Why recovery is more than just physical—and how to pace yourself
Written by Dr. Antonia Repollet
Licensed Clinical Psychologist
Certified School Psychologist
GI Psychology
For those living with chronic illnesses like inflammatory bowel disease (IBD), lupus, psoriatic arthritis, or other autoimmune and gut-related conditions, flares can be intense—painful, exhausting, and emotionally overwhelming. But what happens after a flare can be just as important as how we handle the acute phase. Recovery is not just about healing physically—it’s also about tending to your nervous system and mental well-being.
In fact, research shows that chronic illness flares can leave behind a lingering state of stress and nervous system dysregulation, impacting mood, energy levels, and even digestion long after the acute symptoms resolve (Mitropoulou et al., 2021).
Your Nervous System Just Weathered a Storm
Think of your nervous system like a smoke alarm. During a flare, it’s on high alert—your body is signaling that something is wrong, and your brain is responding by releasing stress hormones like cortisol and adrenaline. This allostatic load (the wear and tear from chronic stress) doesn’t immediately turn off when the flare ends. Your body needs time to shift from “fight-or-flight” to “rest-and-digest.”
Unfortunately, many patients feel pressure to immediately “bounce back”—returning to work, resuming caregiving, or making up for lost productivity. But this mindset can backfire, leading to delayed healing and even triggering another flare.
The Mental Health Toll of a Flare
Post-flare fatigue isn’t just about inflammation—it’s emotional, too. People with chronic illness report high rates of anxiety, depression, and trauma symptoms following periods of increased pain or disability (Reinert et al., 2024). This is especially true if the flare disrupted your daily life, led to hospital visits, or increased feelings of isolation.
If you find yourself feeling:
- On edge or anxious, even though your symptoms are better
- Depressed, hopeless, or unmotivated
- Irritable or easily overwhelmed
- Numb, disconnected, or stuck in “shutdown” mode
…you’re not alone—and you’re not doing anything wrong. These are common signs that your nervous system is still recovering
How to Support Yourself After a Flare
Here are some science-backed ways to recover fully—not just physically, but emotionally and neurologically:
1. Pace Yourself—Literally
Pacing is a core strategy in post-flare recovery, especially for those living with chronic illnesses marked by fatigue or pain. Rather than pushing through exhaustion or trying to “make up for lost time,” pacing encourages you to honor your energy limits and build activity back in gradually. Overexertion can prolong recovery and even trigger new flares (Kos et al., 2015).
One helpful metaphor is Spoon Theory, created by Christine Miserandino. Imagine you start each day with a limited number of “spoons”—units of energy. Every activity, from brushing your teeth to answering emails, uses up spoons. When you run out, there’s no energy left to draw from—only rest can replenish you.
Try tracking your “spoons” across the day. If you know a social event or appointment will cost you several spoons, plan to rest before and after. Prioritize tasks that align with your values, and let go of the guilt that often comes with doing “less.”
2. Re-Regulate Your Nervous System
Simple, consistent techniques can help shift your body into parasympathetic mode (rest-and-digest):
- Diaphragmatic breathing
- Gentle yoga or stretching
- Walking in nature
- Listening to calming music
- Clinical hypnosis or guided imagery (Palsson & Whitehead, 2002)
3. Name the Emotional Impact
Acknowledging your emotional response to the flare can reduce shame and foster self-compassion. You’ve been through something hard—give yourself permission to feel frustrated, sad, or scared.
Journaling, talking with a therapist, or practicing cognitive defusion (stepping back from distressing thoughts) can help you process without spiraling (Hayes et al., 2006; Masuda et al., 2004).
Try saying, “I’m noticing I’m having the thought that I’m behind,” instead of “I’m behind.”
4. Reconnect with What Brings You Joy
Chronic illness can disconnect you from what makes you feel like you. During recovery, even tiny moments of pleasure—making tea, petting your dog, watching your favorite show—can help re-anchor your nervous system in safety and familiarity.
Try writing a list of 5 “glimmers”—small things that spark comfort or joy—and keep it somewhere visible.
Recovery Is Not a Race
Healing from a flare isn’t about bouncing back to who you were before. It’s about tending to the parts of you that need time, care, and compassion. Supporting your nervous system and mental health after a flare isn’t a luxury—it’s a vital part of long-term recovery and resilience.
If you’re looking for personalized strategies to regulate your nervous system, build pacing routines, or process the emotional toll of chronic illness, you can schedule a free 15-minute consultation for 1:1 therapy or enroll in our 8-week virtual IBD Psychotherapy Group, where adults with Crohn’s and colitis can learn evidence-based tools to manage stress and symptoms.
References
Diaphragmatic breathing for GI patients. Diaphragmatic Breathing for GI Patients | University of Michigan Health. (n.d.). https://www.uofmhealth.org/conditions-treatments/digestive-and-liver-health/diaphragmatic-breathing-gi-patients
Hayes, S. C., Luoma, J. B., Bond, F. W., Masuda, A., & Lillis, J. (2006). Acceptance and commitment therapy: model, processes and outcomes. Behaviour research and therapy, 44(1), 1–25.
Kos, D., van Eupen, I., Meirte, J., Van Cauwenbergh, D., Moorkens, G., Meeus, M., & Nijs, J. (2015). Activity Pacing Self-Management in Chronic Fatigue Syndrome: A Randomized Controlled Trial. The American journal of occupational therapy : official publication of the American Occupational Therapy Association, 69(5), 6905290020.
Masuda, A., Hayes, S. C., Sackett, C. F., & Twohig, M. P. (2004). Cognitive defusion and self-relevant negative thoughts: examining the impact of a ninety year old technique. Behaviour research and therapy, 42(4), 477–485.
Miserandino, C. (n.d.). But you don’t look sick? support for those with invisible illness or chronic illness the spoon theory written by Christine Miserandino – but you dont look sick? support for those with invisible illness or chronic illness. But You Don’t Look Sick. https://www.butyoudontlooksick.com/articles/written-by-christine/the-spoon-theory/
Mitropoulou, M. A., Fradelos, E. C., Lee, K. Y., Malli, F., Tsaras, K., Christodoulou, N. G., & Papathanasiou, I. V. (2022). Quality of Life in Patients With Inflammatory Bowel Disease: Importance of Psychological Symptoms. Cureus, 14(8), e28502.
Palsson, O. S., & Whitehead, W. E. (2002). The growing case for hypnosis as adjunctive therapy for functional gastrointestinal disorders. Gastroenterology, 123(6), 2132–2135.
Reinert, M., Nguyen, T., Fritze, D., & Adams, T. (2024, December 11). Early, equitable and Trauma Responsive Care for chronic pain and mental health. Mental Health America. https://mhanational.org/research-reports/early-equitable-and-trauma-responsive-care-chronic-pain-and-mental-health