications, there’s no doubt about that. However, having the tools to deal with negative thoughts about ourselves is a great step in the right direction.

Of course, a positive self-image will not be a magic wand to make our health problems go away. That’s just unrealistic. Positivity isn’t a “cure” but it certainly can’t hurt. It can ONLY HELP!

So, let’s try to flourish and try not to wallow! If we pity ourselves, we’re asking for pity. If we love ourselves, we’re asking for love. If we think like a winner, we are a winner — sick or not! You are beautiful, so embrace it!

Some great resources for dealing with body image issues include OnePinky.com, Women’s Health, The Real You Nutrition, Greatist, the Daily Love, and Oprah.com. Additionally, if you or someone you know as an eating disorder or a condition like body dysmorphic disorder, some great resources include: Love is Louder, The OCD Center of Los Angeles, Healthy Place, National Eating Disorders Association, and NIMH Eating Disorders Page.


Stay Well,

Ashley Boynes-Shuck

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3 thoughts on “Self Esteem, Body Image, and Chronic Illness – by Ashley Boynes-Shuck

  1. This is really good advice. It is so hard to like yourself when you’re chronically ill and in pain. How can you appreciate a body that doesn’t even perform basic functions correctly? It’s especially upsetting when you know that you have the aptittude and intelligence to achieve more, but your body’s limitations hold you back. I definitely feel the need to overcompensate for my body’s weaknesses…which often just leaves me feeling frustrated. On a more superficial note, the physical changes that illness have caused kind of make me sick. Between illness and a poor college student diet, I’ve gained about 40lbs. Now, I can’t do the high impact exercise that I enjoyed and kept me fit. Although there are modified workouts I could do, it makes be so mad that I have to resort to low impact workouts designed for seniors at my young age–I definitely suffer from an all-or-nothing attitude. It’s only been about four years since I started this chronically ill journey, so I guess I just need more time to get to a more balanced place and have a healthy self-image.

  2. Pingback: Fashion: The Enemy of Arthritis Patients? – by Ashley Boynes-Shuck « Wellness With a Side of Life, Please

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