Habits — whether good or bad — are sticky. They are actions that we repeat over time and become automatic behaviors. As the saying goes, old habits are hard to break.
But creating new ones? That can be tricky, too. Studies show that it can take about 18-254 days for a new habit to set in. Michelle Drapkin, PhD, a licensed clinical psychologist and owner/director of Cognitive Behavioral Therapy (CBT) Center in New York City, likens our habits to a slip-and-slide that you “glide down without even thinking.”
“That slip-and-slide is hidden deep in a wooded forest,” Drapkin says. “You have to cut down trees, clear the brush, and do a lot of work just to reveal it. Meanwhile, the old habit is right there, wide open, easy as ever. It takes almost no effort to slide right back down.”
How Do Habits Form?
Habits form after some sort of trigger — a stressful situation, a comment from someone, or a thought we have — prompts us to respond or behave in a certain way. If we get a reward (reinforcement) for this behavior, we repeat the behavior each time we experience the trigger. For example, maybe you bite your nails when you’re stressed or worried. If you find it soothing, your brain associates stress (trigger) with the soothing behavior of biting your nails (reinforcement). Over time, a habit forms.
Building Healthy Habits With Ulcerative Colitis
When you have a chronic condition like ulcerative colitis (UC), creating new habits — even those your doctor suggests could help reduce UC flare-ups — can be even more challenging. “Pain, fatigue, and unpredictability don’t just make life harder in general; they make it significantly harder to get into that forest and start clearing,” Drapkin says. “On a flare day, you’re not cutting down trees. You’re surviving. That’s not a character flaw or a lack of willpower. It’s biology. And any approach to building new habits with UC has to account for that reality from the start.”
If you have UC, your doctor might encourage you to adopt some healthy habits. Here are some common ones and why they might be hard to follow:
Doctor’s advice: Modify your diet
Why it’s hard. This advice can be confusing or misleading, as your specific nutritional needs depend on your disease state. Often, patients with UC are told to avoid or restrict specific foods. This could result in you not getting all the nutrients you need.
Doctor’s advice: Exercise
Why it’s hard: If you have UC, doctors recommend you get 30 minutes of moderate exercise three to five days a week. But symptoms such as pain, fatigue, and constipation can make exercise difficult. If you have diarrhea or feel an urgent need to poop, exercise can feel impossible.
Doctor’s advice: Manage stress
Why it’s hard: Stress can trigger UC symptoms — which can, in turn, cause stress. When you worry or stress about your symptoms, it can cause more gut inflammation, which leads to ongoing symptoms.
Doctor’s advice: Take your medications as prescribed
Why it’s hard: If you take several medications to manage your UC, you may forget to take them on schedule. You might also avoid or delay taking them because of negative side effects.
5 Tips to Help You Stick to Healthy Habits Long-term
Here are five tips on how to make a healthy habit stick:
1. Assess your values
Drapkin suggests figuring out what matters to you and linking your habit-change efforts to that. She says linking your goals to your values increases your chances of creating lasting change. “‘I want to manage stress because I want to be present for my family’ is a far more durable motivator than ‘I want to avoid a flare,’” she says. “Fear gets you started. Values keep you going.”
2. Make micro moves
Research shows it’s harder to make lasting change when you change too much too fast. Drapkin advises making one small change at a time. “The goal is to make the behavior so small that skipping it feels harder than doing it. Five minutes beats zero every time,” Drapkin says.
Gabriel Cartagena, PhD, a clinical psychologist and clinical director of the Psycho-Oncology Program at Yale School of Medicine in New Haven, Connecticut, agrees. He says that setting big goals too quickly not only reduces our chances of achieving them. It can also lead to demotivation, depression, and less behavior change over time. He suggests starting with one change and maintaining it over time.
For example, if your doctor recommends you eat a healthy diet to reduce UC flare-ups, Cartagena advises gradually substituting or removing foods to improve your diet, rather than doing a major overhaul. “If dairy or spices incite flare-ups, but many dishes you eat include these things and are particularly meaningful, start by exploring dairy substitutes and adding them to dishes,” Cartagena says.
3. Habit stack
Cartegena says one of the reasons building and maintaining healthy habits can feel tough is that we feel we have to start from scratch. He says one of the easiest ways to make small habit changes is to identify your existing routines and add (“stack”) the new habit onto that.
For example, if your doctor recommends taking your medications twice each day as prescribed, you may stack that habit onto your morning and nighttime routines. “The banana you eat every morning can become a cue for you to take your meds in the morning,” Cartagena says. “The flossing you do at night can be a built-in cue for taking nighttime meds. You can build upon what works for you without having to reinvent the wheel.”
4. Track your progress
Both doctors recommend keeping a journal or using an app to track your progress toward your habit formation goals. For example, you might keep a food journal to take note of foods that trigger UC symptoms. “Track what you’re eating, when you’re eating, and how you feel before and after,” Drapkin says. “No judgment, no overhaul. Just data. Once you have a clearer picture, you can start making small, targeted shifts.”
5. Get support
Both Drapkin and Cartagena say that building lasting health habits — especially when you have a chronic condition like UC — can be challenging and overwhelming, but you don’t have to do it alone. Your medical team and nutritionists can help you manage your diet and medications, while a psychologist or therapist can support you as you try to develop and sustain healthy lifestyle habits. Find a partner to hold you accountable, or an online community or support group of other people living with UC to help you on your journey. You can find virtual and in-person support groups near you through the Crohn’s & Colitis Foundation website.
Above all else, Drapkin and Cartagena advise giving yourself grace. Drapkin often guides her patients in a meditation exercise she calls “Welcome to the party,” where they accept, rather than resist, the challenges of their condition. “Acceptance isn’t defeat,” she says. “It’s the most efficient starting point we have. Build your habits from there. Small, values-connected, tracked, supported. And when you slide back down the old slip-and-slide, because you will, welcome to that party, too. Then start clearing the trees again.”
Cartagena agrees. “Even if it feels like you take five steps back, one step forward makes all the difference.”
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