‘But You Were Fine Yesterday’: The Misunderstood Fluctuations of Chronic Illness
To the outside world, chronic illness often presents a paradox.
One day, a person may seem energetic, sociable, and fully engaged in daily life. The next, they may be unable to leave their bed. This inconsistency—both bewildering and invisible—lies at the heart of many misunderstandings surrounding chronic conditions.
The phrase “But you were fine yesterday” is rarely said with malice. More often, it reflects a fundamental gap in how society understands health: as a binary state of either wellness or sickness, rather than a spectrum marked by fluctuation, fragility, and adaptation.
The Myth of Consistency in Illness
For many living with long-term health conditions such as autoimmune diseases, fibromyalgia, or chronic fatigue syndrome, symptoms ebb and flow. Pain levels shift. Energy is not just low—it’s unpredictable. Mental clarity one day can dissolve into brain fog the next. This phenomenon is often referred to as “good days and bad days,” but even that language oversimplifies the complex dance of internal and external factors affecting the body.
What triggers these changes? It can be anything from the weather to overstimulation, from food sensitivities to emotional stress. Sometimes there’s no identifiable cause at all—just the body, reacting in ways that defy logic and linear timelines.
The Weight of Invisible Decision-Making
What’s often missed in public narratives about chronic illness is the sheer volume of mental labour involved. Every day becomes a balancing act between desire and capacity. Should they attend the morning meeting, or conserve energy for a family dinner later? Is a ten-minute walk worth the risk of a flare-up tomorrow? Can they make the commitment—social, professional, or personal—without paying for it physically?
These aren’t casual considerations. They’re calculations layered with emotion. The desire to show up fully—to be present, capable, and ‘normal’—clashes with the body’s limitations. Many people with chronic illness become masters of micro-decisions. They budget energy like currency, constantly aware that overspending may have delayed but severe consequences.
When Participation Feels Like Dragging a Weight
Even when someone does say “yes,” it often comes at a cost. Behind the scenes, getting out of bed, preparing for an outing, or joining a conversation can feel like dragging a heavy weight just to keep up. They may laugh, nod, and contribute—but underneath, they’re managing pain, fatigue, or a gnawing fear of overdoing it.
This doesn’t come from a place of fragility or dependence. On the contrary, it reflects deep strength and determination. Many simply want to participate in life—to contribute, to feel useful, to not be left behind by time or circumstance. They’re not seeking pity. They’re hoping for possibility.
Fluctuations Are Not Failures
In a culture that prizes perseverance and consistency, people with chronic illness may internalise these fluctuations as personal shortcomings. The unpredictable nature of their health can lead to feelings of guilt, shame, or the need to constantly explain themselves.
But variability is not a sign of weakness. It’s a reality of living in a body that is navigating chronic dysfunction. Adaptability, not predictability, becomes the key to resilience.
The Emotional Cost of Being Misunderstood
When loved ones, colleagues, or even healthcare professionals question someone’s symptoms based on how they looked “yesterday,” it adds an emotional burden to an already difficult experience. Doubt—whether subtle or overt—undermines trust and can lead to self-doubt.
This misunderstanding can also lead to accusations of exaggeration, laziness, or attention-seeking. In reality, many people with chronic illness expend tremendous energy to appear fine, even when they are far from it. These efforts, while often invisible, come at a cost—one that may delay recovery or deepen exhaustion.
The Desire to Be 'Normal'—Not a Burden
One of the deepest truths often unspoken is this: most people living with chronic illness aren’t worried about others not understanding them. They’re worried about being left out of life. They want to make plans without fearing they'll have to cancel. They want to say “yes” without caveats. They want to be counted on—not as an exception or a question mark, but as themselves.
It’s not about proving something to others. It’s about staying connected to a sense of identity and dignity. They don’t want to be a burden—not because of stigma, but because they still dream of the same things everyone else does: joy, spontaneity, contribution, and ease.
Towards a More Compassionate Understanding
Recognising that chronic illness is dynamic is the first step toward fostering empathy. Employers can shift toward flexible arrangements. Friends and family can learn to offer support without conditions. And society at large can expand its definition of what it means to be “well.”
This shift requires more than awareness—it demands a willingness to sit with discomfort, to accept that not all conditions follow a linear path, and to honour each individual’s lived experience.