In 1969, Dr. Elisabeth Kubler-Ross proposed 5 stages of death and dying in her book On Death and Dying. Most of us are familiar with what is often called 'the five stages of grief', which are:
Since this book was published, Dr. Kubler-Ross's work has been applied to the many situations of change people experience in a lifetime, including onset of a chronic illness. There is no time limit set for each stage, as every person progresses towards acceptance of their illness at their own pace. Some people may experience more than one stage at a time, or in an alternate order. Critics argue that the steps are too rigid, and are not applicable to the grieving process, yet people all over the world have found comfort in Kubler-Ross's work.
The first stage in acceptance of a chronic illness like inflammatory bowel disease (IBD) is Denial. The patient may convince himself or herself that the lab reports were accidentally switched, or the doctor is wrong. With the often-sudden onset of IBD, it can be easy to believe that symptoms are food poisoning, or due to stress, and will go away eventually. Patients might even refuse to take their medication or to alter their diet, because that would mean that the chronic illness is real.
The second stage is Anger. Anger at the doctor who made the diagnosis, the illness itself, and even at the rest of the world for going on about its business as if nothing had changed. Spending too much time at this stage can leave a person resentful of healthy people and bitter towards them. Friends and family may even shun a person who gets stuck in this stage.
Bargaining is the third stage. A person with IBD may rationalize eating unhealthily or not taking medications. Thoughts like, "One day of missing my meds won't hurt," or "I'll schedule my colonoscopy when I'm not so busy" may be prevalent. Unfortunately, IBD doesn't go away for the weekend, and it doesn't care that a colonoscopy is something most people would rather avoid.
The fourth stage, one that is familiar to anyone diagnosed with a chronic illness is Depression. Patients may feel sorry for themselves, and lose hope of ever achieving remission. It is important to recognize that medical help is necessary if depression becomes all consuming or results in suicidal thoughts. Adjusting to a chronic illness is a difficult and stressful time, and seeking out help to deal with it is the best way to ensure a more healthy life.
The fifth and final stage is one of Acceptance. IBD is not going to go away, and becoming educated about the disease and accepting the changes to your lifestyle is the way to lead a healthier life.
Dr. Kubler-Ross's 5 stages provide a guideline in the lonely and perilous journey to accepting IBD as a part of life. That is not to say that a chronic illness should rule one's life, or that the search for a cause and cure should stop, but that regular doctors appointments and medication are going to be part of life. Ideally a very small part of a life that is filled with joy, love, and incredible experiences despite the illness.