Illustration of woman with cape and flares with confidence
Credit: Tatiana Ayazo

These days, it seems the pressure to be perfect — high achieving, articulate, attractive, engaging, all-around amazing — is at a fever pitch. Sure, social media gets part of the blame; after all, it’s only human to wonder how you stack up against your friends’ enviable Instagram feeds. And when you exist in a world ruled by acronyms like GOAT (Greatest of All Time) and FOMO (Fear of Missing Out), how can you help but feel “less than”? 

Add a chronic illness on top of that, something like rheumatoid arthritis (RA), migraine, fibromyalgia, or lupus, where every day comes with challenges you can’t always predict, and it’s no surprise that there are days when your confidence wanes.  

In fact, nearly a quarter of patients with RA have body image disturbance (a distorted idea of what your own body looks like) compared with just 3 percent of healthy subjects, according to research in Archives of Rheumatology. Multiple studies show that people with fibromyalgia experience decreases in self-esteem. And feelings of guilt, shame, and embarrassment common in people with lupus often lead to anxiety and depression. 

Angie Ebba, who lives with a number of disabilities — ankylosing spondylitis, fibromyalgia, chronic migraine, PTSD, and depression — points to “internalized ableism” as part of the problem. “That’s when you take all the prejudices and biases society has about disabled people and internalize them, so you often think oppressive thoughts about yourself,” explains the 41-year-old freelance writer and educator and mom of two from Portland, OR. In other words, you actually start to believe your chronic disease makes you somehow deserving of discrimination. 

Adds Chippewa, WI-based psychotherapist Shelley Ramsey DeJongh, LPC, CSAC, “Between feeling as though your body has let you down, the stigma around illness, financial complications, and trying to maintain a social life and hobbies, it is challenging to stay upbeat and believe you are worthy of all you had before the onset of your symptoms.”  

It’s knowledge that DeJongh has acquired not just from her research and her practice (she specializes in helping people with chronic illness meet the challenges of everyday life) but also from a very personal place: In 2018, she was diagnosed with multiple sclerosis, and it caused her to question everything she once thought to be true about herself. “I lost all confidence in the woman I had grown to love and instead identified myself as my MS.” 

5 Ways to Boost Your Confidence with Chronic Illness  

Yet today, both Ebba and DeJongh are thriving, thanks to techniques that bolster their sense of self and help them look ahead with joy and optimism. Here, they and others living with chronic illness, share a few strategies that have helped them upend some everyday confidence sappers. 

Confidence sapper: Having to use a mobility aid

“As a younger person without visible disabilities, I often would get looks or would be asked what I ‘did to my leg’ or what had happened that caused me to be needing to use a mobility aid,” says Ebba, who uses aids mostly because of her ankylosing spondylitis. “Pair that with internalized ableism and also my own self-doubt (‘Do I really need this?’) and using my mobility aids was hard for me, and on occasion sometimes still is.” 

Confidence booster: “Prettify” them

“I have a teal cane as well as a purple one, and I spray-painted my rollator glittery purple,” says Ebba. “If I’m going out somewhere special sometimes, I’ll do things like add battery-operated twinkle lights to my cane. This has helped me feel more confident and, like my glittery mobility aids, be my fabulous sparkly self. 

Confidence sapper: Using TV as a coping device

When Pennsylvanian Rachel Sussman, 45, discovered that watching TV and movies provided a temporary escape from the unrelenting symptoms of chronic migraine, instead of feeling relief, she was deeply ashamed.  

“I felt like I needed to hide this particular coping mechanism because it didn’t fit inside the box of typical treatments. I worried that because I wasn’t just lying perfectly still in a dark room that people would think I was faking my pain or other symptoms. I thought people would judge what I chose to watch as not high-enough quality or smart enough — that they would think I was just wasting my time.” 

Confidence booster: Write about it

Sussman decided to start reviewing the shows and movies she’d watch while in the grips of a migraine for and My Chronic Brain, a quarterly online magazine for those living with chronic migraine.  

It turned out to be transformative: “First, it helped me process what I was watching, which gave the shows a purpose greater than just helping me get through a migraine attack,” says the married mom of two kids (and two devoted nurse cats). 

