Adapting When Health Changes

Health is one of those things we rarely think about as long as it is there.

We wake up, go to work, make plans for the coming weeks and think about next year’s holiday. We walk up a flight of stairs without giving it a second thought, have a conversation while pouring a cup of coffee, and cycle home after a long day at work. Our body, attention, and energy are simply there, quietly supporting us as we go about our daily lives. Because it all seems so natural, we hardly notice how remarkable it actually is.

That changes when this sense of normality disappears.

Sometimes it happens gradually. A walk that once felt effortless takes more energy. The tiredness after a working day no longer disappears after a good night’s sleep. It becomes harder to stay focused during a difficult conversation or to have any energy left for life at home after a busy day.

Sometimes everything changes in a single moment. An accident, an illness, burnout, or a phone call that sends life in a different direction within minutes.

From that moment on, health becomes visible because it can no longer be taken for granted.

People who experience such a change often discover that it is not only the body that changes. Everyday life changes too. Work that seemed effortless for years suddenly requires much more energy. Activities that once came naturally have to be planned. A diary that used to fill itself now has to be reorganized. Motivation may still be just as strong, while what is possible has changed.

A change in health affects much more than the body alone.

A herniated disc does not only change how much someone can lift. It also changes how they do their work, ask colleagues for help, or see themselves as a professional. Depression affects not only mood, but also the ease with which someone makes decisions, stays in contact with others, or has confidence in the future. Chronic pain does not only limit the body; it also requires conscious choices about how energy is divided between work and other activities.

Every change in our health affects the life we lead.

This does not apply only to illness. Events that are not illnesses in themselves can also profoundly alter the balance between a person and their environment. The birth of a child, caring for a parent, a divorce, the death of a partner, or simply growing older can disrupt what we have taken for granted for years and require us to find a new balance.

From the outside, such changes may look very different. From the inside, they often confront people with the same question: How do you move forward when life no longer fits the life you were used to?

When Life Changes

When people look back on the moment their health changed, they often do not mention their symptoms first. They talk about the things that suddenly became different.

They notice that a working day takes more energy than it used to. That grocery shopping no longer comes easily. That an evening with friends is followed by a day in which the body needs to recover. That appointments suddenly have to be planned around the energy available, rather than the other way around.

It is not one single event that changes life. It is the accumulation of small changes that makes clear that the old balance has disappeared.

There are days when confidence returns and it seems as though everything is possible again. Then comes a day when the same symptoms resurface. This fluctuation makes it difficult to face the fact that something really has changed.

Many people therefore continue trying to hold on to their old life for a long time. They return to work as soon as it seems at all possible. They take on the same responsibilities as before. They want to show that, really, not that much is wrong.

That is understandable. Someone who has been used to being independent for years wants to remain independent. Someone known as a committed colleague does not want to disappoint their colleagues. Someone who has always cared for others may find it difficult to become dependent on others themselves.

This is often where the greatest tension arises. Not between what someone wants and does not want, but between what once came naturally and what life now asks of them.

Work is often the first place where this tension becomes visible.

For many people, work is more than a way to earn an income. It gives structure to the day, brings people into contact with others, and provides a way to contribute. The working week has a rhythm that becomes so familiar that we hardly realize how much stability it provides.

Only when that rhythm changes does it become clear how much it meant.

Peter has worked in construction for more than twenty years. He is used to keeping an overview, making decisions, and solving problems before others notice them. His colleagues know they can rely on him. If something needs to be taken care of, Peter is the one who does it.

After months of recovery, he attends a construction meeting for the first time.

He has prepared carefully. He wants to show that he is back and is looking forward to seeing his colleagues again. As the meeting progresses, he notices that it takes more effort to follow the discussions. Where he once switched effortlessly between schedules, drawings and agreements, he now loses track. By the time the meeting is over, he feels exhausted.

As he leaves, a colleague says kindly, ‘Take it easy. The most important thing is that you recover properly.’

Those words stay with him for the rest of the day.

Do they still see the same project manager?

Or do they mainly see someone who, for the time being, needs to be spared?

