Elly was dreading the upcoming holidays. "Just thinking about the holidays makes me tired and irritable. My IBS symptoms always flare at this time of year. I hate to admit it, but sometimes that's a good thing - because then I don't have to do things I don't want to do."

When her coach asked, "How would you like things to be different?" without hesitating, Elly replied that, for starters, she wouldn't chauffeur relatives back and forth from the airport all week.

"I hate being on call. And the traffic stresses me out. But I don't have a choice. My relatives expect me to help out, and I wouldn't feel right telling them no."

For many of us, the fear of making others angry - or simply disappointing them - is a strong deterrent to saying no. In fact, many people find that the only time they can justify saying no is when they feel sick.

But here's the good news. You don't have to feel sick to say no! While saying no sometimes involves tough choices, it's important not to confuse tough choices with having no choices.

So, how do you make the tough choice to say no? You can start by listing all the things you will gain by putting your wants and desires at the top of the list. Elly's list, for example, was topped by more time to read, rest, and spend time with her children.

Remember that every time you say no to something you don't want to do, you're saying yes to new possibilities, as well as greater peace of mind and enhanced health.

While the immediate confrontation can be stressful, the ongoing stress of ignoring your own needs is ultimately more stressful.

When you live with chronic illness, certain aspects of your health may not be under your control, so it's essential to make wise choices about everything you can control. Here are three simple, yet powerful questions you can ask yourself before agreeing to anything.

1. Is it worth sacrificing my health to keep others happy? That tightness you feel in your neck and chest, or the onset of a headache or stomachache that comes with doing something you don't want to do - all these are messages from your body. And those messages are probably telling you to say no.

Ongoing exposure to stress exhausts the body's immune system. So it's a good idea to seriously weigh the physical and emotional consequences of not honoring your needs and priorities. When you have the courage to say no, you give yourself the gift of enhanced health and energy.

2. What will I gain by saying no? Every time you say no to something you don't want to do, you are saying yes to more time and energy for your priorities - the things you most love and enjoy. Stop and think about what you'll be giving up before you agree to anything.

Elly, for example, was giving up holiday time with her children when she took on the task of shuttling relatives to the airport. When you make choices that support your priorities, you open the door for a more balanced, satisfying life. Your priorities are legitimate, and saying no is an important way to honor them.

3. What other options are available? Many people fall into the trap of thinking that just because they've volunteered to do something in the past, they're obligated to do it indefinitely.

One way to move past this way of thinking is to list as many actions and strategies as you can think of that will accomplish the same goal - without your direct involvement.

The more ideas you generate, the more likely you'll actually find one that you're willing to try or suggest. Most people find it easier to say no if they can offer others a reasonable alternative to their involvement.

Elly, for example, suggested that her siblings take turns transporting relatives or chip in for an airport shuttle service. Recognizing that viable options exist can empower you to say no.

By learning how to say no, you can then say yes when you really want to - not when you feel guilty. So when you want to say no, say so!