NMOSD taught me what being productive means

If you had asked me years ago what productivity meant, I would have rattled off the usual corporate nonsense: doing more, pushing harder, staying available, and proving I could outrun exhaustion like it was a competitive sport. I treated productivity like a personality trait, something I could earn through sheer force of will and an unhealthy amount of caffeine.

Then neuromyelitis optica spectrum disorder (NMOSD) arrived and not so politely informed me that my definition of productivity was not only wrong, but biologically impossible.

When my body defined new limits, I recognized that deadlines didn’t matter to NMOSD. What I’ve learned from having a chronic illness is that productivity isn’t about doing more. It’s about doing what matters with the energy you actually have, not the imaginary energy you think you should have. And yes, I get that it’s wildly counterintuitive.

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NMOSD set limits

Before NMOSD, I treated energy like it was infinite. I assumed I could always push through, as if my body were a rechargeable battery with a five‑second turnaround time. Now, I treat energy like a rare gemstone, which should not be wasted on things like unnecessary meetings, chaotic multitasking, or lengthy emails that could be a quick 30-second conversation.

I’ve become an expert at asking myself questions I never used to consider. What absolutely needs to happen today? What can wait? What can be delegated? What can be deleted entirely because it was never actually important? It’s amazing how much so-called urgent work evaporates when you start protecting your energy. This has been important because having NMOSD can sometimes feel like a whole other full-time job. Between the check-up appointments, scans, and specialist meetings, NMOSD can be all-consuming.

When I started setting boundaries, it felt awkward. I used to think that boundaries were optional, or worse, a sign that I was not a team player. But chronic illness has taught me that boundaries are not only necessary, they’re also productivity tools. They’re guardrails that keep me from driving my life off a cliff. Saying “I can’t take that on right now” or “I’m not available this afternoon” used to feel uncomfortable. Now it feels like self‑respect. The irony is that people actually respond better when I’m clear about what I can and cannot do. Turns out, clarity is also productive.

Prioritization also became a survival skill. When your energy is limited, you stop doing things out of habit, guilt, or social expectation. You start doing things because they matter. I used to treat every task like it was equally important. Now I mentally sort tasks into three categories: must do, nice to do, and why is this even on my list? That third category can get surprisingly large.

Rest is part of productivity

But the biggest shift, the one that still feels the most counterintuitive, is rest. Rest used to feel like failure, like giving up or like letting people down. But chronic illness doesn’t care about my internalized hustle culture. It will shut me down whether I schedule rest or not. So I started scheduling it. Rest is not the opposite of productivity; it’s part of it. It’s maintenance, and it’s what allows me to show up tomorrow without collapsing. When I rest more, I accomplish more, not because I’m magically cured, but because I’m not constantly running myself into the ground.

Living with NMOSD has taught me that productivity cannot be measured by someone else’s standards. It’s not about keeping up with my colleagues, friends, or the version of myself from 20 years ago. It’s about doing what I can, with what I have, in a way that keeps me healthy enough to keep going. Some days productivity looks like finishing a project. Some days it looks like answering one email. And at other times it looks like taking my medication on time and going back to bed.

Chronic illness has taught me that productivity isn’t about speed, output, or constant motion. It’s really about intention. It’s about sustainability, choosing what matters and letting go of what doesn’t. I get how it feels counterintuitive, especially in a world that glorifies hustle culture, but chronic illness has pointed out the truth whether I wanted to listen or not. Productivity isn’t doing more, it ‘s doing what matters without sacrificing myself in the process.

Note: Neuromyelitis News is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website. The opinions expressed in this column are not those of Neuromyelitis News or its parent company, Bionews, and are intended to spark discussion about issues pertaining to neuromyelitis optica spectrum disorder.