Health problems require more than a different distribution of time and energy. They can also affect the roles with which people identify. We are partners, parents, friends or neighbors. But we are also nurses, carpenters, teachers, entrepreneurs or managers. In these roles, we experience that we matter, carry responsibility and are of value to others.

When a change in health makes it difficult to continue fulfilling those roles in the same way, it can therefore feel as though more has been lost than health alone.

People wonder whether they will be able to continue doing their work. Whether they will have to adjust their ambitions. How colleagues, friends or family see them.

Who am I when an important part of the life I knew changes?

Adapting to a Changed Reality

People often continue living for a long time as though their old life could return at any moment. They make plans as though their diary still has the same amount of space. They take on responsibility as they always have and expect of themselves what once came naturally. Every good day seems to confirm that recovery is close. Every bad day feels like a temporary setback that needs to be overcome as quickly as possible.

When life has been predictable for a long time, we expect the future to be, broadly speaking, a continuation of the past. We build our lives around habits, relationships and roles that have proved reliable for years. That is why a major change can feel so disruptive. Not only because the body or mind responds differently, but because our trust in what once seemed certain is shaken.

A great deal of energy then goes, almost unnoticed, into trying to restore the life we had before. Not because people refuse to face reality, but because they long to regain what was dear to them. They want to be the parent who could always be there. The colleague others could rely on. The partner who took care of everyday things without a second thought.

As long as all our attention is focused on what is no longer there, little room remains to explore what is still possible in the present moment.

When people lose their health, they often also have to let go of expectations, plans and certainties. That takes time.

Adaptation begins when people are willing to shift their attention. No longer focusing exclusively on the life they have lost, but also on the life that, under changed circumstances, is beginning to take shape.

Self-Stigma: When the Judgment of Others Becomes Our Own Voice

When people become ill or develop mental health problems, it is often not only their health that changes. The way they see themselves can shift as well. In our society, health, productivity and independence are highly valued. People who are temporarily less able to work or experience mental health problems sometimes find that others attach expectations or prejudices to this. People with burnout may be told that they should have managed stress better. Someone with depression may encounter a lack of understanding or the idea that they should simply get over it. Physical conditions, too, can lead people to feel that they no longer fully count.

These social perceptions do not always remain outside us. Sometimes they become part of the story we begin to tell about ourselves. This process is known as self-stigma. It is no longer only others who see us as vulnerable, weak or less reliable; gradually, we begin to adopt that judgment ourselves (Corrigan, 2004).

At work, this can have significant consequences. An employee returning after burnout speaks up less often in meetings for fear that colleagues will see him as less able to cope. A manager experiencing anxiety delays asking for help because she is afraid of losing credibility. Someone with chronic pain works increasingly hard to prove that he is still the same professional he was before. It is not only the condition that limits them, but also the belief that they have become less worthy.

Self-stigma often operates in silence. It manifests itself not only in shame, but also in avoidance, perfectionism or overcompensation. People try to prevent others from seeing their vulnerability. Ironically, concealing it requires a great deal of energy. Attention shifts from doing good work to protecting a damaged sense of self.

Research shows that self-stigma is associated with lower self-confidence, less help-seeking and a greater risk of prolonged absence from work (Corrigan, 2004; Henderson et al., 2013; Thornicroft et al., 2016). This makes clear that recovery requires not only a reduction in symptoms, but also room to develop a different relationship with oneself.

Self-stigma does not arise in a vacuum. It often begins with wider social perceptions of health, mental health problems and work (Corrigan, 2004).

From an ACT perspective, self-stigma takes on a different meaning. The question is not whether such thoughts disappear, but how much influence they have over what we do. Thoughts such as “I’m not the same person anymore” or “I’m letting my colleagues down” can sound so convincing that we begin to act accordingly. We withdraw, become less likely to ask for help, or try to prove that nothing is wrong. From an ACT perspective, such thoughts do not need to be challenged or proven wrong. When we learn to notice them as thoughts, rather than as facts that determine what we should do, we create space to choose again how we want to act.

