What happens to your body when you’re a stressed caregiver?

Woman having a headacheStatistics show the stress of care giving can result in chronic disease for the caregiver and take as many as 10 years off one’s life. In comparison to caregivers of people in all categories, caregivers of Alzheimer’s patients in particular rate their health more poorly, take worse care of themselves, and spend more money on their health care. Feeling more tired and depleted, they evaluate themselves as less healthy, engage in fewer health-promoting behaviors, and use more health services.

Given the demands on caregivers’ time and energy, they may neglect their own self-care by sleeping less, eating too much or too little, not exercising, or not managing their own health problems. Neglect of their own health may worsen pre-existing illnesses or increase vulnerabilities to new stress-related problems.

The Physiology of Stress

Walter Cannon described the fight or flight response in 1929.  Adrenaline is the fight-or-flight hormone: It causes cells, especially muscle cells, to speed up energy production so that the body will be ready to fight a foe or run away. It is needed for short blasts of stress.

  • Pupils dilate to sharpen vision.
  • Heart rate and blood pressure increase to accelerate the delivery of oxygen to fuel the muscles and critical organs.
  • Blood flow is diverted from non-critical areas such as the gastrointestinal tract to the critical areas such as the heart, skeletal muscles and liver.
  • Liver releases glucose and fatty acids into the bloodstream. Glucose is for immediate energy; fat is needed when the fight-or-flight response lasts longer than expected.
  • Bronchial tubes dilate to maximize the exchange of oxygen and carbon dioxide.

Cortisol bolsters us in long-lasting stress situations. But when the body is dealing with chronic stress, the adrenals get “stuck” in the on position and the whole system goes into chronic “fight or flight.”

  • Glucose that is dumped into your bloodstream goes unused, so your body has to produce an enormous amount of insulin to handle it. Eventually, this may result in hypoglycemia or diabetes.
  • Fat that is dumped into your blood also goes unused, so it clogs your arteries, leading to cardiovascular disease.
  • If you drink caffeine, the stress hormone cortisol becomes elevated, which can set you up for countless health problems including: poor quality of sleep, impaired immunity and age-related deterioration.

Adrenal exhaustion–The adrenal glands produce or contribute to the production of about 150 hormones. When they are stressed, they become exhausted. Once the adrenal buffer is gone, you become a prime candidate for asthma, allergy, fibromyalgia, chronic fatigue syndrome, autoimmune disorders, hypoglycemia

Alcohol, caffeine, sugar and salt put added stress on the adrenals.

Stimulate, such as caffeine increase the effects of your body’s own stimulating neurotransmitters: norepinephrine and dopamine, which are similar to adrenaline in their effects. Caffeine and these natural stimulants provide short-term energy, focus and even a lifted mood. But in the long-term, caffeine depletes your stores of norepinephrine and dopamine, leaving you more tired, sluggish and down than you were before the caffeine habit.

Psychological stress can impact cardiovascular function and lead to cardiovascular disease, and possible stroke/heart attack.

Stress and sleep

Adequate sleep repairs your body, sharpens your mind and stabilizes emotions. Lack of sleep triggers the body to increase production of cortisol, which makes it harder to fall asleep and stay in a deep sleep because on some level your body and brain think they need to stay alert for danger.

  • Loss of sleep as a result of caring for a loved one can lead to serious depression.
  • As little as five nights of poor sleep can significantly stress the heart.

Weight gain and insulin resistance

  • Increased cortisol production leads to weight gain. The adrenals increase gluconeogenesis, which provides the body with glucose from protein, rather than carbohydrates. This decreases serotonin and melatonin, which results in poor sleep and leads to food cravings for carbohydrate-rich foods in order to uplift mood, which releases more serotonin and insulin. This leads to more stress and insulin production to regulate glucose, which may lead to fat storage, weight gain and insulin resistance. It becomes a vicious cycle.
  • Insufficient sleep is also associated with lower levels of leptin, a hormone that alerts the brain that it has enough food, as well as higher levels of ghrelin, a biochemical that stimulates appetite. Consequently, poor sleep may result in food cravings.

