Finding Stability in the Uncertainty of Chronic Kidney Disease (CKD)
Living with CKD comes with many challenges, but perhaps the most difficult is uncertainty. Questions like “Will my condition get worse?” or “How will CKD affect my quality of life?” can leave you feeling unprepared and afraid of what lies ahead. I know this feeling personally through my experiences with IgA Nephropathy (IgAN), dialysis, and receiving a kidney transplant. In my work as a therapist specializing in anxiety and depression challenges, I’m so excited to share practical strategies through a proven mental health health treatment known as Acceptance and Commitment Therapy (ACT).
ACT is built around six core concepts designed to promote psychological flexibility. After years of trial and error personally and professionally, I’ve identified two core concepts that have been effective to manage uncertainty not only for my patients but in my life too. Let’s go over these two practical strategies you can use right now to ground yourself when the waves of uncertainty show up.
Strategy 1: Know What Matters Most to You
At the heart of ACT is the idea of values, the guiding principles that bring meaning to your life. Values are like your inner compass, they guide you toward what really matters, especially when uncertainty starts to feel overwhelming. Take a moment to reflect on what brings meaning to your life. Ask yourself: “What matters most to me?” “What does living a fulfilling life look like for me?” For many, values might center on family, health, relationships, or personal growth. If family is one of your core values, consider these examples as a guide:
"I value creating meaningful moments with my family, whether it’s through conversation, laughter, or simply being together."
"I value prioritizing my health so I can have the energy and strength to share special experiences with the people I love."
Once you’ve identified your values, focus on small, meaningful actions that honor them in your daily life. For example, if family is a top priority, consider ways you can create moments with them, such as talking with a loved one, enjoying a favorite movie or activity together, or taking a leisurely walk to spend quality time. If health is a core value, try preparing a kidney-friendly meal, practicing light stretches, or engaging in mindfulness exercises such as gratitude journaling.
Taking a few minutes each day to write down what you’re thankful for and why that matters helps counter the negativity that uncertainty can bring and teaches your mind to focus on what’s good too.
Strategy 2: Accept What’s Out of Your Control and Focus on What’s Within It
Acceptance doesn’t mean giving up or pretending everything is fine. It’s about acknowledging your thoughts, feelings, and challenges without letting them take over your life. When we resist uncertainty, we often make it feel even heavier. Acceptance frees up that energy for actions that truly matter.
The Tug-of-War Exercise helps illustrate what it means to let go of the struggle.
Visualize the Struggle: Imagine you’re holding one end of a rope, and on the other end is something you’re struggling with: fear of lab results, frustration over symptoms, or anxiety about your future. You’re pulling as hard as you can, but the harder you pull, the stronger the other side pulls back.
Drop the Rope: Now, imagine letting go of the rope. This doesn’t mean you’re giving up. It means you’re choosing not to engage in the fight. Say to yourself: “I don’t have to fight this anymore. I can let it be here while I focus on what I can do.” Holding on to the rope is exhausting.
Recognize the Cost: Ask yourself: “What is this tug-of-war costing me? My time away from what brings me joy? My peace of mind? My mental health?"
Refocus on the Present: Shift your energy to something in your control that aligns with your values.
A Personal Story: Living Aligned With Values
When I was diagnosed with CKD caused by IgAN, uncertainty consumed me. Questions like, “Am I going to die? How will I manage this?” overwhelmed my thoughts. It wasn’t just the physical symptoms, it was the loss of control over my health, future, and sense of normalcy. Through ACT, I learned to reconnect with my core values of family and health, and focus on small, meaningful actions within my control. During tough times, like dealing with prednisone’s side effects, I felt frustrated and limited in what I could do, often missing out on trips with my sisters or feeling too irritable to connect with others.
Discovering my core values helped me stay grounded by focusing on what I could control, like cooking kidney-friendly meals with my family. This not only supported my health but also created cherished memories with my loved ones. Letting go of the struggle against what I couldn’t control didn’t mean I accepted the hardships CKD brought, it meant choosing to direct my energy toward living a life that I cared about.
Taking Control of CKD And Uncertainty
Living with CKD comes with its share of uncertainty, but you don’t need to have all the answers to start living your life fully. Here’s what you can focus on right now, within your control:
Write down what’s most important to you.
Take one small, intentional step each day to honor those values.
Let go of the fight against what you can’t control and focus on what you can do.
If you’re feeling overwhelmed or struggling with your mental health, please seek mental health care just like you’d see a doctor if you were physically sick. We often forget that taking care of mental health is just as important as our physical health. A licensed therapist trained in ACT can help you manage the uncertainty and build tools to cope with the mental and emotional toll of CKD. Therapists can provide a safe space to talk, reconnect with your values, and build a life that feels true to you even while living with CKD.
Try Folia free today by downloading the app and using code “ELLE5” when you sign up!
About the author:
Elle Lee is a licensed therapist in California and Arizona with a personal and professional passion for helping others navigate life’s challenges. Diagnosed with IgA Nephropathy at 26, she’s spent over 15 years managing the complexities of kidney disease, including dialysis, kidney transplant, and acute rejection. These experiences inspired her to create Care Therapy Online, where she provides compassionate mental health support for adults facing anxiety, depression, and the unique challenges of chronic kidney disease. Her approach combines personal understanding with evidence-based care to help patients thrive. If you’re seeking mental health support or guidance in managing chronic kidney disease, you can contact Elle at 949-491-4473 or visit www.caretherapyonline.com to learn more.
