When I returned to work after a nearly six-month absence, I wrote about my need to take time off to practice self-care. For me, this meant doing less so I could carve out time to find my way back to being me. Ever since writing that piece, I have thought a lot about the concept of self-care and who has meaningful access to it.
Is self-care a privilege of the privileged? Yes and no.
Coming out of the depression and stress that had sidelined me, I am grateful that our family had the capacity to get me through it. We could afford for me to take extended time off – albeit marginally. I had access to health care, to occasional yoga and massages, and to alone time to gather my thoughts and regroup.
But what about overstressed moms or dads or teens or employees who don't have the ability to drop a responsibility or two? Who can't make extra time in their day? Who don't have any disposable income for a $20 yoga class or health club membership? Who don't have a spouse or partner? Who may be working multiple jobs to make ends meet? What does self care in their day-to-day routine look like?
"How we define it (self-care) becomes very different for different people. A large part of it is whether they believe they have the ability to have some control over their health," said Tammy Green, chief executive officer of the Anchorage Neighborhood Health Center.
According to its website, the center's mission is "to improve wellness by providing high-quality, compassionate health care regardless of ability to pay." In 2014, it served nearly 14,000 patients, more than 9,000 of whom were at or below the federal poverty line.
Before taking the helm at ANHC, Green served as the director of employee well-being for nearly 80,000 health care workers across a five-state region for the Providence Healthcare System.
"I have a passion for helping people live healthier, more well-rounded lives," she said, explaining it's a mission that goes far beyond telling people to eat carrot sticks or run a marathon.
Regarding overall health, small changes in attitude or choices matter, she said. Like deciding for one day or one meal that the family will drink water instead of soda. Those incremental decisions have a chance to become sustainable lifestyle changes. People give up when they start to feel that there is so much wrong with them or so much to be fearful of that there is no hope of overcoming or preventing illness, she said.
Green believes public health messages have done a lot to educate people about how to stay healthy and what to avoid. But she suspects patients, bombarded with information, have shifted responsibility for their overall health from themselves to their doctors. They've given in to the notion that their own health and well-being is under someone else's control, she said.
Which is not to say people should be left to fend for themselves. Promoting healthy families among all levels of society remains a complex problem. Policies that support making healthy choices -- for example, having healthy food options in all neighborhoods -- matter. "At the heart of it is how we as a society embrace that feeling that we really do have a lot more control over our health than we believe we do," she said.
"Self-care is crucial to everything we do as mothers, fathers, parents, husbands, wives, workers. If we don't take care of and honor ourselves it's hard for us to give what we don't have," Green said. "It's like when you fly and the airline attendant reminds you in an emergency to put your own mask on before you help others."
Green has coined a term she uses when theorizing about what's driving the modern stress epidemic: personal "bandwidth attention deficit disorder," or BADD.
Mobile phones, social media, streaming videos and other technologies aren't helping, she said. The things that connect us also drive us apart, and people have a biological need for human connection.
Green's theory is that people are so bombarded with information, fractured with their attention, hyper-aware and driven by instant gratification that they are operating in "fight or flight" mode full-time. Add other stressors on top of that – financial hardship, relationship tension, being overworked, parenting, poverty, unmet needs – and the situation only gets worse. It's when people can't calm the "noise" that they make unhealthy choices. Drugs. Alcohol. People will seek out anything that will calm the noise, Green said.
There are four quick self-care techniques that anyone can do anywhere at any time. Each will help you refocus on the present.
• Take a few slow, deep breaths.
• Go for a walk. (Around the office, around your neighborhood.)
• Connect with nature. (Go to the park.)
• Connect with other humans. (Talk to a friend.)
"These are very impactful activities that can cause at least a level of soothing and dropping some of that frenetic energy," Green said.
Another is to recognize if you are withdrawing or isolating. Reach out to a family member, neighbor, friend or church group. Confide in someone who can be your ally to help get you through.
Which gets us back to the concept of gratitude and giving back.
For those of us who recognize how our own support networks or privilege came through for us, reaching out and being there for someone else is exactly how we can honor and extend our gratitude.
"It is encumbent upon us as fellow travelers on this journey that we ease the way of others who may not have had the same means," Green said.
In other words, be kind. Be gentle. Be good to each other. Be there for someone else.