Exercise

  1. Insufficient sleep may leave us too tired to burn off extra calories with exercise.
  2. When your body is stressed and prepared to fight or run it’s full of stress hormones. If you’re sedentary, those hormones will continue to circulate and cause damage to your body. Vigorous exercise, however, burns off those hormones. Exercise also releases the neurotransmitter serotonin and endorphins, the body’s natural pain relievers.
  3. Doctors from Nottingham Trent University suggest the chemical phenylethylamine is released during exercise and could play a part in uplifting mood as a result of exercise. Phenylethylamine is a naturally produced chemical that has been linked to the regulation of physical energy, mood and attention.

Impact of food on mood and physiology

Hazards of caffeine

  1. Caffeine stresses the adrenal glands and can contribute to anxiety, insomnia, depression, irritability, anxiousness—not good for caregivers. In fact, studies show that those who drink the most coffee often suffer from chronic depression. It depletes the body of B1, biotin, inositol, vitamin C, calcium, potassium, and zinc. It increases thirst because it is dehydrating, over stimulates and weakens the kidneys, pancreas, liver, stomach, intestines, heart, and nervous system.
  2. Can increase production of cortisol, leading to stronger cravings for fat and carbohydrates. This increases blood glucose, release of insulin and fat stored in the abdomen.
  3. Increases dopamine levels, making you feel good until it wears off
  4. May interfere with restful sleep
  5. Try not to drink coffee after 2pm
  6. Simple carbohydrates increase insulin production.

People who are stressed often crave and overeat sugar and simple carbohydrates, like chips, cookies and white bread or pasta, because those foods provide a fast release of the feel-good chemical serotonin. But eating this way causes a blood-sugar crash a couple of hours later, leaving you tired and moody. The more of these foods that you eat the more you crave. Although these foods are high in calories, they contribute few nutrients and deplete the body of essential vitamins and minerals, raise triglycerides, and contribute to inflammation and excess weight.

  1. Lack of water/fiber can rob the body of nutrients because of problems with digestion and assimilation
  • HFCS and other artificial sweeteners can interfere with your natural production of neurotransmitters. Aspartame (NutraSweet and Equal) competes with tryptophan by blocking its conversion into serotonin. Artificial sweeteners contribute to numerous adverse symptoms, as compiled by the Food and Drug Administration and include everything from menstrual changes, weight gain, and headaches to severe depression, insomnia and anxiety attacks.

High fructose corn syrup (glucose and fructose) can lead to a decrease in leptin production leading your body into thinking it’s hungry so you eat more, especially processed foods. HFCS can lead to insulin resistance and higher levels of triglycerides, as well as obesity, hypertension and cardiovascular disease.

Bad habits, i.e. forgetting to eat, eating on the run, not eating breakfast all contribute to unstable blood sugar and adrenal exhaustion, which makes you grab foods that aren’t good for you, so you end up feeling irritable, moody, and even more stressed.


You get the picture? It’s important to take care of yourself, especially when you are taking care of someone else. I don’t want to overwhelm you with information or preach to you. Here’s a short checklist to help you stay healthy and balanced.

  • Eat a serving of high-quality protein with every meal and snack
  • Focus on complex carbohydrates (whole grains, veggies and fruits), and eliminate junk foods (refined carbs).
  • Enjoy unlimited amounts of fresh veggies.
  • Eat a good breakfast!
  • Eat 3 balanced meals and 1-2 snacks/day.
  • Magnesium, B complex, fish-oil, walnuts, flax seeds, dark leafy greens, and high quality all help reduce stress and uplift mood.
  • Meditate or find some quiet time for yourself
  • Exercise! At least take a short walk everyday.
  • Put on a funny YouTube video and laugh.
  • Use aromatherapy.
  • Do the best you can.

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Barbra Cohn cared for her husband Morris for 10 years. He passed away from younger-onset Alzheimer’s disease in 2010. Afterward, she was compelled to write “Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia”–winner of the 2018 Book Excellence Award in self-help– in order to help other caregivers feel healthier and happier, have more energy, sleep better, feel more confident, deal with feelings of guilt and grief, and to ultimately experience inner peace. “Calmer Waters” is available at AmazonBarnes & NobleBoulder Book StoreTattered Cover Book Store,  Indie Bound.org, and many other fine independent bookstores, as well as public libraries.

7 “mistakes” you’re making as a caregiver for someone with Alzheimer’s and what to do about it.