Sussman was also pleasantly surprised when others reached out to talk about what they watched while they’re stuck in bed with a migraine or other chronic illness flare. This helped me realize I’d been wrong to be ashamed; television and movies can be powerful tools to refocus our attention somewhere other than our pain.” 

Confidence sapper: Wear ugly shoes because of swollen ankles

Angela Lundberg, 43, has been living with moderate to severe RA since she was 18, and over the years the Minneapolis-based teacher has endured many challenges.  

She’s had two unsuccessful surgeries on her right ankle with lingering consequences: “It’s constantly painful and it swells up, and when it’s flaring, sometimes I have to wrap it up and it limits the kinds of shoes I can wear,” says Lundberg. “When I lived in New York briefly, I remember all the walking and climbing up and down the subway stairs, and I felt self-conscious about the ugly sandals I had to wear.” 

Confidence booster: Zero in on style and comfort

“Now in the summertime I live in Birkenstocks,” says Lundberg. “They’re cute and in style, so it doesn’t look like I’m wearing orthopedic shoes. I’m so happy I’ve found shoes that are in style and comfortable.”  

She’s made another recent footwear discovery that’s changed her life: Keen walking shoes. “I came to New York and was able to walk for miles with them, even with my painful ankle.” 

On a similar note, Lundberg recalls feeling “devastated” when her eyes became too dry to wear contacts, so she had to wear glasses. Dry eyes can occur in people with arthritis for a variety of reasons. Now, she says, “It’s fun for me to go shopping for cute glasses. They’ve become a part of me and my librarian style — they make me look smarter.” 

Confidence sapper: Telling a date about your chronic illness

When and how to tell a person about her RA has been a struggle for Lundberg. “I feared the person would judge me or not want to date me or that it would be a dealbreaker.” In fact, she was scared to tell her current boyfriend right away because she really liked him. 

Confidence booster: Remember your self-worth

Lundberg finally concluded that “if a person dumps or rejects you for having RA, they’re not worthy of you anyway.” So when the time was right — a discussion about COVID proved to be the perfect opening — Lundberg let it out. “I revealed I’m high risk because I have RA, a serious autoimmune disease. I explained that it’s not just regular arthritis; it’s where my immune system is overreactive and my body attacks my own joints, and I have to take powerful immunosuppressants for that. I wanted to be honest about things. I didn’t want any secrecy.”

Her boyfriend responded with kindness and compassion, and when he asked if she would be able to accompany him on the walks he likes to take, she happily replied “I can do that.” 

Confidence sapper: Trouble finding the right words

DeJongh admits that she struggles with chronic fatigue, brain fog, and difficulty finding words for everyday objects — symptoms common in other chronic illnesses, such as fibromyalgia, Sjogren’s syndrome, migraine, and more.

“As a psychotherapist, I developed an extreme case of imposter syndrome [the persistent inability to believe that one’s success is deserved or has been legitimately achieved as a result of one’s efforts or skills). I worried my clients would think I was stupid and not helpful. I retreated to a place in my mind where I criticized what I said in every session.” 

Confidence booster: Take a holistic approach

DeJongh worked with a speech therapist, her neurology team, and a psychologist who specializes in people living with chronic health issues. “Through our time together I came to realize that talking negatively to myself was self-defeating. Instead, I accepted that I am an intelligent woman and began the process of grieving the changes my mind and body had endured.”  

In addition to staying on top of her MS treatment, she uses some practical approaches: “I am very mindful of keeping my stress level low, sleeping as much as my body needs, exercising and stretching daily, and using a planner and Post-It notes frequently. When I do all of these things, my issues with word-finding are minimal. The healthier my relationship is with my body, the healthier my mind becomes.” 

Track Your Pain with ArthritisPower

ArthritisPower is a patient-centered research registry for joint, bone, and inflammatory skin conditions. You can select different health assessments that matter to you, and choose how often you want to take them. When you have an upcoming doctor appointment, you can discuss your latest assessments and feel more informed. Learn more and sign up here.

Congcong Z, et al. Impact of Rheumatoid Arthritis on Body Image Disturbance. The Archives of Rheumatology. March 2019. doi:

Interview with WI-based psychotherapist Shelley Ramsey DeJongh, LPC, CSAC

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