by Kate Walford
I have several chronic conditions. I’ve known that I suffered from depression since I was about 19 years old, and began taking antidepressants. In 2017, I was diagnosed with both IBS and ADHD. IBS was not a huge shock—I’ve struggled with stomach issues for years now. ADHD, on the other hand, was pretty surprising. The entire process of diagnosis and then explaining it to friends and family was both lengthy and agonizing.
Receiving these diagnoses was in part an enormous relief as they provided me with a lot of answers. I no longer feel the need to beat myself up for losing my belongings, starting a new project every week that will never, ever be finished, or being unable to remember the plot points of the Game of Thrones episode that I had just watched five minutes ago! And I finally have a name for what caused seemingly inexplicable bouts of what felt like the stomach flu. A diagnosis doesn’t make these symptoms go away, but for me it eased the distress that accompanied them.
Up until this year, I always considered myself “young and healthy”, as many like to proclaim at my age (25). But amidst countless doctor’s visits for diagnoses, prescription management, and counseling, I started to feel different. Most of my peers rarely visit the doctor. In fact, countless young people have proclaimed to me over the years, “I never go to the doctor!” As if this in and of itself is something to be proud of.
Close your eyes and picture “healthy”. For me, I see a thin, white woman wearing athletic clothes who is exercising and eating yogurt. I kid you not! My vision is that specific. We associate a lot of things with health that aren’t actual indicators of well-being, such as appearance, including skin color, size, and shape. In my personal experience, growing up in Western society also taught me that “health” indicated some sort of absence of problems—especially chronic ones. And in the slightly alternative “hippie” environment where I was raised, the definition of health also meant there was an absence of medication taken (read why I think this is so problematic here). I suddenly felt on the margins of “healthy” once I started spending time, energy, and money on maintaining myself physically and mentally through the medical care system.
So, what does “health” really mean? I took to Google to find out what some of the standard definitions are:
- Merriam-Webster defines health pretty statically: the condition of being sound in body, mind, or spirit; especially freedom from physical disease or pain
- Collin’s Dictionary provides a few definitions, including: a person’s health is the condition of their body and the extent to which it is free from illness or is able to resist illness; physical and mental well-being; freedom from disease, pain, or defect; normalcy of physical and mental functions; soundness
- The World Health Organization provides a slightly more balanced definition: health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
- Wikipedia, interestingly enough, was the first place I found a slightly different and more inclusive definition of health: health is the level of functional and metabolic efficiency of a living organism. In humans it is the ability of individuals or communities to adapt and self-manage when facing physical, mental, psychological and social changes with environment.
Interestingly, the Wikipedia definition of health was developed out of a 2011 article in BMJ by Margaret Huber and colleagues calling for a new definition of health that takes into account chronic disease. Aside from this last definition, all of the others leave out anyone with a chronic condition. According to some of these standard definitions, if you’re not perfectly “normal” (whatever that is, anyways), you can’t achieve a state of actual health. Also, if you have any sort of illness or aren’t able to resist illness, health is not achievable. So, I thought, I’ll never be healthy!
I appreciate the definition found on Wikipedia and drawn from Margaret Huber and colleagues’ suggestion that health is an ability to adapt, rather than a static state of perfect well-being. They discuss defining health differently than the World Health Organization, which “declares people with chronic diseases and disabilities definitively ill” (Huber et al 2011) and puts an immeasurable burden of “completeness” on health.
Taking a more fluid and adaptable approach to determining health, people who have chronic illnesses can be healthy. And having this mindset really helps. I’ve learned to be more flexible when it comes to thinking about my health. It’s very easy to take severe stomach pains or a complete inability to focus on what a person is saying as a negative blow to my health and conceptions of it (and feel like an “unhealthy” mess because of these symptoms). However, what makes me feel healthy is how I respond to these symptoms, rather than the fact that I simply experience them. “Healthy” is taking a few minutes out of my day to chew Pepto and sip peppermint tea even when I feel too busy to take a break. It’s also making an appointment with my doctor when I feel like one of my medications isn’t working.
An integral part to feeling healthy for me personally is also accepting these conditions and even identifying with them. Rather than trying to achieve some pinnacle of health and wellness, accepting my limitations as a part of me allows me to take on my own definition. Instead of trying to skirt around the topic of my illness or hide symptoms, I’ve gotten into the habit of speaking honestly about it, and explaining to those close to me how I feel and the treatments I use. I also remind myself that it’s not my job to live up to anyone else’s definition of how my body should function—which has helped me to feel a lot less shame around being someone with chronic illness.
Thinking about health in a more flexible and personal way has helped me to feel more confident and less down about having chronic health issues. A focus on adaptability rather than the complete banishment of difference, disorder, or disease allows me to have a measure of heath that I can actually achieve. Accepting these conditions as a part of who I am, being open and honest about them, and tuning out the noise about notions of “perfect health” all around me are the best strategies that I’ve come across. I hope that reframing health as a flexible and personal concept can help us move towards a more inclusive definition, which allows all people with chronic disease or disability to attain what health means to them.