Helping hands, care for the elderly concept

If you’re like most caregivers you are tired, stressed, and some days just can’t wait to crawl into bed. Are you taking care of yourself? Are you getting enough rest? Do you have the support you need? Are you listening carefully to the person you lovingly care for? Here’s a quick check-list for assessing how well you are caring for yourself and your loved one.

  1. Are you eating a poor breakfast or skipping breakfast? It is so important to begin the day with a nourishing meal. This is true for everyone, but especially important for caregivers. It’s recommended that we eat within one hour after waking to stabilize our blood sugar—which has dropped during sleep—so that your mood stays even and you can perform at your best.  If not, you’ll be more apt to reach for a bagel or doughnut or another cup of coffee. After loading up on carbs and empty calories, it’s typical to feel hungry again within a couple of hours. And every time our blood sugar crashes, it’s a signal to the body to store calories. The same goes for a hungry body. If you don’t eat breakfast, your blood sugar will be low, and this too is a signal to the body to store calories, which adds fat around your middle. And, of course, the same applies to the person you care for.

Breakfasts of Champions

Instead of eating a bowl of corn flakes with a banana and low-fat milk, have a 2-egg omelet, slice of whole grain toast, a cup of fresh fruit and a cup of steamed greens such as kale. Then notice the difference in how you feel. You’ll have more stamina, less anxiety and depression, and will able to get through the whole day more easily.

Other ideas

  • Whole-grain mini-quiche with 1/2 cup berries
  • Oatmeal with prunes or raisins, walnuts or almonds, and cinnamon, whole milk
  • Multigrain hot cereal, Greek yoghurt and fresh fruit, almonds
  • Eggs with beans, salsa, and a side of greens
  • Bagel with hummus, tomato and goat cheese
  • Smoothie with greens, fruit, protein and flax

2. Do you say “Remember when . . . .or, I told you already . . .”

People with dementia typically do not remember what they said a few minutes ago. If your loved one repeats the same question over and over again, try not to get annoyed. Instead of reminding the person that they forgot what you told them a second ago rephrase it, breaking it down into a simple sentence . . . or completely change the subject.

If you reminisce about something instead of saying, “Remember when we were kids and we’d ride around the neighborhood on our bikes, etc.” tell the story: “You had a red bike and I had a blue bike and we loved to ride through the woods on the bike path, etc.”

If he or she asks about a spouse or parent who has passed away, change the subject to something like this: “Mom and Dad met in New York City at a dance, etc.” If the person keeps asking when he or she can go “home” ask the person to tell you about “home.” You might have to distract your loved one by taking a walk, listening to music, looking at pictures in a book or magazine. Saying “You are already home,” probably will not work.

3. Unusual irritability or anger can be the sign of a UTI or other physical ailment that requires attention. Acting out or acting differently than what is the person’s usual behavior can be a cry for help, especially if the person is non-verbal. Make an appointment to see a doctor to rule out anything suspicious.

4. How well are you sleeping? There are plenty of studies linking poor sleep to a host of physical and psychological ailments: poor immunity, elevated levels of cortisol and insulin, weight gain, diabetes, cardiovascular disease and even Alzheimer’s disease. And irritability, foggy thinking and anxiety, depression and low energy can directly impact your ability to care for another person, do household chores and get in the way of your interpersonal relationships. Good sleep hygiene is the first step to improving your sleep. Click here to read a list of things to try when you are stressed, your mind is on overload, or when you’ve just had too much stimulation and can’t fall asleep or stay asleep.

5. Are you and/or your loved one lonely? Caregiving can isolate us from our friends and family.  You may feel that your social network has disappeared or that your friends have “jumped ship.” This may also be true for the person you care for. Set up times for family and friends to visit or take your loved one on an outing. And don’t be afraid to ask your own friends for support. Find respite care and set up a lunch date with a friend. It’s vital to have social interaction for your mental, physical and emotional health.

6. Is there adequate lighting in the home where your loved one lives? People with dementia can become fearful because they don’t see things spatially the same way we do. Their sense of space is distorted and their vision gets skewed, not because there is something physically wrong with their eyes. But rather, the brain interprets what the eyes see, and when the brain doesn’t work right our perception gets distorted. Two things you can do to help are to put extra lights in dark areas of the living quarters and remove throw rugs in order to reduce falls.

