Posts Tagged Stress
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Why does stress bring back my TBI symptoms with a vengeance? It feels like a knife reopening a wound. What goes wrong in the brain after injury that makes this happen?
Stress occurs when there is a gap between the current task demands and the resources you have to meet those demands. Your brain interprets this as a threat. Acute stress — as in immediate physical danger — produces a physical reaction (the fight-or-flight response) that includes increased pupil dilation, perspiration, increased heart rate and blood pressure, rapid breathing, muscle tension, and increased mental alertness. However, less immediately threatening or prolonged stressors, such as ongoing money problems, too many things to get done in one day, even something like unexpected company, will produce these reactions. They may occur to a lessor degree, but ongoing stress reactions, even mild ones, will result in your body preparing for a long-term protective response.
Fatigue, concentration lapses, irritability, and lethargy result as the stress continues without relief. You probably recognize these as some of the TBI symptoms you feel coming back with a vengeance. Having experienced a TBI makes you both more susceptible to these symptoms, and these symptoms make it more difficult for you to effectively use whatever coping or compensatory strategies you may have developed to manage your TBI symptoms.
Learning to manage stress is important for all of us, and of particular importance to the recovery process after TBI. Techniques such as relaxation, time management, goal-setting, organization, cognitive-behavioral techniques, and lifestyle modifications can all be helpful in managing stress. It is recommended that you get some help and support in figuring out which of these techniques will be most useful for you from a mental health provider, a case manager, a life coach, a support group, or even a good friend if the stress levels are not overwhelming or seriously affecting your life. There are plenty of resources available for stress management, and a lot of information online, but sifting through it and tailoring it for your particular needs may be challenging without some support.
For more information on stress and stress management, click here.
Epilepsy affects each person differently. Below is a guide to some common seizure triggers. You may not feel or notice anything in particular. Or you may have triggers which are not mentioned here. Keeping a seizure diary is the most effective way of keeping track of what triggers your seizures.
Some people notice that their seizures occur in response to very specific stimuli or situations, as if the seizure is an automatic “reflex.” In this type of seizure, it occurs consistently in relation to a specific trigger. For example, one type of reflex epilepsy is photosensitive epilepsy where seizures are triggered specifically by flashing lights. Other types of reflex epilepsies can be seizures triggered by the act of reading or by noises. These reflex epilepsies are not common. However, knowing the type of epilepsy and trigger is important information for a correct diagnosis. You can then work on eliminating these triggers whenever possible or find…
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A team of researchers, led by scientists from Michigan State University in East Lansing and the University of Michigan in Ann Arbor, set out to examine the neuropsychological effect of talking to oneself in the third person on controlling one’s emotions.
The researchers’ hypothesis was that talking to oneself in the same way that one would about others would provide some much-needed psychological distance, which may help to control emotions.
The new study – which is published in the journal Scientific Reports – consists of two neuroscientific experiments that tested this hypothesis.
Using an electroencephalograph
In the first experiment – which was conducted at the Clinical Psychophysiology Lab and led by Prof. Jason Moser, of Michigan State University – participants were asked to look at emotionally aversive images (for example, a man pointing a gun at their heads) and neutral images.
They were asked to view these images in both conditions: the first-person condition, and the third-person condition.
In the former, the participants asked themselves, “What am I feeling right now?” But in the latter condition, they asked themselves, “What is [participant’s name] feeling right now?”
The participants’ brain activity was monitored using an electroencephalograph.
Referring to themselves in the third person reduced the participants’ brain activity across the neural mechanisms that are known to be involved in emotional regulation – and it did so almost immediately, within 1 second.
Interestingly, the brain activity – as recorded by the electroencephalograph – did not show an increase in cognitive control markers, which suggests that the strategy is effective at managing stress in a cognitively effortless way.
Talking to oneself inside an fMRI machine
In the second experiment, participants were asked to recall emotionally distressing experiences from their past in both first-person and third-person conditions.
This time, however, their brain activity was monitored using a functional MRI (fMRI) machine.
The second experiment revealed decreased activity in the medial prefrontal cortex, an area known to be a marker for self-referential emotional processing.
