There’s an acronym used in self-help and recovery circles – I think it originated with Alcoholics Anonymous. When you find yourself feeling low, you’re supposed to assess yourself to see if you are feeling Hungry, Angry, Lonely, or Tired – H.A.L.T. Any one of this four states can weaken resistance and put people in a vulnerable position.

I’m lucky enough not to have issues with addiction, but I think H.A.L.T. is a useful tool for pretty much anyone. I know that when I let any of those states get too far, and especially if I’m experiencing all four at once (which has been happening a lot lately), I sometimes make decisions that are counterproductive, even self-destructive. I deal with Hungry by grabbing huge handfuls of M&Ms. I turn being Angry inward and end up with migraines. When I’m feeling really Lonely, I isolate myself. And, of course, when I am Tired is when I most resist going to bed on time, much like a toddler. The relationship isn’t always linear, either – being Lonely or Tired can also get me reaching for the M&Ms. When I am feeling all four, I generally make poor self-care decisions – I don’t eat, sleep, or play well, and my mood gets pretty bleak.

I feel the need to add one important variable to this list: Sick. (Also In Pain, but “HALTS” sounds better than “HALTIP”!) When I am sick or in pain, good decisions become really hard for me. My plans and goals fly out the window. I feel helpless and out-of-control. Also, I develop a strange blind spot – I don’t realize at all that being sick or in pain is the reason for my emotional state. I came face-to-face with this yesterday – it was the day after my Remicade infusion, and I woke up feeling amazing. (This doesn’t always happen.) Birds were singing. Colors were brighter. It was like this.

I used to have all kinds of systems in place for times when I wasn’t doing well. I used to take methotrexate once a week, and because I knew in advance that I would be feeling terrible that day, I had a whole routine set to go. But my RA has actually been doing pretty well for awhile now, and even though this is a great thing, it means I get thrown for a loop more easily when things aren’t good.

It’s not just my own Sick that gets me down. I have a five-year-old son, and he’s been bringing all kinds of germs home from preschool. It seems like one or the other of us has been constantly sick for months. We just seem to pass the bugs back and forth, even though I know that’s not how it works. And when my son is sick, I end up home alone with him, day after day, getting run-down and exhausted. Not to mention that thanks to Remicade and the immunosuppression, and his normal five-year-old tendency to need lots of cuddles when he’s not feeling well, I almost always end up sick too. (That’s a topic for a whole other post – probably my next one.)

I’m struggling with how to make H.A.L.T. work under these circumstances. The idea is that you recognize how you’re feeling and take action to meet the need. It’s clear (although not always easy to do) that you need to eat if you’re hungry, sleep if you’re tired, etc. Anger and loneliness are a little bit trickier, but there are still proactive things you can do to address them.

So what do you do when you’re sick, or your kid is sick, and it’s relentless and constant and it’s depleting you in all of the other four areas too? What do you do when the pain isn’t responding to meds? How do you take care of yourself and protect yourself from coping mechanisms that aren’t helpful in the long run?

This question isn’t philosophical – I know people will want to respond by talking about faith or religion or positive thinking. I’m not discounting those things – it’s just not what I’m asking. I mean, what are some practical things I can actually DO in these situations? What are some things I can do other than reaching for the M&Ms or withdrawing into myself? How do you make yourself do the things that you know are healthy?

I really want to know. It’s clear that I need some new tools.

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  1. Cathy says:

    I have found that having a few luxurious things I like to do for myself helps. Taking 15-20 minutes to soak in the tub with candles or a good book reminds me that despite all that is happening around me, I am important and need to care for myself. Also, thinking of this things as luxurious seems to help me rather than thinking of them as everyday things I do. Sometimes I tell myself I am going to treat myself to a nap. Thinking of it as a treat, rather than necessity, makes it feel awesome.

    With food such as M&M’s, I am not always great. Sometimes though, if I tell myself I can have the treat after I have eaten a nourishing meal, I don’t think about the treat as intensely and generally don’t eat as much of it and occasionally not at all.

