Existential Concerns and the Emergence of Wisdom in Young Adults Living with Chronic Illness

Typically people in their early adult years do not think about the health consequences of activities such as flying in an airplane, lying on a beach, having sex, or running on a treadmill. Young adults who live with chronic physical illnesses, however, do. For example, flying in an airplane becomes a risky endeavor for people with illnesses that cause proneness to blood clots. Young people living with lupus need to stay out of the sun, making an enjoyable activity such as lying on a beach an ordeal involving sunscreen, hats, and lots of shade in order to prevent inflammation, rashes, and fatigue. Having sex, for people who have certain chronic physical illnesses can cause fear of spreading the illness or concern of becoming pregnant, which may pose an entire host of health complications. For people who have rheumatic illnesses, running on a treadmill can cause inflammation of the knees or ankles, and severe pain. Whereas it is not until older adulthood that people begin to think about the fragility of the human body and of life, young people who live with chronic physical illness are in a position where thinking about these existential topics may become a regular act.

For many young people living with chronic physical illnesses, a swollen knuckle can set off a series of thoughts. “What if my illness gets worse; what if this is a sign that there is something else wrong; why is my body failing me; why is this happening to me; I am too young to have these symptoms; will I live for just as long as if I didn’t have my illness?” The experience of coming face to face with mortality and with the imperfections of the human body at a young age may at first seem terrifying. Oftentimes people may want to push these thoughts away because they may be too overwhelming or depressing. Other times people may feel that there is no point in thinking about these things if there is nothing that can be done to change them. There are also occasions when people accept the reality that human life is not eternal and that life in the moment is extremely meaningful, and it is embraced in a way that it has never been before. When this occurs, there can be peace.

In his theory of psychosocial development, developmental psychologist and psychoanalyst Erik Erikson described how people pass through a series of stages throughout the lifespan. In each stage the person must negotiate between demands made by others in their environment, society, and their own innate needs, and successful resolution of a stage follows with the attainment of a “virtue.” According to Erikson’s theory, people in their 20’s and early 30’s are usually in a stage where their primary concerns are intimacy versus isolation. The very last stage of this psychosocial theory is integrity versus despair. During this stage people either come to terms with death and make meaning of their life or they are left with a sense of despair. With integrity comes the virtue of wisdom—an ordered understanding of life and relationships. People usually experience this stage when they are over the age of 65.; however, it is possible for young adults who live with chronic illness to achieve “integrity” and “wisdom” at a much younger age than anticipated by Erikson’s theory of psychosocial development. Yes, according to Erikson, if an early stage is not successfully resolved it will impact the resolution of later stages and therefore jumping to the last stage before having time to tackle the earlier ones may pose some problems…but that is for another discussion. The point is that even though daily activities which may pose health consequences for young people living with chronic illness can terrify and depress, and which you would never wish upon anyone, can at times also allow for the emergence of a sense of meaning-making, peace, wisdom, and acceptance far beyond one’s biological years.