So, the third-person technique decreased activity in the brain area involved in processing painful autobiographical emotional memories.
However, reinforcing the findings of the first experiment, the second experiment did not reveal increased activity in the brain network involved in the cognitive control of emotions, the frontoparietal network.
This suggested, once again, that talking to oneself in the third person may be a simple and cognitively inexpensive way of reducing negative emotions on the spot.
“Essentially, we think referring to yourself in the third person leads people to think about themselves more similar to how they think about others, and you can see evidence for this in the brain. That helps people gain a tiny bit of psychological distance from their experiences, which can often be useful for regulating emotions.”
Prof. Jason Moser
“What’s really exciting here,” says the leader of the second study, Ethan Kross, of the University of Michigan, “is that the brain data from these two complementary experiments suggest that third-person self-talk may constitute a relatively effortless form of emotion regulation.”
“If this ends up being true – we won’t know until more research is done – there are lots of important implications these findings have for our basic understanding of how self-control works, and for how to help people control their emotions in daily life,” concludes Kross.
- Seizures and epilepsy affect all ages. While they tend to occur for the first time in young children or older adults, each age group has unique concerns and problems.
- We aren’t sure just why stress may trigger a seizure.
- While there is no definite evidence that reducing stress help seizures, a recent study showed that nearly 9 in 10 people who actively managed their stress believed it reduced their risk of seizures.
- Try to avoid stressful situations if it makes sense to do so, and if you can avoid it.
How often does stress trigger seizures?
It’s hard to know exactly how often stress triggers seizures, since stress means something different to everyone. It’s also hard to judge how much of an effect stress has on a person.
Stress comes in different forms and has a different meaning for everyone. It can come from a major life event or from more everyday activities that can potentially put us in a bad mood. Some studies have found that major life stressors, either good or bad, could affect seizures. Others have found that a build up of ‘daily hassles’ or stress seems to be more important. Since people are very different, it’s likely that stress can affect people in different ways at different times of their life.
VIDEO: Dr. Michael Privitera, MD talks about the relationship of stress and epilepsy, and an innovative new study to explore how stress reduction may also reduce seizures.
How does stress trigger seizures?
We aren’t sure just why stress may trigger a seizure. Stress is an expected and unavoidable part of life. It is our body’s reaction to any change that requires a physical and emotional response. Stress is known to cause worry, depression, frustration and even anger. Stress may affect people in many ways. Consider the following:
- Stress makes or releases certain hormones related to the nervous system that can impact the brain.
- Areas of the brain important for some types of seizures, for example partial seizures, are the same areas of the brain involved in emotions and responding to stress.
- Stress can cause problems sleeping which is also a seizure trigger.
- Chronic stress can lead to anxiety or depression. Sleep problems are symptoms of these mood problems. Being anxious and depressed can also worsen stress, causing a vicious cycle with more seizures and mood problems.
What can I do to manage stress and prevent seizures?
While there is no definite evidence that reducing stress help seizures, a recent study showed that nearly 9 in 10 people who actively managed their stress believed it reduced their risk of seizures. Common sense tells us that if something is bothering you, see what you can do to avoid it or make it better.
Managing stress is very personal and specific to your situation; however, there are some universal activities and recommendations.
- Use a diary and write down what’s likely to cause stress for you.
- Try to avoid stressful situations if it makes sense to do so, and if you can avoid it! If you can’t avoid it, can you let go of the worry it’s causing you?
- When a stressful situation is unavoidable, make sure you are doing your best to get enough sleep and take your seizure medications on time.
- Find ways to diffuse a situation. Avoid people who cause anger and anxiety if you can. Try to approach them differently – it may help calm down the stressful situation.
- Exercise regularly. Lots of research has shown the exercise helps lower stress.
- Do your best to relax. Try exercise, yoga, tai chi, Pilates, a massage, cat naps, or relaxation and controlled breathing techniques.
- Limit long naps during the day. Sleeping during the day will cause sleep problems at night and make people feel worse.
- Keep to a daily routine. Pace yourself and take frequent breaks.
- Set priorities for what is important in your life and let the rest go.
- Seek help. Talk to your doctor, nurse, or counselor. Let them know what’s bothering you.
