Are We Getting Self-Care Wrong?

Real self-care helps us manage stress in healthy ways—but some things we turn to for comfort don't fit that bill.

By Shanna B. Tiayon

What is self-care?

Before you think about your answer, let me clarify: I’m specifically asking what self-care is—not how do you take care of yourself? It’s amazing that an entire industry has built up around self-care—but from what I have seen, few ever try to define self-care.

So what’s your answer?

Did your response sound anything like: exercise, being in nature, or boundary setting? If so, you have just named ways we practice self-care—and what they all have in common is that they support us in reactively and proactively managing stress in healthy ways. At its foundation, self-care is about stress management.

It’s understandable if you’ve never thought of self-care in this way, as the term currently is largely divorced from its roots. Self-care has clinical origins, initially anchored in the belief that individuals can participate in the management of their recovery from illness through health-oriented practices and behaviors. In the 1960s and 1970s, self-care evolved into a term used by social justice activists as a tool for caring for themselves amid their activism. Around the 1980s, we started to see the term used in the context of workplaces, as an antidote for employee burnout; I have some really strong feelings about this; see my article, “Self-Care Can’t Fix Employee Burnout.” As I argue in that piece, poor workplace structures are stressors that no amount of self-care can address. But effective self-care can help us respond to illness and sustain ourselves when fighting injustice, other types of stressors. 

Unfortunately, today the term self-care has been coopted and commodified, referring to everything from luxury handbags to Netflix bingeing. When self-care becomes anything and everything, it interferes with our capacity to effectively utilize it as a well-being tool, causing a lot of us to get it wrong, engaging in activities under the banner of self-care that only offer a momentary distraction from our stress.

I’d like to argue that effective self-care should provide both a physiological and a psychological benefit. Physiological benefits correspond with the body’s biological and physical functions, while psychological benefits are related to the mind, thoughts, and emotions. So how do we differentiate the most effective self-care tactics from activities that, at best, are mere distractions?

The mind-body stress connection

First, let’s unpack the science behind the criteria of a mind/body benefit for effective self-care. Have you ever wondered why when you’re anxious about an upcoming presentation, your stomach feels queasy? Or why your neck, shoulders, or back feel tense when you’re managing a stressful period in your life? How about when you’re experiencing gastrointestinal issues and your mood is low or you lack focus?

When we perceive something as stressful, that kicks off a response that floods our bodies with hormones (epinephrine or adrenaline, norepinephrine, and cortisol), which affects our body in physical ways (like increased heart rate and muscle contraction).

There’s also the role of the vagus nerve, which originates at the base of the brain and extends into the heart, lungs, and intestinal areas of the body; this is the embodiment of the mind-body connection. The communication pathway between the vagus nerve and the brain works in both directions, from the brain to the lower body (that’s why when you perceive the speech as a threat, you get butterflies) as well as from the lower body to the brain (if you’re having gastrointestinal issues, your mood may dip). 

Communication happens through something called vagal tone, which is a measure of the activity level of the vagus nerve. The more active your vagus nerve, the more your health and well-being benefits. For example, more vagal activity promotes greater cardiovascular health, while less activity is linked with depression.

Thus, it’s not surprising that the vagus nerve is the primary component of our parasympathetic nervous system, the one responsible for putting the brakes on our stress response. The vagus nerve is the highway that directs our self-care efforts. For these reasons and more, effective self-care involves both physiological and psychological components.

Now that we have a better picture of what self-care is and what effective self-care entails, let’s explore some “self-care” tactics to see if they pass the litmus test. First, I’ll define the activity, and then I want you to ask yourself if it’s an example of a distraction or effective self-care. Afterward, I’ll share a science-based analysis of each.

Exercise: Self-care or distraction?

Definition: Planned, structured, or repetitive physical activity, with the focus of improving physical fitness. Is this a distraction or self-care? Walking, hiking, running, working out, kayaking—these can indeed be effective forms of self-care, because exercise packs both physiological and psychological benefits.

