By: Jennifer McMillen Smith, LISW-S, HIV Social Worker at MetroHealth Medical Center and medically reviewed by Ann K. Avery, MD, Infectious Disease Physician at MetroHealth Medical Center
Is resilience something you're born with, or something you build? According to Emily Mally, a licensed independent social worker, the answer is both.
Emily has learned a lot about resilience. She spent 18 years in the emergency department at MetroHealth, working with patients and families dealing with trauma, abuse, or neglect. And, when a patient died in the emergency room, Emily was the one who guided families through the post-death process. For the past three years, she has worked on MetroHealth's HIV care team, focusing on behavioral health. She does mental health assessments, connects patients with therapy and psychiatric care, and leads activity-based groups for patients.
"Some of us come into the world with a calmer nervous system or a more easygoing temperament, so stress doesn't hit quite as hard at first. But that's just where you start. There's also psychological research that shows resilience is not a fixed trait," she says. "It functions more like a muscle. People can actively develop it, practice it, and strengthen it over time."
How we're raised shapes how we handle problems and build resilience, and as adults, we can strengthen our resilience through intentional positive daily habits.
"We have to acknowledge problems and setbacks," Emily says. "Making a plan to conquer those setbacks and problems will help build resilience."
Resilience doesn't mean you aren't scared
One of the most common misunderstandings about resilience is that resilient people don't struggle. Emily disagrees.
"Someone can clearly be resilient while feeling scared, angry, depressed, or overwhelmed," she says. "Being strong does not mean you don't feel pain. It means you keep moving forward while you feel those heavy emotions."
In fact, feeling those emotions is part of the process. "You have to let yourself feel the pain. You cry, you get mad, and that's okay. You accept the moment. Things hurt right now. I don't feel my best right now, but I'm going to get through this, and I'm going to take one small step each day."
Getting through hard emotions also teaches you something valuable about yourself. "You went through these really hard things, and now you've learned you can actually do the hard things."
10 practical steps for hard times
When you're in the middle of a difficult period, it can be hard to think clearly. "You're so focused on the negatives or what's happening," Emily says, "you have to be practical." Here's what she recommends.
- Start with the basics. Emily keeps this simple: eat regular meals, drink water, and try to get some rest. "Hydration is really important, as well as healthy meals," she says.
- Keep small routines. Make your bed. Brush your teeth. Doing a few normal tasks helps keep you steady when everything else feels off.
- Break problems into small pieces. “Don't tackle the big problem. Tackle small ones.” The whole crisis might be too much to handle at once, so go after the smaller pieces first, one step at a time.
- Connect with others. Talk to a trusted friend or family member, even if it's just a quick chat to run an idea by them. She also encourages people to join peer groups and get to know local advocates.
- Calm your body. Take slow, deep breaths. Step back and take a time-out. Try a grounding exercise–stop where you are and name five things you can see around you. Keep going with the other senses: label four things you can hear, three things you can feel either on or around your body, two things you can smell, and one thing you can taste.
- Write it out. Emily encourages people to journal for 10 to 15 minutes a day.
- Get outside. A short walk in a green space can help you feel calmer. Daily life demands a lot of focused, effortful attention, like screens, traffic, and to-do lists, and that kind of attention wears out fast.
- Avoid harmful escapes. "Alcohol and drugs make you feel like you're escaping," Emily says, "but really they just add more stress and make the process harder in the long run."
- Simplify what you can. Sometimes stress comes from just plain adulting. For example, if you're always worried your medication refill won't come on time, ask your care team about mail-order prescriptions. It's a small fix, but Emily says it matters. "When we find solutions for people, then I think resilience grows because they know there are options."
- Lean on your care team. "There's always someone ready to help you or listen to you," Emily says. "We work for the patient and are always here for them. If a patient needs help, come get our support."
Reminders for the hard days
Emily shared a few reminders worth keeping close:
You're not alone. You can feel sad and still be resilient. There is power in asking for help. Focus on what you can control and let the rest go.
Failure is part of it. "We all have failures. You just pick up and go. If anything, use it to build your resilience, because you know what? We all fail at it, but we pick ourselves up and tackle it again, and again, and again."
Also, protect your peace. "If you're feeling tired, let your body rest. You have to protect yourself."
For anyone who has just been diagnosed with HIV, Emily has a special message: "Your worth is unchanged. An HIV diagnosis is not going to define your future, your value, or your capacity for joy and fun. Tough moments will pass, so give yourself some grace. You're going to get through this, one day at a time."