Coping with setbacks: understanding resilience in young people with chronic illnesses

Resilience: what exactly is it? What makes some young people with chronic illnesses more resilient than others? Sabine van der Laan seeks answers to this in her doctoral research at University Medical Center Utrecht. There is one thing Van der Laan is very clear about: "Resilience is not a personal superpower. It’s not a character trait. It’s a dynamic process influenced by all kinds of factors.”

What is resilience?

"People often see resilience as a character trait. They say to each other: ‘You're resilient, because you can handle a difficult situation.’ But if you look at the science, you will see that, in recent decades, different definitions of resilience have been defined. Today’s resilience researchers are moving away from the idea that resilience is a character trait; they demonstrate through research that resilience means that a person maintains or regains their mental well-being after going through a stressful event. I use this definition in my research, too."

What makes some young people with chronic illnesses more resilient than others?

“All kinds of factors influence how young people deal with setbacks. Factors within the individual as a person are important: certain genes, the body’s hormonal response, how the brain works, the severity of the disease, and certain character traits such as optimism and flexibility.

But how a person is able to cope with stress comes not only from within the individual themselves but also from outside. Having parents who help you figure out how you can still do exercise when you have asthma, for example, can teach you how to manage your illness. And it also makes a difference if you have a doctor who engages in a conversation with you about what you need, rather than a doctor who decides for you or who doesn't listen to you.

The culture and environment you grow up in also have an impact. And the times we live in are important as well. During large parts of the COVID-19 pandemic, we were all indoors; in that case, the influence of your home situation is even greater. Means of escape, like hanging out with friends, a game of football, or a listening ear from your mentor, were no longer guaranteed. Plus, things change for each person individually over time: an illness can get worse, which may also make you deal with it differently.

How young people with a chronic illness see themselves in relation to that illness can also be important for mental well-being. In one of our research projects, we saw that within a large group of young people with a chronic illness, only some of the young people said that they had a chronic illness. The young people who stated that they had a chronic illness had lower mental well-being compared to those who did not state that they had a chronic illness. This raises questions. Why do some young people say they have an illness while others do not? And how is this linked to mental well-being? It could be that your own interpretation of your health affects how you feel mentally."

Can young people strengthen their resilience?

“Absolutely! Research by Anne Laura van Harmelen (a professor at Leiden University) has shown that friends are very important to young people. They saw a switch in adolescence: at that time, the support of friends became more important than the support of family in terms of resilience^.1,2 So, I would say this to all young people: call your friends and ask how they’re doing. Maintain your social network. Do fun things with each other. Make sure you have someone to turn to if things go wrong at school or at work. And strengthen your friends' resilience too by being there for them.”

Why do you find it important to make it clear that resilience is not a personal characteristic?

“Viewing resilience as a personal trait places undue pressure on the individual – it implies you are doing something wrong if you are struggling to cope with stress. I think it’s important to see resilience as a dynamic process, which is influenced by both personal factors and the environment. Let's take a kinder approach towards our fellow human beings. That way, people will also be kinder towards themselves.”

Let's take a kinder approach towards our fellow human beings. That way, people will also be kinder towards themselves.