By Alice D. Domar, Ph. D.

As a caregiver, you may recognize signs of stress in other people, but it’s not always easy to recognize these signs in yourself. You may be so accustomed to balancing   schedules and needs for your loved one and your family that you simply don’t realize you are stressed.   Or, you may realize there is a certain amount of stress associated with your daily routine, and you may feel that you are “dealing with it” and “coping” appropriately.  But chronic stress takes a toll, even if you are not aware of it. If stress is left untreated, it can affect your health and therefore, your ability to care for a loved one.  

Am I Stressed?

What is stress and how do you know if you’re experiencing “stress overload?”  Below, we’ve listed some tips to help you understand stress, as well as its potential impact on you, your family, and the person in your care. 

Acute & Chronic Stress

There are two types of stress: acute and chronic.  Acute or short-term stress can be energizing and helps you stay alert and have the stamina you might need for a short-term crisis. However, chronic or long-term stress can compromise your health, including your immune system (so you may get sick more easily, and stay sick longer). 

Acute stress might include something such as being confronted by a car coming swiftly at you while crossing the street. Your body activates the “fight or flight” response which increases your heart rate, blood pressure, and blood flow to your muscles. These changes in your body allow you to get out of danger more easily (for example, run out of the way of the oncoming car, or jump back quickly to the sidewalk).

With acute stress, your body will be “energized” for a very short period of time. However, once the danger (or perceived danger), is over your body quickly returns to a normal state.

Chronic stress, on the other hand, is characterized by circumstances that are often beyond our control and seem to go on endlessly. You may identify with this type of stress if your loved one has a chronic disease or permanent disability. Chronic stress can suppress your immune system and, over time, has the greatest negative impact on your health—both mentally and physically. 

Warning Signs

Change, conflict, and pressure are the most common causes of stress.  Each of us experiences and reacts to these situations differently.

How can you determine if stress is affecting your life and caregiving responsibilities? Being able to recognize warning signs of stress is a first step toward addressing and better managing stress.  Here are some of the common signs of chronic stress—check if any are familiar to you:

• Having trouble sleeping
• Biting your fingernails
• Easily irritated by almost any situation
• Muscle tension, especially in the neck and back
• Frequent headaches
• Crying easily
• Feeling tired most or all of the time
• Stomach aches and/or a change in bowel habits
• Grinding your teeth or having jaw pain when you wake up
• Sweating more than usual, even in a calm situation
• Noticing that you interrupt others’ conversations
• Speaking rapidly
• Chronically late for appointments or even social activities
• Overeating, craving certain foods or conversely, eating very little 
• Drinking excessive amounts of alcohol 
• Chain-smoking 
• Withdrawal from family, friends, co-workers
• Feeling lethargic or hopeless about your future

Coping with Stress

If you can identify with several of these warning signs and notice that you experience them on a continuous basis, it’s very likely that you suffer from chronic stress. Better understanding what triggers your stress and how to deal with it will help you stay healthier. Here are a few tips:

•       Listen to Your Friends and Family
Your family and friends know you best, and are often the first to tell you that you are stressed (or acting irritable, or engaging in self-destructive behaviors such as chain-smoking).

Listen to what your friends and family tell you, or ask them for their observations. Take a deep breath, and as a first step, work on carving out some time from your day, and then sit down and listen to their observations about you. Their insight may reveal situations or incidents that you weren’t aware of—such as consistently being short-tempered with your loved one or other family members. Seek their support to help ease your caregiving workload, which in turn will help reduce your “stress load.”  Sometimes just asking for help can provide a calming effect.  And perhaps more crucial, accept any and all offers of help.

If you find you’re unable to resolve your stress-related issues by talking with family and friends and getting their support, be sure speak to your doctor about alternative ways to deal with the stress in your life.   There are many ways to reduce one’s stress level, ranging from relaxation techniques to medication.

•       Avoid Being an Over-Achiever
Doing everything for everybody all the time can be rewarding, but it can also be mentally and physically draining.  Seems the more you do, there’s always more that has to be done—often without support from others.

Family members’ expectations may be that you’ll always “rise to the occasion,” putting your loved one’s needs and care ahead of your own well-being. Unfortunately, this approach to caregiving may not be sustainable long-term. It is not sustainable particularly when you’re caring for a loved one with a chronic condition or disease, such as Alzheimer’s disease, Parkinson’s disease, cancer, or other chronic conditions.

The stress associated with providing long term care can negatively affect your health and in turn, potentially the quality of care you can provide your loved one. Family members may be so focused on your loved one as well, that they forget about your health and your needs.

If you are someone who is doing it all, it’s time to stop and realistically re-examine your loved one’s needs and your ability to satisfy them.  Doing this may help you determine your limitations, and also motivate you to look for other sources of support—including family, friends, and outside caregiving services—to help alleviate your stress.     

•       Don’t Be in Denial
Many of us would like to believe that we can indeed “do it all” and that we are strong enough to withstand whatever life tosses our way. But in situations like this, you need to take a step back and truly listen to your heart and body. If you are having trouble sleeping, if your back and neck feel stiff, if you are constantly tired…your body is trying to tell you something. If you find yourself snapping at people you love your mind is signaling that you are in overdrive. What good are you going to be for your loved one if you can’t even take care of yourself?

•       Learn to Say No
If you find that you’re being asked to do more than you can manage—whether physically, emotionally or financially—learn to set boundaries and remember that “no” is a complete sentence. 

The word “no” is empowering and lets others know that you’re willing to do whatever you can, but they need to step up and assist with your loved one’s care as well.  There are other ways to say no, such as “no, because….” or “no, but how about….”  Memorize some good comeback lines to use when someone asks you to do more than you can.  Remember, there is an ancient expression which says that saying no to someone else is saying yes to yourself.

Your loved one appreciates your care and devotion. However, you need to address your needs during this time as well. By applying some of these suggested coping skills, you can reduce your “stress load” so you can deal effectively and compassionately with your loved one’s needs and your own—and stay healthy in the process.     


Resources

Domar Center for Complementary Healthcare

HelpGuide.org

AARP—Caregiver Physical & Mental Health