5 Ways to Set Healthy Limits

There's really no glory in Doing It All. And when you have a painful chronic illness like psoriatic arthritis, your valiant effort could reward you with a killer flare. Who needs that? Here's how to say no and keep feeling great.

by Lambeth Hochwald Health Writer

If you have psoriatic arthritis, a good day is one where you feel so good that you pack in as many activities as you can. Trouble is, when you over-commit, you can actually overdo it, which for you may be no small thing, leading to extra stress, pain, swelling or worse. The key is to find the balance of just-enough. And the way to get there is to start saying no just a little bit more. Here are five ways to wrangle your schedule back into the productive (and out of the punishing) zone.

Break Up Day-Long Home Projects

Instead of talking yourself into weeding the entire vegetable bed, clipping the hedges, and mowing the lawn in one afternoon, focus on one thing at time (and probably on different days). “If you like to garden, keep doing it but look at ways to break up tasks into pieces,” suggests Lynn Ludmer, M.D., medical director of rheumatology at Mercy Medical Center in Baltimore. You may not be able to garden for three hours so set your timer and spend 15 to 30 minutes on a project, she says. Then, take a break and do a little more.“This makes the whole experience way more pleasant and will prevent you from feeling physically worse the next day,” adds Dr. Ludmer.

Unstuff Your To-Do List

The goal: to minimize the pressure you put on yourself and rethink the very concept of a to-do list. “If you’re going to make a list know that you may not be able to check everything off,” says Marni Amsellem, Ph.D, a clinical psychologist in Trumbull, CT. “There will be things on the list that you may need to modify as well. For example, if it’s moving boxes around, see if you can bring in someone to help or make a modification and tell yourself ‘I will only lift the light ones and won’t set myself back.’”

In other words, consider making a ‘To Don’t’ List, instead! This tactic helps prevent those familiar bursts of energy followed by crashes. If you have three doctor’s appointments and have to go to the grocery store, move the shopping to the to-don't list. If you're planner, try to get your groceries delivered so you don't wipe yourself out, says Stephanie Davidson, Psy.D., a psychologist and adjunct professor at Pepperdine University in Malibu. CA. If you're not and you really need to grab stuff for dinner, try to hit a smaller market and pick up only the essentials. Less walking, less carrying, more relief.

Try to Let Go of the Used-to-be's

It’s counterproductive to dwell on all that you used to be able to accomplish in a day, says Derek Mihalcin, Ph.D, a licensed psychologist at Oakwood Counseling Center in Warren, OH. “I often hear patients say, ‘I used to be able to work all day without any problem,’” he says. “That may be true, but if it’s no longer the case, it’s okay to change your mindset and truly accept all that you realistically can and cannot do.” The secret to doing this is to develop your own individualized script, Dr. Davidson says. “It could be something like ‘I have psoriatic arthritis. It causes some pain and sometimes I need to take breaks because of it,'” she says. “Then reassure yourself that you’re going to find ways to manage your symptoms.” Practicing these tips is great first step.

Say Yes to Stress-relieving Support

When you have a chronic condition like psoriatic arthritis, you want to seek out activities that reduce your stress. In fact, because it is so effective, researchers from the University of Montreal say stress reduction should be a standard part of treatment offered to people with psoriasis. “These include relaxation exercises, yoga and meditation,” says Dr. Davidson. Talk therapy can also be helpful in finding strategies for managing anxiety and coping with pain and depression. “Talk therapy teaches people how to talk to their boss, friends and co-workers about their health,” Dr. Davidson says. “It’s a way to help them find support and help, especially when they feel isolated because of their condition.”

Tune Into How You Feel

The pattern of pushing yourself too hard and then crashing can lead to a difficult cycle of pain, fatigue, and frustration, Dr. Davidson says. If you find yourself experiencing this, Dr. Davidson suggests that you track two things: your energy levels and your pain levels on a zero to 10 scale with 10 being the most energy/pain and zero being the least. “If you can record in your journal how you’re feeling at the same time every day you’ll start to see patterns,” she says. “You should also jot down what you accomplished and how much energy you had. Notice the things that zap your energy and the things that don’t. This will really help you make decisions on how to prioritize. After all, the things that take energy may be the things you need to phase out when you’re experiencing pain.” And that's 100% ok.

  • Stress and Psoriatic Disease: National Psoriasis Foundation. "Stress and Psoriatic Disease." psoriasis.org
Lambeth Hochwald
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Lambeth Hochwald

Lambeth Hochwald is a consumer lifestyle reporter covering health, fitness, marriage and family.