Managing Anxiety When Waiting For Your Next Flare To Strike

Like many of you, I have Crohn’s disease. I’ve had it for 22 years and while I’ve certainly learned how to manage flare-ups, I still struggle with the periods in between. Don’t get me wrong—those “in between” periods are obviously easier—but what can come with remission is fear. How long will this last? Am I eating and doing the right things to prolong this good period? If I get another flare, will I need to change my meds?

In addition to having Crohn’s, I’m also a psychotherapist specializing in IBD so my observations are not just my own. Through both my personal experience and my work with clients, I’ve come to know one thing for sure: the anxiety doesn’t disappear with the good news of a clean colonoscopy. In fact, sometimes it ramps up. The uncertainty of our health can make it hard to relax, plan, or simply trust our bodies.

While it can’t be eliminated, there are ways to manage the anxiety more effectively. Here are 5 ways.

How to enjoy good days with IBD

This might sound obvious, but we often try to protect ourselves so much that we hold ourselves back from enjoying healthy periods. Fear of a flare can lead us to skip activities “just in case” or hesitate to commit to plans like travel, social events, or outdoor activities. While occasionally those decisions are warranted, sometimes it’s simply anxiety preventing us from fully engaging in life.

When those worries creep in, try:

• Staying in the present and recognizing the health and energy you have now
• Making plans that can be adjusted if needed
• Explaining to loved ones that flexibility helps you feel more comfortable

Move away from flare prediction and focus on preparation

Instead of constantly trying to predict when the next flare will happen, use your energy to prepare for one. It’s hard to think clearly when you’re not feeling well, so having a plan in place makes a big difference. Preparation reassures your brain that you can handle the difficulties that lie ahead.

Consider creating a flare plan that includes:

• A clear idea of when to reach out to your GI doctor
• Keeping medications stocked
• Identifying your support system
• Making any needed arrangements for school, work, or pets

It’s also helpful to remember that anxiety can create physical symptoms, especially gut-related ones. When anxiety ramps up, use deep breathing, grounding exercises, or guided meditation to calm your nervous system so you don’t unintentionally increase your own symptoms.

Expanding your identity beyond Crohn's or colitis

When I was first diagnosed, I immersed myself in learning everything about Crohn’s. I attended conferences, joined support groups, and talked about it constantly to anyone who would listen. While that helped initially, over time I noticed my identity becoming centered around being “sick” and all that did was keep me focused on fear and vigilance.

To decrease the fear, try expanding your identity:

• Find hobbies unrelated to IBD
• Connect with people outside the IBD community
• Try activities you might normally avoid out of fear
• Notice ways your body is strong and capable

Having an illness is not the same as being defined by one.

Set boundaries around symptom monitoring

It’s important to recognize signs of a flare, but constant monitoring can increase anxiety. There’s a balance between awareness and hypervigilance. When we analyze every sensation, we unintentionally keep ourselves in a constant state of alert.

Helpful strategies:

• Limit how often you monitor symptoms
• Identify your personal “red flag” signs
• Avoid Dr. Google!
• Remind yourself that occasional GI symptoms are normal

Finding that “sweet spot” between awareness and over-monitoring can significantly reduce anxiety.

Recognize your own resilience

This may be the most important strategy and one that I’ve used countless times. Anxiety often shows up when we fear we won’t be able to handle what’s ahead. But if you’re worried about a future flare, it means you’ve already experienced one—and you got through it.

When anxiety rises:

• Reflect on previous flares and what helped you cope
• Remind yourself of the resources/supports you’ve used successfully
• Reframe “What if I can’t handle it?” to “I’ve handled this before”

Waiting for the next flare can be emotionally exhausting. Even when you try not to let anxiety take over, it’s hard when you know how disruptive a flare can be. While you may not be able to control when a flare occurs, you can influence how you respond to the uncertainty with some small changes to your thinking and behavior. With practice, those “in between” periods can begin to feel less like waiting for something bad to happen and more like what they truly are—time to enjoy feeling well.