What should teens with a chronic illness consider when choosing a career? Advice for high-school students questioning their future, and for their families.
In the guidance lesson, the teacher asks everyone the same question: "Where do you see yourselves in ten years?" While your classmates list doctor, engineer, pilot, athlete, you stay quiet. The question running through your mind is a different one: "Can I do that with my illness?" For many young people living with diabetes, epilepsy, a heart condition, Crohn's disease, a rheumatic condition or another long-term health condition, the question of career choice for teens with chronic illness is not just a matter of preference; it is also a question full of fear, uncertainty and sometimes anger. This article is for high-school students who are questioning their future because of their illness, and for the families who walk alongside them. The medical assessment of which jobs your illness may or may not affect should always be made together with your doctor; here we will look at the emotional and intellectual side of this process.
Will My Illness Limit My Dreams? The Question Young People Ask Most
Young people growing up with a chronic illness often find themselves caught between two extremes when they think about the future. On one side is the wish to ignore real limits by saying "My illness changes nothing, I can do anything"; on the other is the tendency to close every door with their own hands by saying "I can't become anything, I'm ill anyway".
The truth usually lies somewhere between these two extremes. Some professions have specific health requirements; some working conditions, such as long shifts, heavy physical work or irregular sleep, can be more demanding alongside certain illnesses. But this does not mean "you can't become anything". Most professions have more than one route, different ways of working and conditions that can be adapted.
Commonly heard thoughts include:
- "If they find out about my illness, they won't hire me."
- "My parents already say 'choose a job that won't tire you out', so I must have to give up on my dreams."
- "I don't know what will happen to my health, so what's the point of making long-term plans?"
- "Everyone else chooses the degree they want; I have to choose the degree I 'can do'."
Each of these thoughts is a different face of worry about the future. You can find more detail on how worry about the future works in general in the article on anxiety about the future; with a chronic illness, the uncertainty of the body is added on top of this worry.
How Does Chronic Illness Affect a Teenager's View of the Future?
Adolescence is a period in which identity and dreams for the future take shape. Living with a chronic illness during this time can affect how a young person sees themselves and their future in several ways.
Their sense of time can narrow. Frequent hospital stays, check-ups and treatment routines can make a young person focus on "today". Thinking about five years from now can sometimes feel too distant or too frightening.
Their sense of control can weaken. The course of the illness is not in the young person's hands; this experience can turn into the generalisation "Nothing is in my control" and spread into areas that can be controlled, such as choosing a career.
Comparison with peers can increase. While their friends work during the summer holidays, do internships or go to sports clubs, the young person may have missed out on some of these experiences. This feeds the feeling "I've already fallen behind".
Their identity can merge with the illness. A young person who has been known as "the sick child" for many years may start to define themselves primarily through their illness. Yet they are also curious, talented, funny and passionate about particular things.
I discuss the general emotional load of living with a chronic illness in adolescence separately in the article on teenagers with a chronic illness.
Career Choice for Teens with Chronic Illness: What Should You Consider?
Choosing a career is a hard decision for everyone; a chronic illness adds a few extra questions to this decision, but it does not remove the decision itself. The steps below can make the process less frightening and more structured.
First the "why", not the "what"
Asking "Why do I want this profession; what is it that I love about it?" instead of "What do I want to be?" opens doors. For example, what a young person who wants to be a pilot actually loves may be aviation, technology, travel or the feeling of taking responsibility. Even if being a pilot is not possible because of health requirements, many different paths can be found in the aviation sector. A young person who wants to become a doctor may enjoy helping people, science or being part of a team.
Recognising your values, that is, identifying the things that give your life meaning, offers a more flexible road map than sticking to the name of a single profession.
Getting the right information from the right place
One of the most harmful things in the process of career choice for teens with chronic illness is hearsay. Generalisations such as "They won't take anyone with diabetes anywhere anyway" or "Someone with epilepsy can never drive, so they can't do that job either" are often incomplete or wrong.
Instead:
- Talk to your doctor. Describe the working conditions of the profession you are interested in and ask what matters in terms of your health.
- Look at official sources. The health requirements of some schools and professions are officially published; they need to be read carefully during the university application period.
- Get support from the school counsellor. The school guidance service is an important resource for the application process and for learning about professions.
- Talk to people working in that profession. Hearing about the real daily life of a profession from someone who does the job reduces the uncertainty in your mind.
Flexibility and adaptability
Today many jobs can be done under more flexible conditions than before: remote working, part-time working, freelancing, project-based work. Within one professional field there are also different roles: instead of working in the field, roles such as planning, training, research or consultancy can be chosen in the same area. For a young person living with a chronic illness, thinking "this field" instead of "this profession" can widen the options.
Trying things out through small experiences
It is possible to get to know a profession not only by imagining it but through small experiments. Joining the school science club, volunteering for a few hours over a summer at a workplace you know, starting a free online course in an area that interests you, or attending a careers day are steps that let you see both your interest and how your body responds to those conditions. It is important to adjust these experiments to your energy and treatment routine. If an experiment goes badly, this does not mean "I can't do anything"; you have simply gained new information about which conditions suit you. Asking yourself after each experience "What did I enjoy, what tired me out, what could I have done differently?" makes it easier to choose the next step more consciously.