- Make sure the epilepsy team knows that stress is affecting your seizures.
- Seek counseling or psychotherapy. If you think you may have anxiety or depression, talk to you doctor about treatment options.
- Join a support group or online support community. Reach out to the Epilepsy Foundation affiliate near you.
Patients with epilepsy face many challenges, but perhaps the most difficult of all is the unpredictability of seizure occurrence. One of the most commonly reported triggers for seizures is stress.
A recent review article in the European journal Seizure, by researchers at University of Cincinnati Epilepsy Center at the UC Gardner Neuroscience Institute, looks at the stress-seizure relationship and how adopting stress reduction techniques may provide benefit as a low risk form of treatment.
The relationship between stress and seizures has been well documented over the last 50 years. It has been noted that stress can not only increase seizure susceptibility and in rare cases a form of reflex epilepsy, but also increase the risk of the development of epilepsy, especially when stressors are severe, prolonged, or experienced early in life.
“Studies to date have looked at the relationship from many angles,” says Michael Privitera, MD, director of the UC Epilepsy Center and professor in the Department of Neurology and Rehabilitation Medicine at the UC College of Medicine. “The earliest studies from the 1980s were primarily diaries of patients who described experiencing more seizures on ‘high-stress days’ than on ‘low-stress days.'”
Privitera and Heather McKee, MD, an assistant professor in the Department of Neurology and Rehabilitation Medicine, looked at 21 studies from the 1980s to present–from patients who kept diaries of stress levels and correlation of seizure frequency, to tracking seizures after major life events, to fMRI studies that looked at responses to stressful verbal/auditory stimuli.
“Most all [of these studies] show increases in seizure frequency after high-stress events. Studies have also followed populations who have collectively experienced stressful events, such as the effects of war, trauma or natural disaster, or the death of a loved one,” says Privitera. All of which found increased seizure risk during such a time of stress.
For example, a 2002 study evaluated the occurrence of epileptic seizures during the war in Croatia in the early 1990s. Children from war-affected areas had epileptic seizures more often than children not affected by the war. Additionally, the 10-year follow up showed that patients who had their first epileptic seizure during a time of stress were more likely to have controlled epilepsy or even be off medication years later.
“Stress is a subjective and highly individualized state of mental or emotional strain. Although it’s quite clear that stress is an important and common seizure precipitant, it remains difficult to obtain objective conclusions about a direct causal factor for individual epilepsy patients,” says McKee.
Another aspect of the stress-seizure relationship is the finding by UC researchers that there were higher anxiety levels in patients with epilepsy who report stress as a seizure precipitant. The researchers suggest patients who believe stress is a seizure trigger may want to talk with their health care provider about screening for anxiety.
“Any patient reporting stress as a seizure trigger should be screened for a treatable mood disorder, especially considering that mood disorders are so common within this population,” adds McKee.
The researchers report that while some small prospective trials using general stress reduction methods have shown promise in improving outcomes in people with epilepsy, large-scale, randomized, controlled trials are needed to convince both patients and providers that stress reduction methods should be standard adjunctive treatments for people with epilepsy.
“What I think some of these studies point to is that efforts toward stress reduction techniques, though somewhat inconsistent, have shown promise in reducing seizure frequency. We need future research to establish evidence-based treatments and clarify biological mechanisms of the stress-seizure relationship,” says Privitera.
Overall, he says, recommending stress reduction methods to patients with epilepsy “could improve overall quality of life and reduce seizure frequency at little to no risk.”
Some low risk stress reduction techniques may include controlled deep breathing, relaxation or mindfulness therapy, as well as exercise, or establishing routines.
Stroke can lead to ongoing communication problems, but recovery is often possible.
Unfortunately, we often judge people on how well they communicate. From the outside, a person who has difficulty speaking may appear to have difficulty thinking, too, but this is not necessarily true.
For a person who has had a stroke, the ability to think and communicate depends on the part, or parts, of the brain that have been affected.
Having a stroke can be a frightening and frustrating experience. Not being able to tell people what is going on in the aftermath can extend the trauma.
