Running with a Chronic Illness Ep. 2: The Mental Games We (Need to) Play

In episode one, we focused on the physiological side of running with a chronic illness. Today, let’s discuss the psychological implications, including motivation strategies, expectations, and the double-edged sword that can be resilience.

Hello, my name is Pav, and I live and run with several chronic illnesses. Let’s continue our journey of the what and how of running with a chronic illness, focusing on the mental games we sometimes need to play.

(Disclaimer: I’m not a health care professional. The following information is compiled from peer-reviewed research and personal experience. Always listen to your body and check with your healthcare provider before starting a new exercise regime.)

Three years ago, I was in the middle of my Saturday long run. The sun was shining and I’d just met a guy in flip flops riding his bike through the middle of nowhere to go swimming in a little pond in the woods. He had given me an apple and a few encouraging words before he rode off. All in all, it was a perfect day, a perfect meeting, and a perfect time to be alive and running. I, however was struggling and had been for a couple of hours.

The struggle wasn’t physical; it was all in my head. And, for the first time ever, I didn’t come out of the struggle victorious. A few miles later, I was picked up and driven home; I couldn’t imagine taking another step. That was the first time I lost my battle with the psychological impacts of running with a chronic illness.

Written and edited by Pavlína Marek

Living with a chronic illness often presents unique challenges that can significantly influence one’s mental well-being. For runners, these challenges are twofold—affecting both their daily lives and their athletic pursuits. Chronic conditions often bring about feelings of frustration, anxiety, or depression due to persistent symptoms and limitations they impose on physical capabilities. When you understand these impacts, you can develop tailored motivation strategies that cater to the unique challenges faced by chronically ill runners.

Motivation Strategies for Chronically Ill Runners

Maintaining motivation is essential for all runners, and especially those of managing chronic illnesses.

  • Routine Flexibility: Allow room for modifications in training plans based on daily physical health fluctuations. (Find a coach who can do this; different coaches have different methods.)
  • Inspirational Role Models: Following stories of other chronically ill athletes who have succeeded in their athletic endeavors can serve as powerful motivators. If you’re anything like me, a healthy person simply saying, “It will be okay,” will only get your blood boiling.
  • Good Ole’ Bribery: Simply bribe yourself to do it. Have a reward waiting at you at home. Stop by your favorite café to buy that absolutely heavenly cake you love so much. Treat yourself. I’m sure you probably don’t need me to say this but really, you live only once. I got sick despite living a very healthy lifestyle. Now I treat myself to cake because it won’t worsen my health but will improve my life by multitudes.
These strategies will help you stay committed to your (running) goals, even when faced with mental challenges. (Self-bribery also works great when you have to go for yet another medical check-up but you really don’t want to pick up the phone and schedule that appointment.)

The Dual Influence: Chronic Illness and Sports

I must be completely honest: motivation strategies won’t work every time. Their more reliant sibling, persistence or downright pigheadedness, got me through more dark places. However, everything has its limits. Back when I was in the middle of my long run, I had already implemented several of my strategies; in the end, I had to admit it really wasn’t my day.

It took me several months to stop beating myself up over that run; I had always priced myself on not stopping, on always pushing through. However, over time, I learned one crucial piece of information; whatever stuff you may hear on the internet and even in some books, sometimes, taking a step back is the hardest—and most important—decision you can make.

When engaging in sports like running, those of us with chronic illnesses will often face additional mental roadblocks stemming from our conditions. However, participating in sports can also offer profound psychological benefits. Running, for instance, releases endorphins—often referred to as “happy hormones”—which can alleviate stress and improve mood.

Setting Realistic Expectations and Celebrating Small Achievements

One effective strategy and perhaps the most crucial one is setting realistic expectations. By doing so, you can avoid the pitfall of comparing yourself to your healthier counterparts. Celebrating small victories—whether it’s completing a short run without pain or maintaining consistency over time—can foster a positive mindset. These incremental achievements build confidence and encourage continued commitment to running despite the hurdles posed by a chronic illness.

Coping Mechanisms for Mental Resilience

Incorporating specific coping mechanisms can significantly bolster mental resilience.

  • Mindfulness: Practicing mindfulness can help you stay present and reduces negative thought patterns. Techniques such as meditation or deep-breathing exercises can be particularly beneficial before or after runs.
  • Positive Self-talk: Replacing self-critical thoughts with affirmations can really empower you. (During my doomed run, I was simply unable to come up with any positive affirmations. Have them prepared and written down beforehand; that’s what saved my next difficult run and I ended up doing extra miles!) Many online self-help resources will suggest language like “I am capable” or “Every step counts” to reinforce self-belief. I say, create your own. These two do nothing for me, however, hearing elite Navajo ultra runner Shaun Martin’s view on running as a form of prayer will save almost any run, no matter how bad.

