In modern times, the term self-care has become ubiquitous with treating oneself. And while we can all agree that the occasional pampering is healthy and beneficial, for some it’s not merely an indulgence, but a daily struggle. For those with a chronic illness or disability, self-care can be the difference between life and death.

For someone who can barely get out of bed, the idea of doing a face-mask or taking a bubble bath seems inconceivable, exhausting and frankly, absurd. How can you run a marathon when you can’t walk a mile? When you’re in survival mode, self-care needs to be about taking tiny steps, not giant bounds.

In a 2003 essay, Christine Miserandino coined the term “spoon theory”. Spoon theory “is a disability metaphor…used to explain the reduced amount of mental and physical energy available for activities of living and productive tasks that may result from” having a disability, chronic illness, autoimmune disease, or mental illness. (wiki)

Each day, a healthy person is seemingly doled unlimited spoons (mental and physical energy) to complete tasks. A person suffering from an illness may start their day with only five or ten spoons. Each task throughout the day costs them a spoon. Brushing your teeth costs a spoon. Taking a shower costs a spoon.  And the spoons don’t automatically replenish! The next day, you might have even fewer spoons, so you have to decide what the best use of your spoons is because you don’t know when the next one might come. All the small daily activities neurotypical, able-bodied people take for granted, are viewed by “spoonies” as a limited resource that must be carefully rationed.

Let’s just go ahead and kill the notion that self-care is always fun and uplifting. For some, self-care is survival. Self-care is not just allowing yourself little luxuries – a piece of chocolate cake on the weekend or pedicure once a month – but finding the energy or will to take care of yourself on a daily basis. Self-care can mean paying a bill you’ve put off paying or making a doctor’s appointment that’s long overdue. Self-care can mean taking daily medication. It can mean doing a simple task – like getting out of bed or washing your hair. Everyone’s allotment of spoons is different, so everyone’s approach to self-care should be unique and tailored to their own ability.

Many people develop an all or nothing approach to self-care.  If you don’t have the energy to clean your entire bedroom, why bother cleaning at all? What difference will it really make? It’s not laziness or lack of motivation – quite the opposite – all-or-nothing mindsets are often symptoms of perfectionist personality types. The perfectionist mindset tells us, “If I can’t do it perfectly, I won’t do it at all.” In the face of failure, we become paralyzed or procrastinate until we are weighed down by guilt and anxiety and the small task becomes a looming, insurmountable obligation.

So where do we go from there?

1. Take Baby Steps.

The truth is, when you’re low-functioning, any tiny change to your routine or environment can ease stress and improve well-being. Breaking down larger tasks into smaller tasks or baby steps can help conserve energy and improve your sense of accomplishment. If you can’t brush your teeth for the recommended two minutes dentists suggest, brush for thirty seconds and swish around some mouth wash instead. If taking a shower is too daunting, take a bath. If your bedroom is a mess and you don’t know where to start, pick up the clothes from your floor and put them in the laundry basket. This should take five minutes tops and having a cleaner environment will boost your mental state and self-confidence. Let go of the ideal of perfectionism. Your space doesn’t have to look like a Pinterest inspiration board. Give yourself permission to half-ass it. Take five small steps instead of one large one.

2. Do What Feels Good.

Being told to “just exercise” when you’re feeling depressed or have chronic pain issues, can feel a little insulting, even condescending. But you don’t have to take an hour-long walk to reap the benefits of serotonin.  Do some stretches when you first wake up. Meditate for five minutes. Listen to a feel-good, upbeat song.  Dance if you can. Light a candle. Put a few drops of essential oil into your diffuser. Color in an adult coloring book. Write some poetry in a notebook. Stop and smell some flowers (literally). Spend a few minutes bird-watching out your kitchen window. Say some positive affirmations to yourself in the bathroom mirror. (Write them on the mirror with lipstick if you need to!) Do something small to spark joy. (I don’t suggest watching TV or scrolling the Internet because even though these bring you temporary relief, they’re not especially good for mental illness.)

3. Prioritize Your Tasks.

When you have the energy, make a self-care checklist and put it in a place of prominence. (The bathroom mirror or fridge door are good places). Write down the number of spoons each task takes you. Prioritize what tasks need to get done (paying bills, feeding your pets, taking your medicine) and what you can do on a day when you’re feeling more energized (sweeping the kitchen, doing laundry, opening junk mail). And remember to treat yourself with care and empathy! The list isn’t meant to be a reminder of all the things you can’t do and all the ways you’re failing yourself and others. Take pride in every small accomplishment. For some, doing the minimum is doing their best.  And that’s okay!

4. Socialize.

One of the hardest times to socialize is when you’re feeling low. You feel like a burden to others. You self-isolate in an attempt to recharge and refocus, but you only end up feeling more depressed. Even introverts who feel drained by social interaction, need it.  Friends and loved ones act as a mirror that shows you who you are, not your own warped self-perception.

And with the right people, meetups don’t have to be high energy activities. Not every hangout has to be a party. Ask your friend or family member if they’re okay with coming over to order Chinese takeout and watch TV together in pajamas. Don’t stress about what you or your house look like. It’s okay for them to see you’re struggling. Friends are – most importantly – people you can be yourself around. Don’t be afraid to let them see you at your worst.

If they’re struggling too, act as accountability buddies for each other – go to the library together to work on schoolwork or projects, do chores together. Having friends and family around ease the burden of loneliness and pain and give you a much-needed boost of energy.

5. Time Yourself.

Often, we build up tasks in our head to be larger than they actually are.  Not knowing what to expect or how much energy we’ll need to expend can lead us to procrastinate or spiraling into a state of total paralysis. Setting a timer to gauge the length of time a task takes can be reassuring. Knowing it will only take you 5-10 minutes to empty the dishwasher or 6 minutes to throw a load of laundry into the washer can help make tasks seem more feasible. You can also use the clock to push yourself. “I’m just going to write for 5 minutes,” you can tell yourself, and if the timer goes off before then and you still have energy, you can set it to another five and so on… Most of the time, getting started is the hardest part.  Once we get into the groove, we can easily do more than we expected.

6. Make Mundane Tasks Fun.

No one likes doing chores. But we can make it so they’re not completely insufferable. Put on music while you shower. Watch a Youtube video while you get dressed or put on makeup. Get a bath-bomb or bath-oils to make bath time more stimulating. Cook dinner with a family member instead of alone. Talk on the phone to a friend when you have a long commute. Listen to an audio-book while you exercise. Eventually, the task will become more enjoyable because of the positive associations you have with it. Conversely, sometimes really focusing and meditating on what you’re doing and why you’re doing it can be motivating. “I’m showering today because I love myself and I feel better when I do.” “I’m eating a healthy salad to nourish my body today.”

7. Reward Yourself.

Rewarding yourself too often can put you into financial debt or swell your waistline, but every once in awhile, you’ve got to give yourself credit where it’s due. If you can only do five tasks today and you complete all five, it’s a victory! Pat yourself on the back, do some positive affirmations and put a little money aside to buy yourself a treat at the end of the week. Remember, what are baby steps for others are big steps for you!

While it may seem an exaggeration to suggest taking care of ourselves increases our will to live, studies of the link between depression and self-care suggest otherwise. Caring for ourselves leads to improved self-confidence and improved relationships with those around us. Finding a way to care for ourselves, despite our limitations, will have a positive ripple effect.

What sort of self-care do you practice in your own lives? What obstacles stand in the way of your self-care?