Written in September 2023
Self-management week starts today, Monday the 18th of September. It's a topic I am reasonably knowledgeable about, having tutored (in a voluntary capacity) a course for my local NHS trust that teaches self-management skills to adults with any long-term physical or mental health condition. It's called The Living Well Programme, and is offered by a few trusts under this name, or as The Expert Patient Programme.
If you have a long-term condition, whether it's physical, mental, or you've got a long list encompassing both, self-management is the one lifestyle change that will make the most difference to you now and in the future. One of the statistics we opened the course with was that people with long-term conditions spend an average of six hours a year with a healthcare professional, and the other 8,754 hours managing their health themselves.
I liken self-management to maintaining your car. It too spends an average of 6 hours a year with a mechanic having an MOT and a service, and the rest of the time we need to keep the tank full, the windscreen clear with wiper fluid topped up, and the interior and exterior clean(ish). When a check engine light comes on, we take it to the expert just like we make a GP appointment when we notice a symptom in ourselves. If we didn't do all these things we couldn't expect our vehicles to run properly and it's the same for our bodies and brains.
The course covered every aspect of life you could imagine, from loneliness to nutrition, pain to isolation and everything in between. Not everyone with long-term conditions will face challenges with every area of their life, but even when it comes to breathing properly, many of us can make improvements. Doing the course builds a toolkit, a set of strategies you can use to manage, maintain and improve your health (and life) in every area. The contents of the toolkit might change as you do, but once you've got the tool bag you can fill it with the things you need.
One of the things I have added to my self-management toolkit this year is yoga, which I've written about here. Starting yoga daily (well, most days) has made a massive difference to my physical and mental health. I have fibromyalgia, and arthritis in my left hip and ankle, so I have to maintain a certain level of fitness or I will be in a lot more pain. Yoga stretches and strengthens my muscles and fascia, and helps me maintain good posture and alignment.
Yoga is also really beneficial for my mental health, as there are some videos (thanks Adrien!) which I've found useful for grounding, calming, de-stressing, and giving confidence. I find these much better than meditation where you remain still – movement helps me focus while distracting me at the same time. I know why people call it moving meditation.
Walking is something I've done for a few years and it too is really beneficial for my physical and mental health. Being in the woods, or in fields is very grounding and it's easy to access that mindful headspace when you're attending to the natural world rather than your home environment (with all those tasks in it you haven't done), or in a city where noise and people get in the way.
Walking is good exercise – I can do it from my front door (I am lucky enough to be able to get to the woods in one minute, or to access the country park and Downs Link within 5), I don't have to pay, or drive anywhere, or deal with noise and other people (as I do if I go swimming), and it's low impact. It's also something I can combine with foraging, a big passion of mine, or with litter picking (which adds the dynamic of squats, as I don't have a litter grabber).
Self-management and self-care have a few things in common, but self-care is really just one aspect of self-management. Self-management is a holistic approach that covers every area of your life from making and managing healthcare appointments, to being on top of your nutrition, your budgeting and even your social needs. That's why I call it a lifestyle change.