To remain perfectly, honest, I must admit that positive self-talk and mindfulness can only go so far. When the pain is simply too much, your heart doesn’t allow you to run as far or as hard as you once could or as you’d like, or the brain decides to spiral into depression, going over all the ways it’s all so unfair, one often can’t simply talk their way out of it.

However, these practices have the ability to enhance your running experience and make it more fulfilling and empowering.

The Double-Edged Sword of Resilience

Resilience is a remarkable trait that helps individuals bounce back from adversity and continue moving forward despite challenges. In the context of chronic illness, resilience becomes both a shield and a burden. While it empowers patients to persevere through difficult symptoms and setbacks, it can sometimes lead to pushing beyond healthy limits.

This delicate balance requires careful navigation, as the same determination that helps overcome obstacles might occasionally need tempering with self-compassion and wisdom. Years ago, my college advisor made me realize that resilience was one of my strengths. Only now, sitting at my laptop, awaiting surgery, and writing this piece, I have realized it can be a double-edged sword.

The Importance of Knowing You Can Trust Your Decisions

I still love my resilience. It had allowed me to achieve things that wouldn’t have been possible otherwise. It can be exhilarating. When things go south during an ultra (or any run or race for that matter), I still love putting my earphones in and riding into battle against the elements and everything that tells me to stop and go watch a movie like normal people do on a rainy night instead. But I have learned to take care of my soldiers—my body and mind.

When my heart is doing weird things and I can’t breathe properly, I may want to keep going. However, I now know it can be dangerous. I have learned that I can (and should) slow down or stop. And I did.

During one of my dream races in Slovenia, I had to give up the race. It was bitter. But through doing so, I have learned that I can trust myself to make these difficult decisions. And thanks to that trust, I can take on other, bigger adventures—because I know that if I have to stop, I won’t my perceived resilience, my pride, force me to keep going through a dangerous situation. I will live to run another day.

Building a Support System as a Chronically Ill Runner

A robust support system plays an indispensable role in helping those with chronic conditions excel in their running journey. Even before I knew I had health issues that prevented me from getting better, my running friends back in California always stuck with me.

I owe my diagnosis to one of them who suggested, after I had suffered up a mild hill one day, that it can’t be normal; I trained much more than him, could go much farther, yet he could run up that hill like nothing while I barely made it to the top, gasping for air. He was the one who told me to get my heart checked out. Combined with strange states I began to experience around that time, I took his advice to heart. (Ha, get it?)

  • Family and Friends: Having loved ones who understand the struggles associated with a chronic illness is crucial. It provides emotional comfort and encouragement. Not everybody will understand the true emotional turmoil that can accompany an unfinished run cut short by your illness. However, those who do, can be of true help.
  • Fellow Runners: Engaging with other runners who share similar experiences or at least understand your struggles fosters camaraderie and mutual support. Find running friends like this. After living away from mine for three years, I can tell you, it’s crucial for both your physical and mental health.

The psychological journey of running with a chronic illness is intricate yet rewarding. By embracing motivational strategies, utilizing coping mechanisms, and building strong support networks, chronically ill runners can transform challenges into opportunities for growth and fulfillment.

Conclusion

Navigating the world of running with a chronic illness requires a delicate balance between understanding both physiological and psychological facets. Running with a chronic illness can be uniquely challenging, yet it also opens doors to personal growth, resilience, and fulfillment.

Embracing the physiological aspects involves acknowledging the body’s limitations while leveraging the benefits of regular exercise. Exercise helps improve physical health, boosts mood, and enhances the overall quality of life for those living with chronic conditions. Remember to consult healthcare professionals who understand your specific needs to tailor an exercise regimen that ensures safety and efficacy.

Two athletes rest on the running track during their taper

On the psychological front, mental fortitude plays a crucial role. Chronic illnesses often present emotional hurdles that can impact motivation and self-esteem. However, developing tailored motivation strategies aids in overcoming these barriers, allowing for a rewarding running experience. Establishing a strong support system made up of family, friends, and fellow runners can provide invaluable encouragement and understanding.

Pursuing your passion for running despite having a chronic illness is not only possible but can also be incredibly enriching when approached with awareness and preparedness. As you continue this journey, take pride in each step forward—your resilience is a testament to the power of determination and hope. I’ll be cheering you on, whether it is from the sidelines of a hospital bed or out there on the course.

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