Q: Lately my lupus has taken a turn for the worse.  I’ve been in and out of the hospital with lupus complications.  I’m on a lot of medication and often feel lethargic.  I’m trying to accept that I can’t work right now and that’s not easy.  What is also difficult for me is that I can’t accomplish much (other than napping) and that makes me feel bad about myself.  Any suggestions?

A: It is not uncommon for illness and even temporary disability to result in a loss of self-esteem.  For someone like you who may be used to being active and productive, it can be a major adjustment to be unable to function well in your daily life.  Most of us derive a large part of our self worth from our jobs and accomplishments.  If that is taken away, we tend to look to our daily tasks for a sense of productivity and esteem.  If you are just out of the hospital, struggling with fatigue and exhaustion, it’s natural and understandable that your day to day functioning will be limited.  Try to remember that there is nothing you ought to be doing right now other than trying to get well.  This is your job.  What does this mean?  It means following your doctor’s recommendations and listening to your body.  If all you can do is rest (nap), then for you, napping is productive.  When you wake up from a nap remember to tell yourself:  “Great, I rested for my body health. That’s what I need.”  If you can do more, your activities should be health enhancing, e.g. meditation, reading about your condition, non-strenuous creative endeavors (listening to music, books on tape, watercolors), lupus support groups (if you’re up to getting out) and gentle exercise.  Over time, these activities will help you to feel productive.  It is inevitable that your current health situation will create feelings of sadness and loss a t imes.  You are entitled to feel and release these feelings. Remember to be kind to yourself.  You are recovering from a health crisis.  It will take time.