The YKS application period
As YKS (Turkey's national university entrance exam) preferences approach, anxiety usually rises. The thought "If I make the wrong choice, my life is over" can become even heavier when combined with health-related uncertainties. The article on anxiety about university preferences can also help with the general anxiety of the application period. An important point to remember is that no choice is completely irreversible. It is possible to change degree, to change field through a master's degree, and to change direction in working life.
Career Choice for Teens with Chronic Illness and the Family's Role: Between Protection and Restriction
Parents raising a chronically ill child have made great efforts over many years to protect them. This protective attitude may continue during the career choice period; but sometimes it can unintentionally start to restrict the young person's dreams.
Sentences parents often use that can leave a heavy mark on the young person:
- "That job isn't possible with your health; don't bother dreaming."
- "Choose a comfortable desk job, don't tire yourself out."
- "There's no way you can go to a city far from home; study here."
- "We're thinking of what's good for you; what do you know?"
These sentences usually come from love and worry. However, the young person may hear them as the message "You can't make decisions about yourself; there's something lacking in you".
Supportive approaches, on the other hand, might sound like this:
- "Can you tell me why you want that profession? What excites you about it?"
- "Let's talk to your doctor together; let's find out together what's possible and what's hard."
- "If you want to study in another city, let's research how we can continue your health follow-up there."
- "This decision is about your life; we'll be by your side."
Going to university in a distant city can be especially worrying for a young person with a chronic illness and their family. If matters such as the medication routine, check-ups and the possibility of an emergency are planned in advance, this step can become possible, both for the young person's growing independence and for the family's peace of mind.
Illness can change the shape of some paths; but it cannot take away a young person's curiosity, their values or their right to dream.
Disclosing Your Illness at School and Work
Many young people carry the worry "If I tell them about my illness, they won't take me". This worry is an early fear about future working life, but it can also affect career choice.
A few important points on this:
- Who knows about the illness, when and how much, is mostly the person's own decision. In some situations, for example in jobs where safety is a factor, it may be necessary to declare a health condition; the rules on this vary from profession to profession.
- Disclosing an illness is often also the way to request suitable adjustments. Arrangements such as time off for check-up days or flexibility in working hours may be possible in some workplaces.
- The experience of sharing an illness in the school setting during high school or university can be a rehearsal for how you will handle this issue in working life later on.
It can be useful for the young person to prepare a short, confident explanation. For example, a fictional young person might say: "I have type 1 diabetes. I need to check my blood sugar during the day; apart from that, there's nothing that stops me doing my job."
When Should You Seek Professional Support?
Worry about the future, uncertainty and, at times, hopelessness are common among young people living with a chronic illness. However, it can be helpful to get support from a professional in the following situations:
- The young person avoiding every conversation about the future and often saying things like "I have no future"
- A marked drop in interest in lessons, or thoughts of leaving school
- Intense anxiety, sleeplessness or changes in appetite during the exam and application period
- Constant conflict in the family over career choice
- A marked decline in following treatment, a "What difference does it make?" attitude
If a young person's hopelessness turns into thoughts of death or a wish to harm themselves, do not carry this alone; in an emergency, call 112 (emergency services) or go to the nearest emergency department.
How Are Worries About the Future and Career Choice Addressed in Therapy?
Psychological support does not choose a career on the young person's behalf; but it can help ensure that this decision is guided by values and accurate information rather than by fear. Within cognitive behavioural therapy, catastrophising thoughts such as "I can't become anything" and "Everyone will reject me" are noticed and re-evaluated together with the evidence.
In work drawing on acceptance and commitment approaches, the focus can be on helping the young person identify their values and explore ways of building a meaningful life even alongside the illness. Difficult conversations with the family, for example how to express the wish to study in a distant city, can be rehearsed in sessions.
Adolescent counselling offers young people a space to talk about their own dreams, fears and anger independently of their family. Family sessions can also be added to the process when needed. For young people who have to go to hospital often or who experience fatigue, sessions can also continue online.
Frequently Asked Questions
I've found out I can't do my dream job because of my illness; what should I do?
First, allow yourself to grieve this loss; feeling sad or angry is very natural. Then think about what draws you most to that profession. Other paths that carry the same interests and values can often be found; exploring these together with a school counsellor or a professional helps.
My family keeps insisting I choose a particular degree because of my health; what can I do?
Starting by showing that you understand your family's worry makes the conversation easier. Then explain concretely why you have chosen the field you want and how you will look after your health. Getting your doctor's view together can help you base the discussion on information rather than worry.
How should I take my illness into account when making my choices?
Consider your interests and the working conditions together. Look at the official health requirements of the school and the profession, and consult your doctor. Seeing your illness not as the only deciding factor but as one of the factors to take into account helps you make a more balanced decision.
Making plans for the future feels pointless to me; is that normal?
When living with an uncertain health condition, this feeling is very understandable. Starting with small goals of a year, or even a few months, rather than long-term plans can work. If this feeling continues for a long time and is pulling you away from everything, talking to a professional may help.
Bu yazı genel bilgilendirme amaçlıdır; tanı veya tedavi yerine geçmez. Yaşadığınız güçlükler için bir ruh sağlığı uzmanına başvurmanız önerilir. Acil bir durumda lütfen 112'yi arayın.
Eda Erkan Alapala
Klinik Psikolog. İstanbul Kent Üniversitesi Klinik Psikoloji Tezli Yüksek Lisans mezunu; bilişsel davranışçı terapi, çocuk merkezli oyun terapisi ve çocuk-ergen psikoterapisi alanlarında eğitimlerini tamamlamıştır.
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