Physiological: Exercise is its own stressor from a hormonal perspective. At a minimal effort of 50-60% of VO2 Max, equivalent to light walking, as our exercise intensity or duration increases, the release of the key stress hormones epinephrine and norepinephrine—and cortisol—increases, too. After we finish exercising, our hormonal levels return to pre-exercise levels, sometimes lower. Over time, the more we engage in exercise, our hormonal stress response attenuates. This is where the magic happens, because this attenuated hormonal stress response carries over to stressors other than exercise, helping us to better cope with them.

Psychological: Exercise can positively impact our mood, countering the low mood often associated with stress. There’s a wide range of reasons why exercise positively impacts our mood: the feeling of accomplishment, social desirability, and neurological effects. The prevailing hormones of interest in the neurological explanation of exercise-induced mood enhancement are endorphins.

But they don’t affect our mood the way you might think. When we exercise, our body produces beta-endorphins in our bloodstream, but beta-endorphins are too big to permeate the blood-brain barrier. Instead, it supports our mood by reducing pain and triggering the release of dopamine in the brain.

More recent science is now focused on endocannabinoids released during exercise, that easily cross the brain-blood-barrier, as a contributor to the positive mood impact of exercise. Endocannabinoids are structurally and functionally similar to cannabinoids found in cannabis and believed to be a key driver in the post-exercise “high.”

Exercise helps us through acute stress through mood enhancement and reducing the presence of stress hormones in our body. It supports us more proactively by increasing our resiliency, reducing our baseline levels of stress hormones, and training our body to manage and quickly recover from stress.

Binge watching TV: Self-care or distraction?

Definition: Consuming multiple hours of television (including TV or movies) in one sitting. Is this a distraction—or is it effective self-care?

This is an example of a distraction and quite a popular one: 83% of U.S. adults watch streaming services and, according to a recent study, 57% of U.S. adults stream TV and movies for one to three hours, with 38% streaming for longer periods.

Physiological: The bad news is that from a physiological standpoint, bingeing is bad. It encourages a sedentary lifestyle and can dull cognitive function. Besides a potential moderate boost in cognitive function through the consumption of high-quality educational content on TV, there are minimal physiological benefits.

Psychological: Many of us might feel a psychological benefit. Binge watching activates our brain’s reward system, triggering the release of dopamine, one of the feel-good hormones. This reward can work to counter the negative emotions of stress. In fact, there’s a correlation between binge watching TV and stress, with higher stress increasing the likelihood to binge watch TV. Binge watching also serves as a form of escapism, allowing us to temporarily avoid or stop thinking about the source of our stress. But with anything that activates our reward system, there’s the likelihood for excess, making it challenging for us to stop.

Bingeing TV distracts us from our stress and offers a small emotional boost, but can have adverse physiological effects and cause more stress related to neglected responsibilities while bingeing.

Spending time with loved ones: Self-care or distraction?

Definition: Spending time with friends, family, and pets that you care about. This one is definitely self-care. Spending leisure time with loved ones supports our capacity to manage stress in a variety of ways.

Physiological: Oxytocin is widely known as the love hormone; it’s associated with activities involving connection with loved ones like hanging out with friends, sex, breastfeeding, and so on. Interestingly, our bodies also naturally produce oxytocin when we encounter stress as a protective measure. That’s when the presence of oxytocin can cause us to seek social support or pull those we love closer in the presence of stressors.

This behavior is called the tend-and-befriend response. It’s an evolutionary response to stress or a threat: strength in numbers. Increased oxytocin due to social connection during stressful moments packs powerful physiological benefits, helping to attenuate the stress response by lowering cortisol levels, inflammation, and blood pressure, for example. The higher our oxytocin levels, the greater benefit to us by lowering our responsiveness to stress and encouraging resilience when we encounter stressors. (However, stress-induced oxytocin in the presence of unsupportive people can actually exacerbate the stress response.)

