The New Normal: Well Understood for those Living with Chronic Conditions

The New Normal: 

It was several years ago that I first heard the term "the new normal." I remember the day and where I was standing. I remember the patient. I really don't know why the day stands out so vividly among days that have so many other memories. But it does.

It was a busy clinic day. I was running a bit behind. There were a few too many patients added to my clinic list before I was to leave for a meeting abroad. A patient was describing her symptoms, and the way she was feeling and dealing with hair loss and how the world around her was equally responding to her changes and feelings.

"It's the new normal, Dr. Donovan."

The New Normal

The term "new normal" has many meanings. Those living with a chronic health conditions understand what is meant by the "new normal." There is no good definition but it refers to a resetting of some kind of internal mechanism to deal with new changes in how one looks or feels after experiencing a change in his or her health. At least that's my definition.

New Normal and Hair Loss

The new normal is often talked about in the context of patients living with cancer, heart disease or other chronic internal illness. But it equally applies to many with hair loss.  

Significant hair loss, especially if it occurs suddenly causes severe emotional distress for many patients.  For some whose hair loss is likely to be of a more permanent nature, an entirely new means of coping sets in. Such patients often tell me that they find their "new normal." To say that they accept their hair loss is not accurate for all patients. To say that they learn to deal with it is also not accurate for all patients. But they will tell me it's their new normal.

Some of my patients with alopecia totalis, alopecia unversalis and some forms of advanced scarring alopecias will tell me that over time they find their new normal slowly. For some, the new normal is explaining their hair condition to family. For others it'stalking about hair with their friends, hairdressers or even complete strangers.  

For some with scarring alopecias, or hair loss from systemic illnesses like lupus, the new normal relates not only to the emotions and feelings that come with hair loss but actual physical symptoms. This might be the chronic itching or chronic fatigue they experience that comes and goes even when on the very best of medications.   

"It becomes the new normal, Dr. Donovan."

Conclusion

The "new normal" refers to something different for every one of my patients who use the term.  I have learned over the years that it does not necessarily mean that the patient is doing fine or coping well with a new emotional or physical change in the body. It simply means their internal mechanism for dealing with chronic life changing event has been reset.