Friends and family members, for their part, can also find themselves tongue-tied. They may feel embarrassed, lost for words, or they may think that this is no longer the person they once knew.
Post-stroke rehabilitation can help people to regain some or all of their skills. Speech therapists specialize in communication, but nonspecialists can also play a key role.
It is important for friends and relatives to understand that what a person expresses on the outside, after a stroke, is not necessarily what is going on in their head. They should also remember that, although a person faces new challenges after experiencing a stroke, they are still the same person.
This article will offer some tips from people who have “been there” that can give us the necessary skills for helping someone get back to communicating after a stroke.
How does a stroke affect communication?
A stroke is a brain injury that results from bleeding or a blockage in the brain. The effects can be sudden or gradual, and the damage may impact various aspects of mental and physical health.
- Motor skills
- The senses, including reactions to pain
- Thinking and memory
A stroke can affect a person’s use of language in a variety of ways.
Not only can the processing of language be impaired, but paralysis or physical weakness in the face, tongue, or throat muscles could make it hard to swallow, control breathing, and form sounds.
The type and extent of communication problems will depend on the form of stroke and what kind of injury has occurred. The damage and resulting levels of ability will also vary.
The Stroke Association describe three conditions that affect communication after a stroke: aphasia, dysarthria, and dyspraxia. A person may experience one or a combination of these.
Aphasia, or dysphasia, results from damage to one of the “language control centers” in the brain. While it influences communication, it does not impact intelligence. It may affect just one type of communication – for example, reading, listening or speaking, or a combination.
Fast facts about stroke
- Stroke can lead to paralysis or weakness on one side of the body
- There may be difficulty with thinking, awareness, attention, learning, judgment, and memory
- It can be hard to understand or form speech
- Mood and emotions can be affected.
Damage to a part of the brain known as Wernicke’s area can lead to receptive aphasia.
This makes it difficult to understand long and complex sentences, especially if there is background noise, or if more than one person is talking. The person may feel as if others are speaking in a foreign language. Their own speech may also become incoherent.
If there is damage to Broca’s area, expressive aphasia can result.
The person can understand others, but they will be unable to explain themselves. They can think the words, but they cannot speak them or put them together in order to make coherent, grammatically correct sentences.
A person with expressive aphasia may be able to make sounds or say short words or parts of sentences, but they may miss out important words or use the wrong word. They might have the word “on the tip of the tongue,” but not be able to get it out.
It may seem to the speaker that they are talking normally, but to a listener, it can sound like nonsense. Listeners may believe that the speaker is confused when they are not. They just cannot get the ideas across.
Damage that affects multiple areas of the brain can lead to mixed, or global, aphasia with challenges in all aspects of communication. The person may no longer use language to convey thought.
Dysarthria and dyspraxia
Dysarthria and dyspraxia relate to the physical production of speech sounds.
A person with dysarthria can find the words, but they cannot form them because of a physical problem, such as muscular weakness. This may cause the words to come out slurred or in short bursts. This slurring does not necessarily reflect the person’s state of mind. It is likely that only their ability to communicate is limited.
Dyspraxia involves difficulty with movement and coordination, so that the muscles needed for speech sounds may not work properly or in the correct order. This, too, can affect speech.
Other changes that can make it hard to contribute to conversations include:
- A loss of voice tone, normally used to express emotions
- Fixed facial expression
- Problems understanding humor
- Inability to take turns in conversation.
These can make the person appear depressed, even if they are not.
Some people are aware that they are experiencing these changes. If so, letting others know what the problem is can help to combat the issue.
However, a person with anosognosia will be unable to recognize that anything is wrong, due to a lack of insight resulting from damage to the brain. This can hinder recovery.
Depending on the damage that has occurred, vision and hearing problems can also affect communication and writing ability.
Tiredness is a common result of stroke. Conversation might also be tiring, because it demands so much effort.
After a stroke, stress and personality changes can occur. Stress can exacerbate communication problems, especially if the person becomes impatient with themselves, or if others become impatient.
Mood changes, due to the stroke’s effect on the brain, can further add to the strain.
What does a speech therapist do?
Speech therapy is a key part of rehabilitation after a stroke.
