Taking care of yourself when the chips are down

August 15, 2022 12:35 AM

When things are going well, I'm good at taking care of myself, but I neglect my physical and emotional health badly when things are tough. How do I change this?

For the past month I have been through an extended family medical situation which has been nerve-wracking with many unexpected twists and turns. I'm the only person who is dealing with the situation as my family is diminished in numbers, elderly, and none of them is really capable of dealing with reality at the moment thanks to their various health issues. So I've been the only one triangulating with doctors, organising hospital admissions, making sure prescriptions are filled, sorting out groceries and paying the bills etc. I do have some people to delegate to - I have hired a caregiver who deals with the day to day care (toileting, washing, etc) of my relatives and a lady who comes in to do the cooking etc. But I'm very much where the buck stops.

I have been feeling so depleted. I have been too stressed to eat - like literally I can barely eat when things are bad - I haven't been able to sleep, and I have barely taken any time for myself. The one or two times I have taken a bit of time to see a friend or grab a coffee, things have suddenly taken a downturn shortly after, and superstitiously I feel like anytime I even momentarily relax my vigilance, things will go to shit. Even though I know logically that there is no causal effect between my stress levels and the way a situation will go.

Anyway, one of my relatives seems to be improving and I've been taking advantage of this by doing some leisure reading, getting a haircut, and arranging to see friends. I've been sleeping better and eating more. I feel a lot better. But part of me is terrified that because I'm not currently consumed with anxiety, something bad will happen. And another part of me knows that I need to take care of my emotional and physical health all the time, not just when I feel like I have the space to.

Anyway. How do I make the mental space to take care of myself when in the thick of family stuff? I know it's good for me and makes me better able to care for and advocate for my family, I just find it very hard to find space amongst the endless to-do list and all the anxiety.

posted by unicorn chaser to Health & Fitness (9 answers total)

First, I am sorry to hear you are in such circumstances.

But remember the safety briefing from the flight attendants before your plane takes off: if the oxygen masks drop, your first duty is TO PUT ON THE MASK YOURSELF, THEN to put it on someone else such as children.

In other words, save yourself, THEN you can try to save someone else, if you can. Which you are aware of, but may have a little problem actually... doing.

Maybe SCHEDULE some off-time, me-time, whatever you call it. Sleep, lounge, zone out with the tube, whatever relaxes you so you don't think about things (much). AND maybe a little pamper time. Reward yourself a little. A cone or a parfait from McD. A small slice of cheesecake.

Once you have setup a proper care system for your other relatives, simply ask yoruself, have you done all you could with reasonable expectations. (i.e. no, you can't drop everything and fly over, that's not reasonable) then there's really not much else you could have done. And accept that.

Some people enjoy "fighting fires" because it makes them feel... they are accomplishing something. But logically, it'd be much better PREVENTING fires, since there would be a lot less trauma consumes a lot less resources and time. And I do mean fires in a very figurative sense. I think I read this in a newsletter: if you are fighting fires all the time you are not managing the situation, but perpetuating it.

You *are* managing the situation, and you need to basically give yourself credit for doing that, maybe with a little reward.
posted by kschang at 4:56 AM on August 15, 2022 [2 favorites]

I agree with kschang that it’s important to recognize yourself for all that you have done and are doing to manage the situation. Giving that message to yourself is definitely self care.

Box breathing is the one self care habit I am able to reliably do during overwhelming duties caring for multiple others. I vividly remember how it rejuvenated me the first time I did it standing in front a sinkful of dishes during a family member’s hospice. It can be done anywhere, anytime and in moments (but is definitely better to do it longer.)

