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Mentally Coming to Terms with Having a Chronic or Terminal Illness

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Deathing with one’s death is something that almost everyone will have to come to terms with eventually. However, the knowledge that one’s life will be ending imminently is difficult knowledge that weighs heavily on the mind of people facing a terminal diagnosis. 

While dealing with death will never be easy, there are steps you can take that will make the experience a little bit more comfortable for you and your loved ones. In this article, we look at a few steps you can take to come to terms with the mental effects of a terminal diagnosis. 

Understand the mental process of dealing with grief

Accepting the terms of a terminal illness follows many of the same patterns observed in other forms of grief. Of course, everyone experiences the process of a chronic or terminal illness diagnosis a little bit differently. However, there are common experiences that may help you contextualise and process your illness. 

Risk factors

It’s not only the illness or chronic condition itself that contributes to a fragile mental state of mind. There is, of course, a significant psychological burden that comes from knowing that you are suffering from a condition that will never improve. 

However, it’s worth keeping in mind that that is just the tip of the iceberg for many people. Treatment methods can be just as worn on a person’s mental state. Chemotherapy involves constant exposure to concentrated doses of poison. 

In fact, many of the symptoms that are consistently associated with cancer (pain, nausea, etc.) are actually caused by the chemo. When terminal patients get off chemo, they often start to feel a little bit better-not because their disease has abated but because they are no longer dripping harmful chemicals into their bodies. 

The same can be said for dialysis, or even for the side effects that are associated with rheumatoid arthritis medications. 

When talking about one’s mindset, it’s important to keep in mind that physical discomfort can be just as difficult to deal with as thoughts of one’s mortality. In fact, many feel that it is even worse to live in a reduced state, still alive but no longer able to participate in life the way that they once did. 

Anxiety

After getting a cancer diagnosis, around 40% of people report experiencing high levels of stress and anxiety that manifest themselves in the form of panic attacks. Anxiety currently ranks among the most common causes of psychiatric treatment amongst the terminally ill. 

Studies have shown that anxiety levels are often influenced by the type of care a person is receiving. Surprisingly, more invasive treatment methods (chemo, for example) are consistently associated with higher levels of anxiety than end-of-life/palliative care treatment. 

Depression

It is believed that almost 80% of people with a terminal illness diagnosis experience heightened levels of depression. Chronic pain conditions have been shown to produce similar rates of depression. Interestingly, however, depression levels are not necessarily associated with the probability of survival. While about 40% of people experience depression after giving up on chemo,  the figure pales compared to the 60% of people who suffer from depression after a heart attack. 

Though this may seem unusual it tracks with other research that suggests a reduced capacity for the experience or usual activity is more emotionally challenging for people than grappling with death. 

Coming to terms with a terminal illness

Now that you understand what hazards might be lurking ahead, it’s important to understand how you can navigate them. While dealing with a terminal illness is difficult, it is an experience that almost 3/4ths of people will deal with at the end of their lives.

Below, we include a few steps you can take to deal with a terminal illness diagnosis. 

Equip yourself with knowledge

Mysterious things tend to be a lot scarier than things you understand. When researching a terminal illness, the goal is not necessarily to find a way out. You can, and possibly should, explore different treatment options that could extend your life or improve the comfort of your care. Patients often have to be their own advocates, and the more you know the better equipped you will be to fulfil that role. 

Your broader goal should be to understand what to expect. Knowledge is power, and knowing what experiences await you can help you to mentally prepare for them, and even to adjust your lifestyle to meet them on your own terms. 

Speak freely

Watching your loved ones deal with your terminal illness can be almost as difficult as living with it yourself. While you might feel tempted to suppress conversations about the disease for other people’s benefit, doing so puts the burden solely on your shoulders. 

It also doesn’t do them any favours. Keep in mind that they are going through a similar mental experience as you. They may not be worrying about their own end-of-life choices, but they are grappling with stress, anxiety, and depression. 

Speaking freely about uncomfortable topics is hard, but it can take some of their power away. Speak with your loved ones about things that are weighing on your mind. It may help you feel better, and it can also be beneficial for them. 

Plan your death

Planning one’s death is, in a way, something of a unique privilege. With the burden of knowing that you will die comes the opportunity to dictate the terms. You may be able to decide on conditions that will make the experience comfortable and even get to include loved ones in a way that feels appropriate and comforting. 

Knowing how things will go at the end may ease some of your emotional discomforts. It can also take the burden off your family members. Remember that during this process, they will be eager to find ways to help you. By planning out the conditions you would like at the end, you give them a playbook – something they can reference in the hopes of better meeting your desires.


Ellen Diamond, a psychology graduate from the University of Hertfordshire, has a keen interest in the fields of mental health, wellness, and lifestyle.

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