Personal Hygiene: Bathing, Grooming, And Dental Care:

Is waking up early enough to shower before work getting harder and harder to do? Does finding the energy to floss, brush your teeth, AND use mouthwash feel like a laundry list of impossible stuff?

Dressing: Being able to make appropriate clothing choices (Being able to choose warm clothes in the winter) and being able to put the clothes on by yourself

Do you put as much effort or thought into your clothes everyday like you used to/usually do? Example: being someone who usually loves to accessorize to wearing all black to avoid all the effort

Eating: Being able to feed yourself by any means – cooking, Grubhub, etc.

Are you losing your appetite? Are you losing the motivation to cook like you used to? Are you constantly reaching for not so healthy, fast, processed food because you just don’t have it in you right now to do anything else?

Mobility: Moving around on your own

Does getting up out of bed feel impossible? Do you feel hopeless whenever you wake up in the morning to the point that you’d do almost anything not to get out of bed? Does your body ache so much that getting out of bed takes extra energy? Does moving around feel like you’re slowly walking underwater? Or everything is starting to happen in slower motion? Is it getting harder and harder to concentrate on what people are saying and doing around you?

Continence: Having the mental and physical ability to use the bathroom/toilet on your own

Y’all know what this means.

Mental and physical illnesses can make activities of daily life hard to keep up with. For people who have never lived with constant mental and/or physical illness symptoms, things (like waking up, getting out of bed, and walking to the bathroom) can feel like they’re happening on autopilot every morning. Barely any real thought goes into it. It’s just something one does. But that’s not the situation for everybody. For many people, even getting out of bed is a struggle. And this struggle can be hard to put into words and explain to someone who’s never dealt with it. Spoon theory was created by Christine Miserandino initially as a way to explain personally living with a chronic physical illness. Spoon theory is now used to explain people’s lived experiences with any chronic illness, physical or mental. I love this theory and use it personally and with clients when appropriate.

• Spoons are like a kind of currency. Spoons are basically the energy someone has, the “fucks” they have to give, their motivation, their physical ability to do something, etc.
• So everyone wakes up with spoons. But not everyone wakes up with the same number of spoons. Some people wake up with more spoons than others. And some people lose spoons faster than others.
• Reflect on all the things you do throughout your day. Waking up takes at least 1 extra spoon when you didn’t get enough sleep last night. Then there’s getting out of bed, walking to the bathroom, using the bathroom, brushing your teeth, etc.
• People, who are living with physical and mental illnesses/disabilities, tend to wake up with less energy and less spoons. And because of how their mental and/or physical symptoms affect them, it can take more energy to do the basic activities of daily life and more spoons are used just to get through 1 activity.
• If someone is forced to use up all of today’s spoons before the day is over, they gotta borrow into tomorrow’s spoons. Unfortunately, this means that the person wakes up with even less spoons to get by the next day.
• And even more spoons are used to strategize and figure how to survive the entire day on what they have left.
• People, who aren’t living with constant mental and/or physical symptoms, wake up with a full deck of spoons and may feel like they have endless spoons. Yeah, there are good days and bad days, but overall, they live each day with the confidence that they will be able to shower and/or dress themselves with little-to-no problem the next morning. Or don’t have to wonder how if they’ll be able to eat tomorrow. It is a privilege of able-bodied and/or neurotypical people to rarely, if ever, have to intentionally count spoons.

Y’all remember that “How to Know If/When You’re Depressed” post I wrote in January? Look over the symptoms of depression. It’s not hard to imagine how these symptoms could affect someone’s ability to keep up activities of daily life. Low energy, poor concentration, sleep problems, changes in appetite, etc. could stop anyone in their tracks even without the almost constant depressed mood and/or inability to feel pleasure in most things. To put in perspective: imagine trying to get out of bed when you don’t want to wake up with limbs feeling heavy like lead. Or walking to the bathroom feeling like you’re walking underground or being held down by invisible weights. It could take extra effort and energy to concentrate on what you have to do during the day. To figure out what you are going to eat, if you’re even hungry. Or maybe you’re grabbing the first sweet or salty thing you see because it feels good right now. And depressive symptoms trick you into thinking you are always going to feel like this forever.

It sounds like torture because it honestly is. Depression isn’t something you can wish away or sprinkle some positive energy over it and call it a day. That’s why it’s important to recognize the symptoms and seek help/support. Being able to recognize the difference between your baseline and when there are changes is a huge key. Your baseline is what you usually do and how you usually act. And then something stressful might happen and then your behavior changes. Beyond baseline. Beyond the usual. In that situation, your behaviors are symptoms and signs of a larger problem.

If you are noticing that it’s getting harder and harder to keep up your usual daily routines, it is a sign that something is going on. Pay attention to these small red flags. Awareness is the key here.

Here are some suggestions if you start to notice your ability to keep up with activities of daily life is starting to change:

1. Be kind to yourself. You are not a failure. You have a legit illness and the fact that getting shit done feels impossible is a symptom of that illness. Compromise with yourself. Some days are better than others. Some times of the day are better than others. Try to start taking note of those moments and try to schedule as much stuff as you can during those times. Not everything but as much as possible. Maybe it would be easier to shower at night and brush your teeth in the mornings. Or during a moment when you have spoons, clean your space and put everything you use most often in easy to grab spots so it’s easy to grab and go in the future.
2. Making lists and using daily reminder apps/notifications to help you break tasks down to their basic components & space it out realistically for what you can do that day. The benefit of making lists/reminder apps is you don’t have to spend as much energy/spoons remembering things and can use that energy in other ways. It can feel like magic during those moments of poor concentration and low energy.
3. Ok so you can’t shower this morning? Wash the necessary areas like the genitals, armpits, face, etc. in the sink with soap and water (or use wet naps), put on deodorant, and make peace with the rest for the day. Good enough. Maybe you can try again tonight before bed.
4. Use self care strategies as a way to preserve some spoons. Remember setting boundaries with people is self care. Actively and intentionally spending time with people who give as much as they take from you is self care. Like Christine Miserandino says to her friend in her explanation of spoon theory: “I don’t have room for wasted time, or wasted “spoons” and I chose to spend this time with you.”
5. Build and use your social support system: Who do you trust? Who can you ask for help? What kind of help can you get from each person in your life? Eat meals with people if that helps you eat more. Seek comfort with friends. Communing with people you trust will at least temporarily make you feel better.

Not being able to keep up with hygiene, etc is a hard thing to talk about. It’s hard enough to admit to yourself that you aren’t doing what you used to do, you ain’t at your best. But you aren’t alone. I wouldn’t have taken time out of my life to write this post if this wasn’t something that is very, very, VERY common. Shame and stigma (based in a general misunderstanding of mental health and psychology) only make the situation worse.

Thanks for reading. The next post will start my 4-part “You Probably Think This Kid Is About You” parenting series. In the 1st part, I will be writing from the point of view of a therapist helping people in a romantic relationship work through the idea of having children together and figuring out how solid of an environment their relationship is for raising children.