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Learning How to Navigate Birthdays When You Have a Chronic Illness

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Pass the party poppers and grab a slice of cake. It’s time to talk birthdays and aging, which is one thing we all have in common.

It’s different for everyone: A time of celebration, “just another day” or a time of anxiety, disappointment and loneliness. With chronic illness, birthdays can be doubly challenging to navigate.

The Having-Fun-Hype

There’s a lot of pressure on birthdays. You need something Instagram perfect and this is very pronounced on social media. As you get older, this transforms and the focus seems to be a lot more on having people close to you — a partner, your own children, dear friends.

Chronic illness changes the playing field in various ways. We can lose friends, our jobs and therefore our colleagues. We may not be well enough to go out. It may not be possible to plan an event in advance or we may have to cancel at the last minute.

Even those without illness can empathize with things like being alone and feeling lonely, the feeling of impending doom over aging — feelings of regret, disappointment, frustration or worry.

We want connections, perhaps even more so if we’re feeling low on a birthday. And chronic illness can be isolating. We can yearn for those we want to spend time with — those that cheer us up, that we can have deep, honest conversations with. Birthdays have a way of painfully showing us if we’re lacking those true connections. 

We feel we “should” be doing all the things we hear about being birthday appropriate: drinking, eating cake, partying, interesting days out, activities with friends.

There are also things we might really want to do but physically aren’t up to doing. If you’re not partaking in these things, it can feel like a let down — like you’re not good enough. Like you’re missing out. (FOMO, anyone?) 

This is where we need to change our perspective, adjust our expectations, assess what’s really important to us and find ways to adapt.

Age Anxiety 

Remember when you were 14 and couldn’t wait to be 16? After 21, instead of wanting birthdays to come around more quickly, we’re desperately trying to keep them away. There are lots of question marks over the future with chronic illness, adding to the anxiety.

I’ve talked before about social rules and expectations and how painful such pressures can be. There seem to be unwritten guidelines on what you “should” be doing and “should” have achieved at certain ages and points in your life.

When a birthday rolls around, we often compare ourselves and our situations to others. More often than not, we end up feeling like we’re lacking and that we’re behind in life.

Maybe we think of how we thought our lives “should” look by the time we reached this age. I know my life went off the rails with chronic illness. Now, it looks nothing like what I’d ever anticipated.

I’m a Party Pooper

I find feeling down about your birthday can set off a heap of guilt. Guilt is a common element with chronic illness, so it’s perhaps unsurprising. My inner dialogue last year was atrocious. It was the big 3-0 and it went down like a lead balloon.

Guilt sneaks in anywhere it possibly can and it’s always a no-win situation. Layered on top of that is physical pain, illness and regrets — maybe even resentment, loss, hurt and everything in between.

Figuring out what, if anything, to do on your birthday can cause far more hassle than it’s worth, too. With chronic illness, you may not get out and do as much any more, so any time you do something there’s more pressure for it to go perfectly. Yet, your health is so unpredictable, it’s impossible to plan. Before you know it, you’ve tied yourself up in knots. It’s exhausting.

But none of that really truly matters. What you do is only part of it. It’s about facing what’s bugging you and facing what the deeper problems, issues, worries, regrets and frustrations are.

That’s life with chronic illness and chronic pain. Acknowledging things aren’t what they used to be and that as we age, it’s hard not to think of the years lost due to our health. The present is difficult and the future is murky, but there’s always hope for brighter days. 

Let’s say, ‘Stuff it’ to the pressures, the regrets and resentment — and “Screw it” to the “should’s” and expectations.

Aging: Numbers Versus Muffins

I hope the saying, “You’re only as old as you feel” isn’t true — though I wouldn’t look too bad for a 110 year old.

The skeptics would say birthdays were invented by Hallmark to sell cards. It’s probably not far off in the sense that birthdays are social constructions. You get a new number each year. Personally, I think we should get survival medals rather than numbers. This number comes with a heap of emotions, thoughts and expectations.

But imagine instead of a number, you’re assigned a muffin flavor. If you’ve just turned Berrylicious Blueberry, next year you’ll be Banana. It seems far less anxiety-ridden when you take away the insignificant number, doesn’t it?


Forget the numbers. In August this year, I turned Chocolate Chip! It was very quiet but I enjoyed starting a new good book — and I was grateful for home comforts. With fibromyalgia, a stoma, chronic fatigue and a few other things thrown in for good measure, saving spoons and being comfortable is important — and you can still find joy in the small things.

Tips for Birthdaying With Chronic Illness

Here are just a few thoughts on ways to better manage birthdays when living with chronic illness and/or pain:

  • Instead of trying to cram too much into one day, consider it a birthday week, or even a birthday month.
  • Think big (like a day trip, a get together, going to the cinema) — and small (like a drink in your favorite coffee shop, a whole afternoon to snuggle with a good book, a special film night with snacks). Those small things can often be far more valuable to our well-being and mental health, while also being more budget-friendly.
  • The main point is to find things you can enjoy that are manageable, whatever they are. Focus on what you can do, not what you can’t.
  • Forget what you feel you “should” be doing or what a birthday “should” look like.
  • As on any other day, prioritize rest and self-care.
  • If you have friends and family who want to help you celebrate, speak to them about any concerns you may have with their plans. You’re not letting anyone down and they may not realize how you’re feeling. You can try to find ways together to manage any get togethers or activities. They’d rather work around your health needs than have you struggle.
  • If you don’t have others to celebrate with, enjoy your own company and see it as a chance to do whatever you want, whenever you want.
  • If you feel lonely, reach out. Don’t suffer alone. The mental barriers of guilt and feeling unworthy can compound negative thoughts and feelings around birthdays. Samaritans has a free phone number — 116 123 — you can call any time. Speak to your tribe online, through blogs or social media groups. I’m always here if anyone needs to talk, too.
  • RememberYou’re worth it. Give yourself permission to feel however you’re feeling. Practice gratitude. Treat yourself. Most importantly, be kind to yourself.

Follow this journey at InvisiblyMe.

Getty Images: RuthBlack

Originally published: November 8, 2019
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