Psychological: Oxytocin also has a calming effect, reducing psychological distress associated with stressors. But beyond the wonder of oxytocin, a main strength of spending time with loved ones is the social support component. Social support is a known moderator of stress, with the potential to minimize the likelihood that the stressors lead to distress. Social support can actually help us to resolve or re-contextualize the stressor, reducing feelings of worry, fear, or anxiety. 

Drinking: Self-care or distraction?

Definition: The consumption of alcohol, from one to multiple glasses. Distraction or effective self-care?

OK, I have to be transparent here and state that this has been one of my go-to strategies at the end of a long and stressful day for years. In fact, it was the frequency of my “just-one-glass-of-red-wine” strategy that got me thinking about the topic of effective self-care. But this, my friends, is not effective self-care. It’s hands-down a distraction.

Physiological: There are no documented physiological benefits to alcohol consumption, sorry. In fact, the long-vaunted health benefits of red wine have been debunked. Instead, alcohol hurts our brain function, causing adverse effects on things like memory and coordination. It can also disturb our endocrine system, disrupting our hormones. Additionally, alcohol can disrupt our gastrointestinal system by causing inflammation in the stomach lining, inducing nausea, vomiting, and longer-term illnesses, especially if consumed in excess.

Psychological: So if all of the above is true, what draws people to alcohol when stressed? Alcohol can penetrate the blood-brain barrier in five minutes, and you start to feel the effects within 10 minutes. It acts as a central nervous system depressant, increasing GABA neurotransmitter levels (which produce a calming effect), dopamine, and serotonin, associated with feeling good. Alcohol also decreases the neurotransmitter glutamate, decreasing alertness. These all combine to produce a relaxed, euphoric, and less excited state—almost immediately.

But in exchange for this relatively calm state, alcohol, even when consumed in small amounts, impairs our brain function: decision making, focus, memory. With respect to memory, alcohol seems to most strongly affect our capacity to form new long-term memories, like remembering fact-based details, when we are under the influence.

In short, alcohol offers a chemically induced calming effect that allows us to minimize or escape from our stressor, but in exchange we “pay” in other physiological and psychological ways.

Breathwork: Self-care or distraction?

Definition: The use of structured breathing strategies that manipulate the breath for therapeutic purposes. Is breathwork an example of a distraction or effective self-care?

Did you guess self-care? Right again! Breathwork is an effective tool to manage stress, especially reactively, when we find ourselves in a full-on stress response.

Physiological: We can manipulate vagal nerve activity through respiration. Vagal nerve activity decreases during inhalation and increases during exhalation (remember more vagal nerve activity has greater well-being outcomes). Consequently, the heart rate accelerates during inhalation and decelerates during exhalation. Breathwork helps to counteract increased heart rate, a common symptom of the stress response. Breathing techniques focused on extended exhalation, slowing down the breathing (ideally to 10 breaths per minute or less), holding the breath briefly, and then exhaling have all been shown to slow down the heart rate. The magic is in the exhale.

Psychological: Common feelings after breathwork include feeling more positive and alert, and less aroused by stressors. When our heart rate slows down, we have more cognitive control, our amygdala becomes less excited, and our prefrontal cortex functioning is enhanced. Research has shown that slower breathing increases alpha activity (brain wave activity associated with a relaxed and focused state) in the parietal and the cortex regions of the brain, which can result in focused attention, increased creativity, and inhibiting irrelevant stimuli. Those are all great resources when trying to resolve a life stressor.

The main takeaway is that we should not confuse coping mechanisms with self-care. Self-care strives to offer us recovery and restoration on the other side, which goes back to the original definition of self-care. Distractions serve to only temporarily pause the distress. Effective self-care abides by the “do no harm” rule, while distractions like bingeing TV and drinking do not. 

I’m not suggesting that you throw all of your distractions out the window, because sometimes a temporary release, even with the associated adverse impacts, is what we need. But let’s make a concerted effort to not let the coping mechanisms overtake effective self-care—and let’s be honest and call each what it actually is.