Holding ourselves accountable (or not)

The jury's still out.

Credit: Ferenc Horvath on Unsplash

Welcome to Solicited Advice, our weekly column that celebrates the helpfulness in health. Because in a world where strangers at the grocery store love to tell you that a specific brand of magnesium will indeed “cure” what ails you (it probably won’t, so sorry), we’re all about passing on our lived experience in a way that makes your life a little better. Are we experts? Nah, not really. But we’re great listeners who have perfected the art of pillow screaming. Let’s get into it!

I’m learning that health conditions both rely on and buck the concept of routines regularly — and it’s frustrating to my brain. I’m curious about your experiences: Are you routine people? If so, what do they look like? How do you hold yourself accountable?

Ash: Routine is frustrating because it helps but my brain absolutely hates it. OK OK, that’s not exactly true, because part of my brain absolutely craves it. I know I’m feeling my best in my body when I have a routine — ultimately because it means I’m properly taking care of myself — but I also need flexibility. The issue is when I allow too much flexibility and it breaks the routine fully. And the hardest part of when a routine breaks is that it requires you to rebuild it piece by piece, because jumping back into everything all at once can be insurmountable. I think the easiest way to explain this dichotomy is a few pros and cons about my experience with routines in general and how it works for me and my brain.

Pros:

• When I'm in a bad headspace, I don't have to think about anything and just follow through with whatever that checklist looks like.

• Routine benefits my bipolar disorder which thrives under a fairly consistent sleep schedule.

• It benefits my autism in that taking care of myself doesn't become overstimulating or a sensory nightmare.

Cons:

• When I'm physically unwell — especially during my cycle — it can be difficult to find the energy to do everything, and when it continues, post-cycle things can break and require starting from scratch.

• My ADHD craves novelty and I can get bored/not want to do things out of demand avoidance.

• When my schedule is wildly different or I'm away from home, it can be disorienting to adapt.

In terms of keeping a routine, it’s using a mix of calendars, alarms, the Finch app (after BFFs recommended it), post-it notes, physical or digital to-do lists, or literally any tool at my disposal. I do what works, and what works can change.

All in all, I think there’s something to be said about building a routine that works for you. Routine doesn’t have to be cut and dry and perfect — it just has to benefit you. That being said, take it slow. Add in one piece at a time and once you have it down and feel good about it, bring something else in, and slowly build from there. Most importantly, recuse yourself from the guilt that may accompany missing parts of your routine. After all, we are humans and not robots.

Jess:

This meme is basically me. Do I love the idea of a routine? Yes (eh, usually). Do I hate executing a routine? Also yes. 

I have been known to spend hours coming up with the ✨perfect✨ routine — kinda like going on the search for the planner that’s going to change my ADHD life — and I will never touch it. As soon as I’m excited and ready, I feel caged in and can’t seem to make myself do it. I will think about it as I bypass doing the things I listed out. I will be frustrated with myself for not doing it, while consciously not doing it. I actually wrote about it here around the time I was bringing it up in therapy. 

It’s only been in the last few years that I realized “consistent” doesn’t actually mean “every day.” For so much of my life, I was beating myself up for not doing something *every day* and therefore “not being consistent” without realizing I was misunderstanding the term to begin with! Some things do need to be every day (brushing the teeth I want to keep, for example) but some things don’t. 

This came up with a different therapist in 2021 when I mentioned that I still had 111 things on my task list for the day, and my then therapist thought I was being hyperbolic. Then they thought I was mixing all the things together. No. I was only talking about the things I thought I needed to be doing every.single.day. I’m sure you can imagine their reaction. 

All of this is to say, you are definitely not alone in this, and I think we’re all just doing the best we can at any given moment, and maybe we should give ourselves a little pat on the back for that.

Kat: I deeply relate to your frustrations (which is to say, you’re not the first person with a health condition to feel that way). In general, I live for routines. I find comfort in predictability and I rely on them for my mental health, and I think it’s one of the main reasons I miss a more structured work environment when I don’t have one. While those positions swallowed up my days (and energy levels), they at least provided guideposts for pre- and post-work routines to flow around. But you’re right, the harsh realities of living with a few chronic health conditions mean our routines don’t exist in a bubble. Some days we can’t get out of bed. Other days we have to go back to bed after only being awake for two hours. And then there are chaotic days where we have treatments or surgeries or medical tests that require us to fast or not take our daily and/or pain medications. And you know what doesn’t love all of that ambiguity? Routine!

I know this is not really a feasible piece of advice, but it’s ultimately what helped me the most — adopt a pet. At first we rescued our dog because I was drowning in the longest depressive episode of my life. Now I realize how much I rely on him to guide me through each day. He demands his breakfast at around the same time each morning, which leads me down this path: Take him out, feed him breakfast, take my vitamins, eat a protein bar to get ahead of my nausea (I’ve been obsessed with these since my surgery because of how soft they are). Then I usually read a little, even if it’s just a couple of chapters — this helps my brain fog clear up a bit — before taking my meds and doing a full-body symptom scan: What hurts today? How can I get ahead of it? Then, assuming I’m not in horrific shape, I mix up electrolytes in my water bottle (it’s a Yeti, sorry to Stanley and Hydrojug loyalists), cruise on my walking pad for about 20 minutes before my joints and migraine brain yell at me, take a shower, and then depending on *gestures around* I eat some semblance of breakfast before I work, do chores, slog through health admin tasks, go to appointments, etc. And that’s if I’m having a decent day!

A more accessible piece of advice might be to make a variety of versions of the same routine based on your symptom/pain levels: mild, moderate, and high. On low-symptom days, you can have a more intricate routine; on high-symptom days, you might have one or two things you have to do but then don’t expect anything more out of yourself. Routines are honestly something I think a lot of able-bodied people take for granted, because it means they have a predictable body/mind (let alone a stable home environment, etc.) to follow through with them in the first place. Me? I rarely have two days in a row where I feel exactly the same way. But having to forgo my routines sometimes has sure taught me a lot about taking care of myself vs. pushing through a flare. I don’t feel better about myself when I get frustrated by what I can’t do, so I try to focus on what I’m able to do right then, and remind myself that it doesn’t mean I’ll feel that way in the evening, or even the next day. It’s a temporary blip in my day, my week, my month — even if the blips start to look like an abstract painting as the years collect. 😅

P.S. And whatever you do, don’t fall down the TikTok rabbit hole of watching perfectly curated morning or evening routines that have been spliced, filtered, and edited to trendy sound. They are fake (as is most of the internet), and your health is very real.

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