A speech therapist will help people with swallowing; this can be severely impaired, and it has an impact on language production.
Speech therapy can involve practicing forming words.
Language practice activities that speech therapists may use include intensive exercises in:
- Repeating words
- Following directions
- Reading and writing.
Examples of more extensive practice are:
- Conversational coaching
- Rehearsing speech
- Developing prompts to help people remember specific words
- Working out ways to get around language disabilities, such as using symbols and sign language.
Communication technology has expanded the range of ways to practice and improve communication. An example of this is pressing a key to activate a voice simulator.
Some tips from people with first-hand experience
Medical News Today asked two men, Peter Cline and Geoff, about their experience in regaining communication skills after a stroke. Peter, an engineer, had a stroke at the age of 59 when he was just starting a holiday in Tasmania. Geoff, who ran his own business until his retirement, was living in Spain when he became ill.
Both men have worked hard to regain their communication skills.
We asked what advice they would give people in order to help them communicate with someone following a stroke.
They gave us this list of dos:
Songs help some people to relax and communicate.
- Do look directly at the person when you are speaking to them
- Do speak slowly and clearly, but use a normal tone of voice
- Do use short sentences and stick to one topic at a time
- Do ensure there is no background noise
- Do reassure the person that you understand their frustration
- Do write things down, if it will help
- Do find out about the person’s employment, interests and passions – now and before the stroke – and try to relate to these
- Do give people a chance to say what they want to say, without jumping in or correcting them.
They also gave us some don’ts:
- Don’t finish the person’s sentences for them
- Don’t speak too fast
- Don’t push them too much
- Don’t speak to the person while they are driving, for example, because they cannot concentrate
- Don’t assume that because the person is having difficulty understanding, they must be stupid
- Don’t “talk down” to the person, or speak to them as if they are a child
- Don’t keep “rabbiting.”
Geoff told MNT that he feels his communication skills “go up and down.” It becomes harder for him to communicate when he is tired, and when there are more than two people in the conversation.
Both Geoff and Peter have made remarkable progress in their communication skills, and they each offered some words of encouragement for people who have had a stroke.
Geoff’s advice is:
“Take time to recover, and, when communicating, take time to explain, and don’t let yourself feel rushed.”
- Persevere and don’t give up. Things will gradually improve but not as quickly as you want them to
- Expect peaks and troughs in your recovery
- Enjoy relaxing with something you are familiar with, for example, old films, music, or whatever your “comforter” is.
Peter explains that after a stroke, an individual can feel as if they are inside a bubble. “It helps if you can get someone to understand that,” he says.
Activities that can help
Friends and family can engage in regular practice activities to help someone recover their communication skills after a stroke.
It may be helpful to arrange regular slots for communication practice, at a time when the person will not be tired.
Here are some activities for sharing, depending on individual styles and taste:
A photo album can be useful for prompting conversation.
- Songs, especially if the person was a keen singer before. Some people can sing after a stroke, even if they cannot speak, because singing and speaking use different parts of the brain
- Card games that involve the person saying the name of the card
- A photo album, to share and discuss the people and events in the pictures
- A personal file, with information about the person’s life, jobs, and family, in order to provide topics of conversation and nonverbal clues when access to key words is difficult
- A diary, with records of visits, events, and conversations. Friends and family can be encouraged to write in it, to help the person track their progress
- News stories to read in advance and discuss during the session.
If an important conversation is coming up – with the insurance company or hospital, for example – these slots can be a good place to prepare.
Other tips for self-help
If a person has difficulty expressing a word or idea, encouraging them to write or draw what they mean can help. Some people can spell a word, even if they cannot say it.
Strategies that people have used to practice alone include:
- Rehearsing speech sounds, such as vowels and consonants
- Using children’s books to practicing reading and writing
- Reciting poems or nursery rhymes
- Saying the names of famous sports personalities
- Watching the news, and copying how the newsreader speaks
- Persevering in conversation with friends or family, however difficult it is
It is important for friends and family to continue to treat the person as an intelligent adult, and to be aware that while their ability to communicate has changed, their identity has not. They are still who they are, with interests, skills, and a past.