Recovery, then, does not mean returning to who someone used to be. It means being able, with one’s vulnerability, to find a meaningful place in work and life again.

As people begin to move forward in work and life, new choices arise.

Being Open Takes Courage

Whether or not to be open about your health is rarely a simple choice. And if you do choose to be open, what do you share?

Openness can lead to understanding, appropriate support and realistic expectations. At the same time, many people fear misunderstanding, stigma or negative consequences for their career. Research shows that the decision whether or not to be open is influenced by the sense of safety within the team, the relationship with one’s manager, previous experiences and expectations about how colleagues will respond (Brohan et al., 2012).

From an ACT perspective, there is no universally right answer to the question of whether someone should be open about their health. Sometimes openness is consistent with what a person finds important. In another situation, it may be wise to keep certain information private. Psychological flexibility does not help us make the perfect choice, but it can prevent fear or shame from automatically determining the direction we take. The question then becomes not only: What is important to me? but also: What, in this situation, fits with the person I am?

The same consideration arises when health problems begin to affect the work itself. Here too, people try to find a way between what their body or mind requires and what they find important in their work. For one person, this means temporarily stepping away from work; for another, working fewer hours or adjusting their tasks. Someone else may try to carry on for as long as possible, even as their symptoms increase.

Not everyone struggling with health problems takes sick leave. Many people continue working even when their symptoms are clearly affecting their ability to function. They do not want to burden colleagues, fear being seen as less committed, or feel that they cannot afford to be absent. This phenomenon is known as presenteeism: being present at work despite health problems that actually call for recovery or rest (Aronsson et al., 2000; Johns, 2010). At first glance, this may seem like a sign of commitment. Yet research shows that continuing to work while ill for prolonged periods can delay recovery, reduce productivity and ultimately increase the risk of long-term absence from work.

From an ACT perspective, therefore, what matters is not only whether someone continues working, but also what drives that choice. Continuing to work may arise from values such as responsibility, commitment or professionalism. But it may also be driven by fear of disappointing colleagues, being seen as weak or losing control.

Staying true to what matters, therefore, does not always mean carrying on. Sometimes it means acknowledging what is and is not possible at this moment. That is not giving up, but a different way of moving forward.

Adapting Is Not the Same as Giving Up

When people can no longer live their lives as they did before, sooner or later they face a difficult task. Not only because something has been lost, but also because the future has become less certain.

When health is temporarily out of balance, recovery often seems the obvious goal. But not every change can be reversed. Sometimes life does not ask us to return to what was, but to learn how to live again with what is.

Adaptation, therefore, is rarely a one-time decision. Research on people living with a chronic condition or another major life change shows that this process usually begins not with a solution, but with a change in perspective. Gradually, attention shifts from the question, ‘How can I get my old life back?’ to ‘How can I build a meaningful life again under these circumstances?’ (Livneh & Antonak, 2005).

This change in perspective does not unfold in the same way for everyone. Research on resilience following major life events shows that many people, despite loss or illness, gradually manage to find a new balance (Bonanno, 2004). This does not mean that sadness or uncertainty disappear. Nor does resilience mean that someone emerges from a difficult period unchanged. It refers to the ability to give direction to one’s life again, despite what life has changed.

This shift from holding on to reshaping changes the way people look at their lives. As long as attention remains focused on restoring what has been lost, every limitation becomes a reminder of how life falls short. Every setback feels like a step backwards. Every comparison with the past makes visible once again what is no longer possible.

When people begin to see the possibilities of today again, something changes. The loss and disappointment do not disappear, but alongside them, space opens up to discover what is still possible.

Adaptation, therefore, does not mean settling for less. Nor does it mean that sadness, anger or longing disappear. It means being willing to reshape one’s life without continuing to measure it against a reality that no longer exists.

That takes courage.

Those who adapt to a changed reality learn not only to relate differently to their health, but also to look at work differently. Not by asking how things used to be, but by asking how work can take on meaning again under changed circumstances.

This brings a new question into view.

What enables work, particularly when health changes, to contribute to resilience, health and a meaningful life?

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