You could google it, but basically using the count of four to draw a box of breath. Breathe in four seconds, hold for four seconds, release for four, hold for four and start again.
posted by Phyllis keeps a tight rein at 6:36 AM on August 15, 2022

Something I've discovered is that when I think "I need to eat" or "I'm cold" or "I need __" the message doesn't get all the way through unless I think "The baby needs to eat" "The baby is cold" "The baby needs to rest". (I don't have a baby). It sounds silly but it's like a cheat code in my brain. Taking advantage of some ancient neurological pathway. It instantly unlocks energy & executive function that I really did not know I had. Give it a try. It might even just work as a placebo.
posted by bleep at 8:11 AM on August 15, 2022 [9 favorites]

Also, keep just one to do list and just work through it step by step; I have "shower", "eat breakfast" and "eat lunch" on my list so I get points for doing those things & a visual reminder.
posted by bleep at 8:15 AM on August 15, 2022

part of me is terrified that because I'm not currently consumed with anxiety, something bad will happen.
Something bad will happen, but your failure to be consumed by anxiety will not have caused the bad thing to happen. And if you happened to have been consumed by anxiety immediately precedent to the bad thing happening, your anxious brain will devise some other reason the bad thing could have been avoided except that You Did It Wrong. It's just the way humans work. We want to be able to be the cause of everything in our lives because then we can control it all. But we cannot. Death comes for us all etc. etc. blah blah blah.

Speak kindly to your terrified brain whenever it does this. Say, "Yes, yes, it could be that Great Aunt Tilda is even now as I attempt to concentrate on this crossword puzzle diving headfirst into the root cellar and will be smothered under an avalanche of stored potatoes. But it is just as likely that if I drove over there right now in my state of anxious turmoil I could sail off an overpass or drive into what looks like a puddle but it turns out to be The Abyss and the car sinks to the center of the Earth and we drown in a lightless void."

This last is something my own brain is convinced is going to happen. A lot of my dreams the moral turns out to be: "NeVeR dRiVe ThRoUgH pUddLeS tHeY hAvE nO bOttOmzezzzzzz ayeee..." That is the default condition of the anxious human brain. Be very gentle, but disallow this nonsense.
posted by Don Pepino at 9:06 AM on August 15, 2022 [3 favorites]

I'm sorry you're going through this. I've also been managing a family medical emergency this past month and it has been exhausting. Do you have a therapist or group support for caretakers? I see a therapist regularly anyways and the sessions were basically the only thing I did this past month that wasn't tied to taking care of my relative. It was the one thing I really tried to maintain as part of my self-care. She helped me think through priorities and boundaries, managing hopelessness and finding what my values are during this time, and talking through my guilt when I do take time for myself. Especially as my relative's health has been so up and down, I'm just always waiting for it to go into crisis again. Being able to talk through what was significant/valuable to me the past month and what to mentally/logistically prepare for the next round has helped me a lot.
posted by inevitability at 9:29 AM on August 15, 2022

Working with a therapist would be a great idea. You have a lot that you're dealing with, and a lot of people depending on you! Do whatever you can to take care of yourself, and know you're not alone.
posted by SaharaRose at 10:43 AM on August 15, 2022

While Self Care (capitalized) is so important, for me, recognizing the little moments and opportunities for self care has been really helpful. For example: slowing down a little while I’m brushing my teeth to enjoy the feeling of cleaning my mouth or putting lotion on my hands the first time after I wash them that day.

I want to mention the anxiety and not eating: I think it would be good to talk to your doctor about this when you can. I have been so anxious before that I stopped eating. At that point, my doctor and I determined it was time for me to try some meds. (they have helped.)

Finally, do you like listening to music and/or singing along? My therapist says that there’s research that singing helps calm anxiety. You could make a point to sing next time you drive from a to b or every time you wash your hands.
posted by CMcG at 11:41 AM on August 15, 2022

One of the first things you learn when you study Incident Command System is that when you run across someone in distress who needs rescuing, you don't immediately jump in to help them because then there are two people in distress who needs rescuing (this is basically "put your own mask on first"). In fact, larger incidents will have a "safety officer" whose job is to keep track of all the other responders and make sure they're doing OK. You need to be in good health in order to be helpful.

So, like kschang, I recommend giving yourself a schedule, and maybe you need someone to check in with you every day to keep you honest.

Also, I don't know if you can reframe this problem in your head, but I draw a distinction between fretting, which is pointlessly spinning my wheels, and planning. I'm not saying I don't ever fret (I do), but I recognize it's not doing any good, and I can at least try to do something else, or distract myself.
posted by adamrice at 9:28 AM on August 17, 2022 [1 favorite]