In addition, everyone is different, and the effects of stroke vary. For this reason, there will not be a “one-size-fits-all” solution.
Full recovery is not always possible, but patience, help, support, and practice can go a long way in helping people to regain their communication skills after a stroke.
Harrison Ford has played a hero in the movies, but in real life, he gives that distinction to his 26-year-old daughter, Georgia. Earlier this month, the actor revealed that Georgia has epilepsy, and that it took years for her to get the proper treatment. “I admire her perseverance, her talent, her strength,” he told the Daily News.Epilepsy isn’t always easy to identify. The disorder typically isn’t diagnosed until a person has had two or more “unprovoked” seizures—that is, seizures that don’t have a clear trigger, explains Vikram Rao, MD, PhD, an assistant professor of neurology at the University of California, San Francisco.It turns out there are multiple things that can trigger a seizure, which is essentially a surge of electrical activity in the brain. And just because you have one, that doesn’t mean you’ve got epilepsy. But you should always get checked out by a doctor afterwards, says Dr. Rao.Here, six things that are known to trigger seizures even in people who don’t have a neurological condition—and what to do when a seizure strikes.
Seizures triggered by stress look similar to epileptic seizures, mainly because they can have the same symptoms—numbness, confusion, convulsions, and more. But there are differences in the brain electrical activity between the two types. In fact, research suggests that somewhere between 5% and 20% of people with epilepsy may be misdiagnosed and, in fact, suffering from seizures provoked by anxiety or underlying trauma.RELATED: 25 Surprising Ways Stress Affects Your Health
Low blood sugar
Your brain is a huge consumer of glucose, says Dr. Rao. When your blood sugar levels drop too low—a state called hypoglycemia—your brain has trouble functioning normally and the result could be a seizure. Since hypoglycemia is a potential a side effect of diabetes medications, diabetics may be at a higher risk for this type of seizure.
You already know that playing soccer for hours on a scorching-hot day can be dangerous. In that kind of heat (and under that kind of exertion), people can have trouble cooling themselves down. Once your internal thermostat reaches about 104 degrees Fahrenheit, you risk damaging your organs, including your brain: “The brain doesn’t function as well at higher temperatures,” says Dr. Rao. Once heat illness sets in, the brain can misfire, possibly triggering a seizure.
An estimated 2 million people may experience alcohol withdrawalevery year, according to a 2004 study in the journal American Family Physician. People can develop a tolerance to (or dependence on) alcohol, and the wiring in their brains can reflect that. So when some people quit cold turkey, it leaves their brains in a new, altered state that can set them up for a seizure, usually within 48 hours after their last drink, says Dr. Rao.
Antidepressants like bupropion (a.k.a. Wellbutrin and Zyban) have been associated with seizures in certain studies. And some antibiotics, like penicillins and quinolones, and pain medications like tramadol (sold under the brand name Ultram) might increase the risk of seizures too.
Too-little sleep is a powerful trigger for seizures, says Dr. Rao. (He’s seen seizures in college students who’ve stayed up for days in a row cramming for an exam.) “No one knows the exact reason behind this,” says Dr. Rao, “but sleep is restorative. We spend one-third of our lives sleeping, so we know it’s important.”RELATED: 30 Sleep Hacks for Your Most Restful Night Ever
What to do if someone has a seizure
Oftentimes, less is more. Rule number one: Keep the person safe. That means making sure she doesn’t accidentally hurt herself, either on a nearby sharp object or by falling down the stairs.As Anto Bagić, MD, PhD, the chief of the epilepsy division at the University of Pittsburgh Medical Center puts it: “There’s no ‘heroic’ measure necessary.” Don’t try to restrain the person (she might panic and lash out even more aggressively) and do not put anything in her mouth (she might choke on it). Besides, it’s a myth that people can swallow their tongue during a seizure.Either give her some space or, if necessary, guide her to a safer area, Dr. Bagić explains. If she’s lying on the floor, gently turn her on her side so that her saliva doesn’t block her airway.Most seizures resolve themselves within five minutes, so if it goes on for longer than that, you should call 911, says Dr. Bagić. More often, however, the person will regain consciousness after a few minutes—and when she does, stay calm.“When people are coming back [from a seizure], that’s when they’re at their most vulnerable,” says Dr. Bagić. “It can be scary if the first thing they see is people staring at them or panicking.”Another key point: Stay with the person until you’re sure that she’s completely recovered. Do all that, and it’ll be heroic enough.
