The Spiritual Practice of You: Chronic Conditions 

The Spiritual Practice of You: Chronic Conditions  February 25, 2024

A Long-Distance Runner with Long Covid 

I went for a 12-mile trail run today. It was strong and I really felt the effects of yesterday’s three-hour spin in a good way. I call runs like this rebound runs. My goal this year is to return to running 50k’s. I ran my last 50k in 2020 and was still posting personal records (PR’s) in 2019. All this changed with COVID-19. After the second shot, I felt like I aged 10 years, and after having COVID the following fall, I noticed a lot of change in my tidal volume, recovery, and lingering fatigue. I did not complete any of the 50k’s I planned in 2021 and took the 2022 and 2023 season off to recover. This year, in 2024, I am planning a 50k race in September and my overall op tempo for races is pretty high this year with twenty-five events on my list, half are shorter 10k – half marathon events, gravel and road bike events, a bike packing trip and a backpacking trip.  

Long Covid and New Research 

I have tracked down my symptoms of long Covid to my mitochondria and mitochondrial dysfunction is showing up quite a bit in the research around the fatigue many are experiencing.  

Two articles showed up in my news feed this week around current research around long COVID. 

The first article was published in the journal Science on 18 January 2023 (DOI:10.1126/science.adg7942 ) points to these symptoms of long COVID: fatigue, post-exertional malaise, and cognitive impairment. This study showed that patients with long COVID had elevated platelet activation markers and monocyte–platelet aggregates. As I am not a doctor or a scientist, much of this article was above my paygrade.  

The second article I came across was more in my wheelhouse. Published on 4 January 2024, in the Journal, Nature Communications ( this article points to “A subgroup of patients infected with SARS-CoV-2 remain symptomatic over three months after infection. A distinctive symptom of patients with long COVID is post-exertional malaise, which is associated with a worsening of fatigue- and pain-related symptoms after acute mental or physical exercise, but its underlying pathophysiology is unclear.” (Appleman, et al.) This article I found to be particularly helpful in understanding some of my symptomology and the symptomology of several clients I am working with right now.  

This second article also points to the same list of long Covid symptoms pointed to in the first article I cited. The conclusion from this article showed “that skeletal muscle structure is associated with a lower exercise capacity in patients and that local and systemic metabolic disturbances, severe exercise-induced myopathy and tissue infiltration of amyloid-containing deposits in skeletal muscles of patients with long COVID worsen after induction of post-exertional malaise.” (Appleman, et al.) 

Managing Chronic Conditions a Cognitive Behavioral Therapy Approach 

Dealing with and managing chronic conditions can be mentally and physically exhausting. With long Covid and many of the autoimmune problems I see as a mental health clinician, the answers to these medical concerns are not as easily addressed by simply offering a medicine. Often it takes a lot of sleuth work on the patient to then present to the doctor. If the doctor is willing, a collaboration between doctor and patient occurs and other specialties like endocrinology, dermatology, psychiatry, and others are brought in to address the concern integrally.  

As a clinician, my main approach to helping clients with their chronic conditions is Cognitive Behavioral Therapy. In this form of therapy, the therapist hears concerns from the clients, asks questions and often times will focus on confronting thinking errors around specific thoughts a client may have around a problem. I often add acceptance work and grief work with my clients when dealing with chronic conditions.  


Each of us is a work in progress. We never truly arrive on the road we are on; we are constantly in the process of becoming. Everyone will experience changes in their lives, inevitably, time will catch up with us and we will have to face a procedure, a test or an illness or injury that may change and challenge our way of living.  

We are all sons and daughters of the divine. We are loved beyond all measure. In my tradition, I cling to the idea of a loving God who does not want to see us suffer. I believe the essence of this God is love. 

If you are in the process of dealing with a chronic injury or illness, you owe it to yourself to get help. Start with a therapist if traditional medicine has not been helpful. Learn how to cultivate an acceptance and learn to live within your new limitations. Adjusting to a new normal is the key to freedom.  


Appelman, B., Charlton, B.T., Goulding, R.P. et al. Muscle abnormalities worsen after post-exertional malaise in long COVID. Nat Commun 15, 17 (2024). 

Carlo Cervia-Hasler et al.,Persistent complement dysregulation with signs of thromboinflammation in active Long Covid.Science383, eadg7942(2024). DOI:10.1126/science.adg7942 


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