When Activities of Daily Life Are Insurmountable

My first job out of school, I burned out. I spent twice the amount of time I had been employed recovering from the damage of that job. I have always lived with depression, but, during my burnout, activities of daily life (ADLs) became impossible.

Things like (the classic) getting out of bed, checking the mail, answering the phone or door, showering and other types of self-care. Sometimes I would stay in bed just because I couldn’t summon the energy to even think about getting out of bed; not because I was particularly depressed or avoidant, just exhausted. Showering was an effort mentally and physically — I would emerge with every ounce of energy spent, and would sit trembling on the side of the tub for ten or fifteen minutes until I had recovered enough to dry myself off.

My first job post-burnout was a work-from-home affair, so I could still neglect ADLs as long as I got my work done. Once I was ready to join the workforce in person, again, I realized I had a big problem: it’s one thing to make a deal with myself — I’m not going to brush my teeth today so I can shower— but other people don’t understand that. I was making tradeoffs — clean clothes or clean teeth or clean me or groomed me — with things “normal” people consider non-optional.

Knowing that the outward-facing ADLs (I can neglect my correspondence as long as I am presentable) were necessary in order to interact with people in a professional setting, I set up a checklist of the minimum number of things to do each day before leaving for work: brush teeth, brush hair, wash self, change clothes. It was a disaster.

About a week into this course of self-punishment, I started having trouble waking up in the morning. My first thought every morning was: Ugh, I don’t want to get up and shower. So I would just hit snooze…sometimes, I didn’t even hear the alarm. I was late for work; fortunately I had a “flexible work schedule” — in name, at least — so my bosses were unhappy; they had no leg to stand on to confront this tardiness, which just made work entirely uncomfortable. Sometimes, in my haste to get out the door, I would skip some ADLs — maybe not brush my teeth and chew some gum in the car, or not brush my hair and do a quick make-do effort on the drive, or not shower and put on some powerful deodorant. This resulted in me feeling like a slob the whole day, and constantly wondering if people suspected the truth, if I smelled, if I was losing the respect of my co-workers.

Waking up, being clean, being responsible for yourself: these are all things we need to do, and often don’t think about. When that system of self-care breaks down, it feels horrible and isolating. “Every other person in the world can do this, so why can’t I?” There’s a constant fear — “What if I never recover?” — because it doesn’t make sense why this is happening. “Why have I been able to do these things for years, but now they are so difficult?” I was trying my best, and making no progress; it felt like my incompetence, my inherent unworthiness was being put on display, and the whole world was mocking me behind my back.

I needed a new system. I tried enlisting the help of my spouse— you MUST make sure I’m awake by 6:30 and out the door by 6:45 — but this resulted in huge negative consequences on our relationship. I was resentful in the mornings when he would try to get me out of bed, and he was resentful of my attitude when he was doing me a favor. It was a mess. So then it was back on me to get myself going in the morning.

This was where I had my first success: music. I realized I needed something to entice me out of bed, not to punish me out of bed. If I woke up because bad things would happen if I didn’t, it set the stage for me to disappoint myself all day. I created a CD with the peppiest, happiest, most sing-along songs I could think of and put it in my CD-player alarm clock on a really loud volume. That worked okay — until my cat stood on the disc tray and opened it, preventing the alarm from going off; until I started snoozing in bed and singing along in my head until the CD ended without me having gotten up.

So it worked, kinda, but I definitely needed to iterate on the problem. I won’t go through all the iterations, but what I ended up on was: a blue-tooth alarm clock, a fixed-order playlist on a blue-tooth mobile device which is at least 23 minutes long but no longer than 25 minutes, and medium volume. I have two alarms set — the second one 27 minutes after the first, so I get to hear my full playlist and wake up a little, then that short tiny nap before the last song replays and it’s time to get myself up. I have the full duration of that last song to get sitting and standing and out of bed. So usually my last song is the most energizing one. I also have an emergency alarm set on my phone for the 30 minute mark — most of the time I turn this off while brushing my teeth but it has caught me on a few of those tough mornings.

Now I’m awake and in the bathroom. Just the teeth brushing, me-washing, hair-doing, and clothes-wearing to do. Short story is: these were problematic, too. For the teeth-brushing, I had to go a little deeper; my sciatic nerve gets irritated, so I set up a little routine while I brush my teeth that lets me do some standing/sitting exercises for my back while I brush. This both gets me moving, makes me feel good about helping my back, and decreases the likelihood that I’ll skip the teeth-brushing step because it’s mentally daunting. I’ve heard from other people who do squats while brushing, and others who read email or articles on their phone. If I find a 2-minute teeth-brushing song, though, I’ll definitely put it on.

After the teeth-brushing, it’s the hair-doing. I don’t have a good coping strategy for the hair-doing yet, but I muddle through.

For the clothes-wearing, I have to lay out my clothes ahead of time. The night before, I hang my pants and shirt over the railing, just outside the bathroom, put my socks and shoes on the stairs. If I forget the socks/shoes the night before, I usually scrabble for those during the first 15 teeth-brushing seconds. Oops! I have an alarm set for “I need to be walking out the door, now!” too, so I know if I’m taking too long.

After many battles with the me-washing, I’ve ended on doing it the night before. This is where, especially when I’m sleepy or it’s a cold morning, I end up wasting the most time. I set up a playlist, but sometime the allure of the hot water and the deterrent of a cold bathroom have kept me in for longer than my songs allow. I recently heard some criticism for my shower playlist — “Who needs to listen to music in the shower?” scoffed a non-sympathizer in my own family. I explained the careful mechanics of my shower playlist: it is 20–21 minutes long; when the second song plays, I need to be washing my hair (this gives me two full, decadent minutes just being warm); when the third song is playing I need to be rinsing soap off; before the fourth song ends, I should be out of the shower, drying myself; the fifth song is for applying lotion (really dry climate here) and hair-brushing and dressing. Since hair-washing is the longest part of my shower (shampoo/conditioner), the second song is my longest song. The first and fourth are the shortest. In order to prevent myself from getting tired of these songs, I switch one out every few months — it means I have to adjust my task/song switch points, but it keeps me humming along. I know some other people who listen to random tracks from a favorite playlist or podcasts to help incentivize showering and reduce boredom, but, for me, the structure of a known playlist is what keeps me on track.

It’s been a little over five years since my burnout. I still struggle with ADLs. The teeth, hair, and clothes I can usually get in the morning; teeth at night are a whole different tiger. I can keep myself mostly showered — though I recently discovered the magic of dry shampoo, so that has led to a bit of a backslide. I open my mail once every month-ish, sometimes two months. I can actually check my voicemail, now, and pick up phone calls even if they’re from strangers. It’s about 50/50 on whether or not I can answer the door or if that causes a panic attack. I’ve started cooking, again, just a little. My spouse is still handling most of the chores, but I’m picking up a few here and there — nothing I feel I can congratulate myself on, but it’s better than not being capable.

Sometimes I still get angry with myself; I feel useless and lazy. I wonder why these things are so hard. Surely, it’s been five years, surely I should be better by now… When this happens, I have to remind myself how far I’ve come in those five years. If telling myself about how much progress I’ve made isn’t working, I call a trusted friend and ask them to remind me — someone who can empathize with the difficulties of ADLs, not someone who’s going to file away my moment of weakness and spring it on me later. Now, when I struggle, I know that it’s not because I can’t do it, but because something has changed and I need to adapt my routines, my strategies, to meet the new challenge before I lose my footing.