Toni Bernhard
4 min readApr 30, 2021

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5 Reasons Why Chronic Pain and Illness Are Such an Energy Drain

I’ve often said that being chronically ill can feel like a full-time job. This is partly because of how exhausting it is to manage it. Here are five reasons why chronic illness is such an energy drain.

#1: We use up energy continually having to weigh the pros and cons of each activity.

The chronically ill spend a good part of most days contemplating this kind of thing: “If I do this, then I can’t do that.” “If I do that then I can’t do this.” Try repeating this over and over, and then follow up by thinking about the consequences of each of those “this’s” and “that’s.” You’ll see how exhausting it is.

#2: We use up energy deciding what we should ask others to help us with.

This is related to #1 in that it takes a similar form. “If I ask for help with this, then I shouldn’t ask for help with that,” etc. Add to this how hard it is for many people — regardless of the state of their health — to ask for help with anything and you can see how exhausting it can be. It’s not surprising that many people who are chronically ill have to push themselves hard to pick up the phone or send a text or email, asking for help with something.

The irony is that, for the most part, the people we’re closest to want us to ask for help. It makes them feel as if they can at least help us out in some way. Unfortunately, this culture teaches us that asking for help is a sign of weakness. Even after 20 years of illness, I still have traces of that in my mind even though I know it’s a sign of strength to ask for help — strength in the sense that it’s self-compassion in action.

#3: We use up energy figuring out how much to share with others.

This may seem like a minor thing, but for many of us it’s not. If we share too much, it could drive friends and family away, but if we share too little, they may feel left out of our lives. This is particularly exhausting because it’s not a “one size fits all” matter. With each person in our lives, we have to assess what level of involvement they want with our health problems. It’s exhausting having to figure out how to keep relationships thriving with friends and family.

As an example (separate from my ongoing chronic pain and illness) when I had breast cancer surgery in 2014, some of my friends and family wanted to know every detail of the diagnosis, the surgery, and the post-treatment protocol. Others only wanted to know that I’d come through it well. I want to keep all my relationships in as good a state as I can. This requires that I try to get that level of detail right, and that mental activity is exhausting. And… if I don’t get it right, I’ve learned not to blame myself. I did my best and that’s all I can ask of myself.

#4: We use up energy deciding what treatments to try.

I’ll use chronic pain as an example. Do we tough it out? Do we ask for pain killers even though they can make us groggy and run the risk of dependency? Do we try mindfulness meditation aimed at pain relief? Not a day goes by that my mind isn’t ruminating upon some treatment option, going through the pros and cons, trying to make a decision that’s best for me. Just writing that last sentence triggered the exhaustion that this mental activity gives rise to.

#5: We use up energy deciding how to use up what little energy we have!

This may sound absurd, but it’s not. Should I use that little bit of energy to do some much-needed task around the house, or should I use it to do something that’s fun and fulfilling? I’m amazed at how I can actually use up some of that precious energy going back and forth over exactly how to use it until, once I’ve decided, my “energy battery” has drained itself too low to do anything. I hope you don’t do this too!

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I still haven’t always found a way to keep from using up the energy that’s left over from the actual pain and illness I live with every day. However, I have found a friend to help me navigate these choppy waters: self-compassion. Self-compassion simply means being nice to yourself. It also means not engaging in self-blame. Everyone makes the wrong choices at times. Why should you be any different? Learn from your mistakes and then move on.

Consciously evoking compassion for yourself communicates to you on the deepest level that you care about your suffering and about how hard life is for you sometimes. We control so little in this life, but how we treat ourselves is one thing we can control. Always be kind to yourself.

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Toni Bernhard

Toni Bernhard is the author of “How to Be Sick,” “How to Wake Up,” and “How to Live Well with Chronic Pain and Illness.”