Why We're Exhausted
Spoon Theory for Parents of Teens with Health Challenges
“I’m so tired,” Ellie complained, standing at the stove, peeking at the pumpkin muffins that I had just taken out of the oven.
“How many spoons do you think you have left?” I asked.
“I forgot to think about spoons today.” She shrugged and speared a hot muffin with a fork. “Maybe I don’t have any left now.”
As I wrote last week, I appreciate how Christine Miserandino’s Spoon Theory offers both wisdom and compassion in managing chronic health conditions. She used spoons as a metaphor to demonstrate that folks with chronic illness have a limited amount of energy (or spoons), and even routine tasks take a toll. Since we learned about Spoon Theory from Ellie’s doctor, I’ve been thinking about how to help Ellie manage her energy, especially on the days when she wants to pack in more activities than her chronically ill body can manage.
I stretched my legs onto a kitchen chair as I watched her, thinking, I don’t think I have many left either. But I have to stay strong for you. I cleaned up the kitchen from our baking adventure together so that she could rest on the couch. As the sun went down, I reminded her to do her physical therapy exercises. With my husband, I reviewed Ellie’s medical expenses in our detailed spreadsheet which tracks money spent, bills submitted to insurance and reimbursement received. We kept Ellie company until she went to bed so she wouldn’t feel alone. Then I collapsed, despite the nagging pressure of unfinished work tasks - the result of a day majoring in Ellie’s doctor appointments and minoring in office time.
Spoon Theory for Parents
I’ve been considering Spoon Theory for parents as caregivers. It’s difficult to manage our energy as we care for children with health challenges, whether they struggle with mental health issues or chronic physical challenges.
What I hear from other parents is a consistent theme of exhaustion. Here are some quotes:
“I feel like there isn’t enough of me to go around. I’m holding it all together with a thread.”
“We are all so tired. Every single day is a battle and it doesn’t seem to get easier.”
“No one tells you how exhausting it is to parent a child like this.”
“I'm totally overwhelmed.”
“I’m completely out of my comfort zone. It breaks my heart to see my daughter like this.”
“My husband and I said no to everything because taking care of our daughter is all we can do outside of our jobs.”
“I’m so sad and worried about my teen.”
How Caregiving Takes a Toll
There are many ways that parenting a teen with mental health or physical health challenges requires extra “spoons” that lead to our exhaustion. Even though Miserandino’s theory assumes that folks without health challenges have an unlimited number of spoons, let’s assume that everyone has their limits. What if we thought about our daily parenting activities in a format like this?
Are you supporting a teen emotionally, by listening, reassuring, calming, and supporting her through angry outbursts? Three spoons out of the twenty-five spoons for today.
Are you supporting a kid with an eating disorder through Family-Based Treatment (FBT), which requires hours of supervision of meals and beyond? Fifteen spoons, at least!
Are you, like my friend Cameron, barely sleeping, because your teen needs constant supervision due to suicidal tendencies? Fifteen spoons, at least!
Does your kid have “Level 10” meltdowns that require soothing, patience, and encouragement, like my friend Esther shared in this interview? More spoons.
Does your teen need help with basic tasks, like getting dressed, bathing, going to bed, mobility? More spoons.
As you think about how much time you spend coordinating medical care, from therapists to psychiatrists to doctors to specialists to prescriptions to insurance to chauffeuring to appointments, how many spoons does that take in a given week? (Side note: does anyone else feel like they have bonded with their pharmacist in a special way because of how often they pick up their kid’s prescriptions?)
How many spoons does it take to coordinate with the school around a 504 plan or IEP, with administrators and teachers to adjust workload or get accommodations? How many spoons does it take to support neurodiverse teens who struggle with executive functioning tasks like checking emails, completing homework, and remembering to bring lunch to school?
Even managing our own emotions while watching our child’s struggles, from terror to rage to grief to anxiety, takes a toll on us. Finding safe places to identify and express our emotions can take spoons.
