When You Have a Mental Illness, Self-Care Isn't Always a Luxury

Self-care isn’t always face masks and bubble baths, and it often isn’t glamorous. Sometimes it’s boring, lonely or temporarily unpleasant. The popular notion of self-care as a trip to the spa is, for many people, impractical and unrealistic. When you live with a mental health disorder, practicing basic self-care can be hard work.

For many people, self-care is not a luxury. Because I live with borderline personality disorder (BPD), generalized anxiety disorder (GAD) and major depressive disorder, I face additional, ongoing obstacles that directly impact my psychological, emotional and physical well-being. In order for me to improve or maintain my health and keep up with everyday responsibilities, relationships and activities, self-care is essential. Most of the time, it’s not all that fun.

Living with mental illness can be a full-time job – except it doesn’t pay, I never get time off and my efforts frequently go unrecognized. Sometimes self-care in the face of depression is making a point to eat something every day or remembering to take prescribed medication. Sometimes it means taking advantage of brief spurts of energy to go grocery shopping or reach out to a friend. Sometimes it’s celebrating small victories, and sometimes it requires me to do things I really don’t feel like doing.

Because life with BPD can be so unpredictable, seemingly simple acts of self-care often take considerable effort. When I feel overwhelmed by certain symptoms – feelings of emptiness or self-loathing, paranoia or the fear of social rejection — to name a few — caring for my mental health might mean eating a balanced meal instead of ice cream for dinner, avoiding my known triggers or accumulating positive experiences. Other times, effective self-care means utilizing the skills I’ve learned in Dialectical Behavioral Therapy (DBT) to have difficult conversations, confront painful emotions or cope during moments of overpowering distress.

Sometimes caring for myself means staying home when I want to go out, and sometimes it’s going out when I want to stay home. Self-care involves learning when to face my demons and when to box them up for another time. If I gave in to each and every impulse or desire
in the name of “self-care,” I would probably spend all my money, subsist on coffee and beer, and lose sight of my long-term goals. Finding a way to cope instead of giving into these intense urges and emotions is imperative for my self-care — and it takes work.

The notion that being aware of one’s triggers and making conscious, smart, healthy decisions is selfish shows a serious lack of empathy. Recovery is challenging enough, and many people with mental disorders already live with strong feelings of insecurity and shame. Berating the way someone cares for their own mental, emotional or physical health is damaging and contributes to the subjugation of people with mental illness.

Asking for help is not a sign of weakness, but is often an important and necessary step in self-care. Therapy and medication have become crucial aspects of my own mental health care, and I credit much of my recovery to DBT. However, too many people lack access to the treatment they need to heal. The inability to practice consistent self-care when living with mental illness leads to additional obstacles and can ultimately be life-threatening.

Failing to adequately care for one’s own mental health can have serious, long-term consequences. In most cases, it’s irresponsible to assume what’s best for another person, and everyone should have the ability to care for themselves in what ever methods make sense for their situation. What some people find liberating or relaxing, others may find anxiety-inducing or triggering. More than just access to essential health care and respect, people living with mental disorders and other disabilities deserve to live freely and joyfully without stigmatization.

Sometimes self-care is uncomfortable, frustrating or exhausting. Because we live in a neoliberal society that seems to value profit and productivity over health and happiness, living with a mental health disorder often involves labor and sacrifices that go unnoticed. Rather than recognizing anxiety and depression, for instance, as valid, intrusive mental health problems, they are constantly dismissed as excuses that make us “weak,” “lazy” or “selfish.” It’s destructive and ableist to assume everyone can function in the same way, at the same pace. Self-care looks different for everybody, and it’s important we’re all able to consistently and effectively care for ourselves.

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Thinkstock photo via isaxar.