“More than 65 million people, 29% of the U.S. population, provide care for a chronically ill, disabled, or aged family member or friend during any given year and spend an average of 20 hours per week providing care.”
-National Alliance for Caregiving in collaboration with AARP; 2009
Caregivers experience a level of stress that is often misunderstood. Long-term caregivers may suffer deep emotional upset, and burnout with little relief. The caregivers of traumatic brain injury survivors are people who have been called to walk an extraordinary caregiving journey, often without warning or preparation.
How can we help? Are there practical ways to incorporate the “It takes a village” philosophy into the lives of caregivers that you know? The answer is yes, with a little work and a lot of heart, you can assist those who are in a constant caregiving role.
As a caregiver who often feels lonely and overwhelmed, I’d like to offer some practical solutions that have been helpful to me.
1. Get Specific
Instead of saying, “Let me know what I can do to help,” come up with something you can do, and present it. This is something we are all guilty of doing from time to time. As someone who has been in the throes of caregiving for four years, I find it’s most helpful when someone designs a specific plan and sets it into motion.
For example, “I’d like to prepare dinner for your family once a month. You pick a day, and we will make it happen.” Or, “Let’s plan on my giving you a break, the second Wednesday of every month from 4-7.” This helps the caregiver to see that a break is in sight and set up activities of her own.
It’s important to remember that long-term caregiving may make someone feel as if her resources have been depleted, making it more difficult to reach out. When someone offers something specific that will help in a concrete way, it eases part of the burden for the caregiver involved.
2. Offer Clear Praise
Avoid saying things like, “All things considered; you are doing a good job.” Or, “You are doing the best that you can.” Instead go for specific, genuine praise that doesn’t leave room for questions about what the words you are saying might mean. For example, “I know it’s been a challenging four years, you are handling it so well.” Or a simple, “I just want to let you know I care about you.” Build the caregiver up, recognizing that their bucket may feel pretty empty at times, and they need a reserve to refill it.
Once, after an unexpected hospitalization, a dear friend looked at me and said with tears in her eyes, “You are my hero.” I knew that her sentiments were genuine. For the next several days, when I felt defeated, I focused on her praise. It not only lifted my spirit but also made me work harder in my role as a caregiver. Genuine praise is the wind in a caregiver’s sail.
3. Practice Compassion
The caregiver is often pulled in many directions from sun-up to sundown. After spending a month with us, my thirty-year-old nephew said to me, “I don’t know how you do it.”
“Do what?” I asked.
His response: “Life.”
From afar it looks easier than it is. After a time, caregivers pick up on the fact that they can sound like complainers, so instead they often hold things in. Holding in feelings can result in growing frustration. People who offer compassionate understanding when I am overwhelmed allow me to vent in healthy ways.
When a caregiver comes to you and is comfortable enough to share her frustration, please stop, look, and listen. In other words, take time to take in what her reality may look and feel like from her perspective. People often put caregivers on a pedestal, but they get grouchy, groggy and Grinch-like too. Acknowledging the difficulties they face allows them to get to the next step. Denial is unhealthy for everyone, but when faced with continual strain, it is important to have reality checks and friends with whom you can honestly share your feelings.
4. Recognize the Importance of Human Touch
If your finances allow it, consider the gift of massage for a caregiver. Recently, I gave myself this gift and was struck with how much better it made me feel. The massage had barely started, and I could feel the sadness and tension in my entire body. I told myself to relax and let the nurturing take place. Within a few minutes, while lying on the massage table, I began to weep. I was then overcome with such deep sadness, that sobs began to erupt. The therapist’s touch had released a trigger in my body to let some of the pain inside come to the outside. My reaction was not uncommon in this setting. Often, just providing someone a safe place is all that person needs to have the release occur. Caregivers often get in a cycle of not making space for self-care; sometimes a gift is the nudge they need to break away for an hour or so.
