I’ve noticed that some people meet hepatitis C head on, and others seem to fall apart. There seems to be no correlation between symptoms and how much one worries. I know healthy patients who are sick with fear, sure that every twinge is proof that they are dying. At the other end of the spectrum are patients in end-stage liver disease with horrendous symptoms who maintain amazing attitudes. Some travel, work full time, and are physically active despite profound fatigue and hepatic encephalopathy. The bottom line is that some of us are resilient, and some of us aren’t.
One could argue that having hepatitis C might weaken resilience, but research says otherwise. In Resilience Affects the Quality of Life in Patients with Chronic Hepatitis C,[i] Selmi and colleagues found that many hepatitis C patients are quite resilient. There were no significant differences between those who had undergone hepatitis C treatment versus those who had not. Our social relationships and psychological well-being are generally strong and we maintain a good quality of life. Quality of life is affected by individual factors, particularly by the length of time one is infected. Selmi, et al. concluded, “Informing patients regarding the disease natural history is critical to patient quality of life and should not be overlooked when new treatments are proposed.”
As to why some of us are tougher than others, resilience may be part of our physiological fabric. Research is discovering various ways in which our neural circuitry influences how we adapt to stress[ii]. Resilience has a biological component and not everyone has the same genetic material that protects against life’s hard knocks.
However, that does not mean that biology is destiny. Resilience is like a muscle—it can be developed. Just like a muscle, it is developed under uncomfortable circumstances. We don’t learn how to be tough when life is easy. It’s on the job training. Psychotherapy may be helpful, particularly cognitive behavioral therapy. However, you can do plenty on your own.
Here is some advice on how to develop resilience, compiled from a variety of resources, including the Mayo Clinic[iii] and AARP magazine[iv]:
- Connect with others
- Find purpose and meaning in your life
- Make health a priority
- Help others
- Make lemonade out of lemons
- Learn how to manage stress
Notice that last piece of advice: LAUGH. I advocate humor. I could go into the science behind the benefits of humor, but if you need science to convince you to laugh, you are missing out on a lot. Research aside, laughing feels good, except if you recently had abdominal surgery.
We can help each other laugh. Perhaps having hepatitis C isn’t funny, but there is something clicks when we share our stories. We can laugh over brain fog if we are in good company. Collectively we can use our funny bones to make our livers stronger. If we laugh at this together, we will be combining two of the recommended resiliency-builders on the list—staying connected and laughing.
[i] Resilience Affects the Quality of Life in Patients with Chronic Hepatitis C. Selmi, C.; Giorgini, A. M.; Cocchi, C. A.; Meda, F.; Marta, S.; Monticelli, C.; Magrin, M.; Podda, M.; Zuin, M. 2009 American Association for the Study of Liver Diseases meeting. Poster 1644
[ii] Psychobiology and Molecular Genetics of Resilience. Feder, Adriana; Nestler, Eric J.; Charney, Dennis S. Neuroscience 10, 446-457 June 2009 www.nature.com/nrn/journal/v10/n6/full/nrn2649.html
[iv] The Secrets of Resilient People. Howard, Beth. www.aarpmagazine.org/people/lifestyle/secrets_of_resilient_people.html