I love how Chris Prange-Morgan, a writer, coach, and mom puts it: “Pain of any type requires us to call upon energy reserves to get through each day, and motherhood is one of those multitasking endeavors that requires more emotional resources than many folks realize…As a mom with chronic musculoskeletal pain, parenting two teenagers - one of whom has challenging behavioral needs—I have to remind myself over and over, “You’re doing great. Just keep putting one foot in front of the other.””1
Permission to Say No
As we become aware of the toll that caregiving takes, we can become more conscious of how we spend our daily spoons, both in parenting our teens and in the rest of life. Perhaps this awareness can help us give ourselves permission to say no to non-essential activities. I am spending most of my spoons on my daughter’s healing, so I don’t have enough left to volunteer at the school, to run a garage sale, to fix the porch, to take on a new project at work. I don’t have it in me to help a neighbor right now.
My friend Cameron stopped cooking when her daughter’s mental health spiraled out of control. Another friend accepted that her house would be messy for a while. Another friend is taking a sabbatical from her job as a teacher to heal after her daughter’s yearlong health crisis.
When I told my work team that I was reducing my work responsibilities to care for my daughter (read that post here), one of my colleagues grinned at me during our weekly call. “So you’re going to say no to requests, huh?” He asked. “Want some accountability on that one?”
He knows me too well.
“Yeah, I’d love some accountability,” I said, sighing. “You know how much I hate saying no, even when I need to.”
Replenishing Our Spoons
Even as we consider how to guard our energy for caregiving, we also need ways to restore ourselves.
As Ellie stood by the stove, I asked her what replenishes her spoons. What activities restore her heart as well as her body?
Ellie is a neurodiverse teen who needs more sensory breaks than the average teen. She is an introvert, a creative spirit, and an intellectual. She loves puzzles, complex craft projects, and debating politics. She is energized by baking elaborate gluten-free treats which we all marvel over. She loves a good nap.
What replenishes her is different from what replenishes me.
I am an extrovert who thrives on hosting both adults and teenagers. I love a good party. My dream vacation is climbing mountains with friends or biking across a state. I never grow tired of watching waves roll onto the beach. Journaling, praying and reading the Bible steadies me. I access my feelings by talking about them with a good friend. Support groups help me stay balanced. Sleep, healthy food and exercise are daily essentials.
The hard part is that the only way I can say yes to these life-giving activities is by making difficult choices to say no to any non-essential activities. As a caregiver, this isn’t just a preference; it is the difference between halfway decent functioning and angry exhaustion. Sometimes I know in my head what my limits are; sometimes my body tells me that I’ve overspent my spoons by a long shot. But the more I can prioritize those restorative activities, the better parent and human I can be.
As you reflect on your days, where are you spending most of your spoons? What activities help you replenish your spoons so you can keep going? Where do you need support, like me, to say no in order to say yes to what’s most essential, especially in an intense season of parenting?
On the journey with you,
P.S. Before you go, please tap the little ♡. It offers “social proof” and lets others know there’s something useful here. Thanks!
P.P.S. You won’t hear from me next weekend as I’ll be vacationing with my family. But I’ll be back in August!
https://www.psychologytoday.com/intl/blog/full-catastrophe-parenting/202305/to-the-mom-parenting-in-pain-i-see-you#:~:text=The%20%E2%80%9Cspoon%20theory%E2%80%9D%20and%20caregiving&text=Smaller%20tasks%2C%20like%20showering%20or,Pain%20comes%20in%20many%20forms.
I hear you, Serena. Sending hugs. A Caregiver's to-do list never ends, and often, we're stretched like elastic bands beyond what we thought was the snap point. I try to avoid listing things in my head because it's depressing! All we can do is the highest priority/most urgent on the list. We're not superhuman...just perfectly imperfect humans doing our best. Great article with very good points! Take care xo
Following your posts has taught me so much about special needs children and given me an informed perspective on their routines that differ from mine. I have admiration for the intense balancing act of everything you do. Even a spreadsheet of medical expenses. Thank you for sharing your life with us and in effect teaching us about techniques we might adopt for ourselves.