5. Less Judgment, More Lovement
I have shared this phrase before in my posts and blogs, but it bears repeating. The caregiver’s life is demanding. We are presented with challenging scenarios, which are new to us. We have to make the best decisions we can in a given set of circumstances. And we make mistakes.
We must decide on things like when and if we should call an ambulance. We have to be the voice for a person who often resents our having to take that role on for them, and we also have to find our own lives in the mix of fully assisting someone else.
Most caregivers I know deal with some level of anxiety, guilt, and frustration that resulted from their caregiving role. At the end of the day, they do need more love, because they are required to give more love away.
These are just a few ways to help caregivers be the best they can be.
[WEB site] First trial of Cognition Kit wearables demonstrates effectiveness in measuring mental health
The neuroscience company Cambridge Cognition Holdings PLC, which develops near patient technologies for the assessment of brain health, has announced results from a new technology feasibility study. The results demonstrate for the first time that consumer grade wearables such as the Apple Watch® and Microsoft Band can be used to accurately measure clinically relevant cognitive performance in everyday life using the Company’s new Cognition Kit software.
Mental health conditions are among the leading causes of disability worldwide. With more than 450 million people living with mental illnesses, the cost of treatment and care to global economies will double by 2030 to over $6 trillion (Source: World Health Organization).
Current methods of brain health assessment rely on infrequent snapshots to characterise impairment and recovery. Such sparse sampling will often miss clinically significant changes, which can impact on a patient’s quality of life and limit the ability to accurately measure the effect of intervention and treatment.
Cognition Kit is a wearable software platform developed under a joint venture between Cambridge Cognition and London research agency Ctrl Group to address this growing need. The technology will enable doctors, scientists and patients to better understand and manage day-to-day brain health by measuring the key biological and psychological factors affecting mental performance accurately in real time.
The new study shows for the first time that wearable consumer devices can be used clinically to measure cognitive performance accurately when programmed with the Cognition Kit software.
During the study participants wore a wearable device to monitor their levels of stress and physiological activity using built-in sensors of heart rate, galvanic skin response and skin temperature.
Throughout each day, subjects completed game-like micro tests of cognition on the device to measure attention, memory, mood and reaction speed.
After each cognitive game, subjects reported how they felt by selecting one of six faces to convey their current mood. On June 24th, the day of the EU referendum results in the UK, the researchers observed a significant drop in the general mood of the British participants in the study.
The 30 million data points recorded demonstrate distinct patterns of performance within and across days, allowing a rich picture of a subject’s cognitive health to emerge. Cognition Kit thus has the potential to revolutionise brain health treatment at all stages – from patient assessments during the development of disease-modifying interventions to monitoring of patient health.
With drug development companies increasingly being required to demonstrate clinical outcomes-based value of treatments in patients, this Cognition Kit study provides evidence that new technologies could transform healthcare and medical research in a wearable health industry estimated to be worth $2 billion (Source: Soreon Research Wearable Healthcare Report 2014).
Cambridge Cognition is in discussion with a number of pharmaceutical partners following significant early interest boosted by the results of the study and expects to sign the first Cognition Kit contracts in the near future.
Francesca Cormack, PhD, Director of Research and Innovation, Cambridge Cognition commented
”This proof of concept study demonstrates for the first time that these consumer devices are enabling the rapid and accurate collection of largescale scientific datasets. This not only allows dramatically more detailed knowledge of moment-by-moment brain function but also opens up new possibilities to develop machine learning algorithms that will enable earlier detection and intervention in brain disorders.”
Ben Fehnert, Co-founder of Ctrl Group and Director of Cognition Kit commented
”Simple, regular interaction with peoples own phones and wearable devices is key to helping understand daily and longer term fluctuations in cognitive function. This study is the first demonstration of how Cognition Kit software can build a rich picture of brain health using peoples own devices during their daily lives.”
About Cognition Kit
Cognition Kit is a joint venture between Cambridge Cognition and Ctrl Group formed in 2016 to develop digital health tools on mobile and wearable devices. Cognition Kit software takes research out of the lab and into daily life, enabling doctors, scientists and the public to better understand and manage day-to-day brain health.