    Withdrawing is definitely something I do. I can’t say I always think it is bad. For me, I need that time to figure out where I want to go next. As an introvert, that withdrawing time gives me quiet where otherwise everything seems like constant chatter that won’t let my brain rest. However, I do know others need me. I might let them know I need a little quiet time alone so they understand it isn’t them, but me. I’m also working at eliminating distractions such as computer and iphone so that when I am ready to be with others, I am really with them.

    It is hard, I know. I think this is a great post and I am interested in hearing what others have to say.

  2. Carla says:

    It’s good to have you back posting again, although it sounds like you’ve had your challenges. I used to teach stress relief classes and, although I was unfamiliar with HALT, there was a tool called STP — stop, think, proceed. (The theory being that any plan is better than running headlong into a situation.) Perhaps before you reach for those M&M’s, you could take an STP moment. Just don’t forget that it really is okay to say, I’m feeling lousy, I give myself permission to have some M&M’s — you just need to be aware of it. The other thing to remember is that, “This, too, will pass.” When I hit bottom and don’t feel like I can move forward, sometimes I just have to realize that, given a bit more time, the situation will change. Good luck with everything and thanks for a great post.

  3. Annette says:

    I ry not to have M&Ms in the house but weakness in this area seems to be a defining characteristic. So I buy Pockys and Lindt bars just in case of a harsh word or bad thought. They jump into my hand.

    Substitution is my new plan. Pumpkin seeds and sunflower seeds at least have good protein and oils. But not the kind you need to shell with your teeth. The dentist thinks that’s a bad idea.

    Hope you’re doing well

  4. It saddens me to hear this because I know what you mean. I too suffer from chronic pain, only unlike you, have never had a chance to have a real life, I’ve never had the chance to work or finish school or really do anything at all. It’s so hard when all you have in your future is to get more and more pain, it’s like you’re just falling down this endless black hole that gets deeper and deeper and darker…. and honestly I don’t know how to deal with it. The only reason I am not dead is because I’m too afraid of it, otherwise I’d probably have ended it. It’s impossible when you can’t have a life and nothing to really look forward to. When it becomes too hard to even do one little thing….like grocery shopping, anymore, when it was the last “fun” thing you had. It’s so bad that just getting up from a couch causes me so much pain and I’m so weak that it’s honestly one of the hardest parts of the day besides waking up. All I can offer is that I manage with the love of an amazing man who also takes care of me. He is there for me and tries his best to understand. It’s also hard because I have borderline personality disorder, anxiety disorders, OCD and many other health problems, and because of mainly the BPD, things are much more intense. Specifically emotions/feelings. Everything is black and white, to the extremes. Already it curses you with feeling hopelessness and all the things the pain and disability causes, but to have it on top of already feeling that way, it’s unbelievably horrible.

  5. Anna Olsen says:

    Hi, just happened upon your blog when I entered ‘rheumatoid arthritis and eastern medicine’. Glad I got here.
    Ok, here’s what I have for you, I started doing EFT and it really does WORK and HELPS with my depression, pain, unwilling to move on, putting off my daily exercise, food tendencies, etc.
    Secondly, for your problems with low immune during cold season…I always take a product called COLD SNAP. ALWAYS! And if I ever start to sneeze I immediately take a dose every few hours for a day or more till symptom is gone. I can say that for several years now I have not (cross fingers) had a bad cold or flu. Thank goodness.
    Thirdly girl! It’s ok, you are human, realize that and ask God HOW exactly you can move forward. Sometimes I am so dang depressed and I don’t even kow it cause of the pain numbing you were talking about? Yeah, it doesn’t just happen to my physical pain but my emotion as well. Anyway I will be doing my daily Yoga stuff and BAM!! I will start to cry. Really weird since I’m at a gym, people who notice the tears probably think ‘captain insano’. That when I go home and read and be tranquil and pray and call my daughters and cry and cry and cry. Course this is the same treatment I use for my extreme 9+ pain days. Jot too effective but it’s the moly way for me to feel that ok I’ve gone through this maelstrom and now I can do my favorite good for me things like good eating, lots of exercise, blah blah blah. Hey, I hope any part of this was of comfort or even help to you. Feeling your feelings, Anna

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