The onset of a serious medical condition can cause a range of emotional as well as physical difficulties.
While people of any age will struggle to adjust to a new, depleted life, it can be particularly hard for teenagers and those in their early 20s. At a time when the world should be opening up, offering exciting things, it can feel as if a door has slammed shut instead. Their ability to be just like everyone else in their circle of friends and acquaintances is threatened and, for girls, the longing to look as good as the healthy, beautiful women in myriad magazines can seem a particularly sour joke.
A common reaction to the shock of diagnosis is disbelief: this cannot really be happening; it must be a nightmare from which you will wake up. Accepting reality is hard, and you may adjust only gradually.
A degree of denial is no bad thing if it is used positively: 'This is the worst prognosis of how the disease may affect me, but it doesn't affect everyone that badly and I'm not going to be one of the unlucky ones.' This can be a position of strength if it is coupled with taking the very best care of yourself possible – which means following medical advice and learning all you can about your condition.
However, denial can be dangerous if you convince yourself that the worst won't happen to you so you needn't take any notice of advice – or, conversely, that the worst will happen to you anyway and that trying to look after yourself is a waste of time, because nothing will prevent the inevitable.
The onset of a medical condition in the midst of a turbulent adolescence can be particularly difficult, since it's a time when all advice from parents – or, indeed, most adults – is likely to be rejected. At that dreamy age, if life has been reasonably easy so far, it may also be hard to understand that, this time, saying, 'Sorry, I didn't mean it' won't make everything all right again – ever. As for the prospect of a disabled middle or old age if you don't look after yourself, that's so far ahead it's unimaginable.
Men are notoriously reluctant to visit the doctor in the first place, and then often refuse to accept the seriousness of their condition. While women have contact with doctors for smear tests, contraceptive advice, childcare and so forth, men only go to a surgery when there is obviously something wrong. Even then, they may delay the visit through a combination of denial and fatalism, especially if they are employed in a competitive workplace where taking time off for illness may damage their careers.
• People who take control of their medical conditions frequently have better outcomes in terms of mental and physical health than those who are buffeted between GP surgery and hospital with little understanding of what is going on. Don't let thinking about your illness take over your life, but arm yourself with as much information as possible. Knowledge is power.
• Self-help groups can be very helpful in providing you with people to talk to who know just how you are feeling. They can also help you keep up to date with the latest research. However, beware of small groups that have been hijacked by a few people with very negative outlooks; they tend to present newcomers with as depressing a picture as possible. If you find that you have arrived at such a group, leave it and don't return. Look instead for one with practical suggestions and a determined approach to coping with problems.
• Accept that there are some things you cannot do any more, and if you need help, ask for it. Your loved ones will invariably prefer to be helpful rather than powerless to ease your situation.
• Don't dwell on what you can't do, but concentrate on what you can. If your medical condition means you cannot work and have time to spare, explore new interests.
• Don't waste time thinking 'If only . . .' It will be particularly painful if you in any way contributed to your present position, such as neglecting your health. All it will achieve is to make you fritter away more of the present when you could be doing something much more positive and enjoyable. You cannot change the past, so concentrate on making the most of the present and future.
• If your friends, relatives and doctors are all telling you that you should take more care of your health and you are ignoring them, you have a problem. Your best plan is to see a therapist to work out why you are following such a self-destructive path. Understanding your actions will allow you to change them.