How I Take Care of Myself Now That I Have Both a Mental Illness and Autoimmune Disease


Long before I knew I had an autoimmune disease, I had a diagnosis for bipolar disorder II. I received treatment with meds and periods of counseling during challenging episodes. Although managing my life with this undesired companion was at times exhausting, I felt we had developed a mostly successful partnership.

My unwanted companion taught me some important things, like what I do to my body has a drastic impact on my mind, that procrastination is a symptom of my depression and that depression lies. This knowledge gave rise to a set of practices and choices, some of which seem obvious and others only I truly understand.

My practices included getting eight hours of sleep, reducing my pot-a-day coffee habit to   two 6-ounce cups and cutting my alcohol intake to a glass of wine or a beer on special occasions. Knowing procrastination is part of my depression and that depression lies meant coaxing myself to do the most basic activities. “If you get out of bed, you can have coffee. If you do the dishes and tidy the kitchen, you can watch some TV. If you finish the assignment, you can phone a friend.”

During rough times, getting anything done, even taking a shower, involved having a conversation with myself. “You’ll feel better once you don’t have greasy hair.” When I felt too awful to do something, I reminded myself how much better I would feel once it was done. It led to one of my fundamental survival principles: Don’t take your emotional temperature before you do stuff, and it’s corollary: you can do some of your best work on your worst days.

If you enjoy good health, it’s unlikely you have to tell yourself this on a regular basis. And if your health is crap and you’re able to tell yourself this, you are in what I call the “miserable functional zone.” You may not be well. If you were, you probably would not have to talk yourself into putting on pants and eating breakfast. That said, there’s a point when you can no longer talk yourself into anything, even ringing a magic bell that would restore your life to what it was before any of this happened. Please talk to someone sooner rather than later. No one should have to talk themselves into pants and breakfast, which is why my mood stabilizer got boosted with an antidepressant.

I also made some significant choices to accommodate my unwanted companion. I decided not to live alone, as much as I loved the privacy. Having roommates meant I couldn’t isolate myself completely, even if I did choose to stay in. I learned there’s nothing like physical activity to take you out of your head, so as I progressed through school slowly, with a lighter course load, I worked as a retail merchandiser. Whether I was off-loading freight or carting shelves up and down ladders to build displays, my days were physically demanding. It became clear this was positive for my health, if not my bank account, so I kept doing it, even after I graduated.

Eventually, I grew too sick from my undiagnosed autoimmune disease to keep up with the physical demands of my work. I took some time to rebuild my strength after my diagnosis, thinking I would soon be able to go back to life as I knew it. I did go back to work for a short amount of time, but soon I needed to take more time off. Rinse, lather, repeat. It was a humiliating cycle. I recently learned my diagnosis was part of a boxed set, and I have finally surrendered to the reality that my body can’t do everything it once did — even the things that were for my health.

Instead of telling myself to forget about how I feel because I know I will feel better once the task is done, I now have to assess how I feel so I can count my spoons and figure out what I can get done. I have spent my share of time being angry about this, but I’m beginning to learn to co-exist with my newest companion. I have a good track record in the department of unlikely partnerships. I will find new practices that sustain the combined demands of mental and physical illness. It shouldn’t be so difficult to reconcile this. At its core, self-care is about gentleness and respect. Respecting your own limits, as they vary from day to day and moment to moment, as opposed to the limits others place on you.

But right this minute, I am finding it difficult because all those years I struggled with mental illness, I lived with a single goal: Show up. I told myself I didn’t have to smile, be brilliant or pass the exam. I just had to show up. Punch the clock. Meet my friends. Write my name in the top right hand corner.

Now I’m trying to figure out what showing up looks like when you can’t leave the house to go to work in the morning and you have to sit down for a break part way through the dishes.

It isn’t true anymore. I don’t feel better when it’s done. I feel exhausted before, during and after each task I undertake. The sense of victory over small accomplishments eludes me, except on the best of days.

Here is what I know for sure: Today, showing up means opening the document and facing the blinking cursor on the screen. And for now, my job is to find the practices that will help me thrive in this next phase of my life.

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