7. Are you and your loved adequately hydrated? Drink at least 6-8 glasses of water each day to keep your body hydrated and to flush out toxins. The brain is 70% water when fully hydrated. When it is dehydrated, neurotransmission—which is heavily dependent on water—is impaired, resulting in poor memory, concentration and impaired abstract thinking. The same goes for your loved one. Memory is much improved when the brain is hydrated. Seniors often lose the signal that they are thirsty and dehydration can be a serious problem for the frail and elderly. If your loved one lives in a memory care home or nursing home, make sure water is provided throughout the day–not just that it is available but that it is offered.


Caregiving is probably the hardest thing you will ever do. You are doing the best that you can, but please remember to take care of yourself.

For more information on how you can reduce stress and boost your happiness and health, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s & Dementia.

 

12 quick energy and stress fixes to use throughout the holiday season . . . and all year long

Young ambitious executive enjoying his business success as he stThe holidays are stressful for everyone, but especially for caregivers. Here’s a list of some of my favorite stress relievers and energy boosters.

  1. Breathe! When we are stressed, we tend to hold our breath. Take a 5-minute break and sit down in a comfortable chair. Close your eyes and take a deep breath, in and out. Then focus on your breath and watch how your mind quiets down and your muscles relax. Then remember to breathe throughout the day. Whenever you feel yourself getting anxious or tight, take a deep breath and let it go.
  2. Drink water. We’ve heard it a million times but it’s always good to be reminded. Forget about sodas and limit the wine and alcohol. Staying hydrated, especially at this time of year, is vital to supporting the immune system and reducing inflammation. It’s also important to support healthy cognitive function and memory.
  3. Eat walnuts. A daily dose of about 9 whole walnuts or 1 Tbs. walnut oil helps your blood pressure from spiking during stress. Walnuts contain L-arginine, an amino acid that helps relax blood vessels, which in turn helps reduce hypertension.
  4. Drink green tea. L-Theanine is the main chemical constituent in green tea. It is an ideal nutritional aid for stress because it produces alpha-wave activity that leads to deep relaxation and mental alertness. This is especially important because in order to mitigate stressful situations, it’s important to remain calm and alert. Theanine also stimulates the release of the neurotransmitters GABA, serotonin and dopamine, which help us feel happy, motivated and calm. Green tea extract is available as a nutritional supplement, which might be easier and quicker to take, and it’ll save you a lot of trips to the bathroom.
  5. While we’re on the topic of “green,” be sure to eat green leafy vegetables for vitamin B and magnesium, both of which help your body cope with stress.
  6. Two handfuls of cashews (make that a small handful, please; one ounce of cashews contains 157 calories.) provide the equivalent mood-boosting effect as a therapeutic dose of Prozac because they are one of the highest natural sources of tryptophan, the precursor for serotonin, the feel-good neurotransmitter.
  7. Did someone mention dark chocolate? It reduces cortisol, the stress hormone that causes anxiety symptoms. Just a couple of pieces should do the trick.
  8. Walk around the block. Just getting out into fresh air will instantly relieve stress, and moving your body gets your blood pumping and will clear your mind.
  9. Light candles and play relaxing music while you eat. It will change the mood instantly.
  10. Aromatherapy is a miracle cure for stress and anxiety. Use a wall plug-in to diffuse the aroma of lavender oil to uplift mood, or place a few drops on a handkerchief and tuck it into a shirt pocket or on a pillow. Other oils to try: vetiver, frankincense, myrrh, orange, lemon, bergamot, and grapefruit.
  11. Music is the universal language, and it is also the universal stress reliever. Whether it’s jazz, classical, or hard rock that makes you feel better, by all means, play it loud, play it soft, dance to it, drive to it, go to sleep to it. It will definitely help.
  12. Getting the proper rest is vital to staying healthy and reducing stress. Prepare yourself for a deep night’s sleep by unplugging from electronics at least an hour before bed, taking an Epsom salt bath (put several drops of lavender oil in the water for added relaxation), and making sure the room temperature isn’t too warm.  Good night, sleep tight!

If you, or someone you care about, tend to suffer from stress, anxiety, or depression, these recommendations might just “take the edge off” and improve your quality of life … without the risk of side effects. May the holiday season begin!

For dozens more tools and techniques for reducing stress, uplifting mood, supporting your immune system, and finding ways to connect on a spiritual and emotional level with the person you care for, read Calmer Waters: The Caregiver’s Journey Through Alzheimer’s and Dementia.

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