How To Avoid Carer Burnout (Without Dropping Care)
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How To Avoid Carer Burnout
Sometimes in life we find ourselves in a caregiving role.
Maybe we chose it. For example, by becoming a professional carer, or even just by being a parent.
Oftentimes we didn’t. Sometimes because our own parents now need care from us, or because a partner becomes disabled.
Philosophical note: an argument could be made for that latter also having been a pre-emptive choice; we probably at some point said words to the effect of “in sickness and in health”, hopefully with free will, and hopefully meant it. And of course, sometimes we enter into a relationship with someone who is already disabled.
But, we are not a philosophy publication, and will henceforth keep to the practicalities.
First: are you the right person?
Sometimes, a caregiving role might fall upon you unasked-for, and it’s worth considering whether you are really up for it. Are you in a position to be that caregiver? Do you want to be that caregiver?
It may be that you do, and would actively fight off anyone or anything that tried to stop you. If so, great, now you only need to make sure that you are actually in a position to provide the care in question.
It may be that you do want to, but your circumstances don’t allow you to do as good a job of it as you’d like, or it means you have to drop other responsibilities, or you need extra help. We’ll cover these things later.
It may be that you don’t want to, but you feel obliged, or “have to”. If that’s the case, it will be better for everyone if you acknowledge that, and find someone else to do it. Nobody wants to feel a burden, and nobody wants someone providing care to be resentful of that. The result of such is two people being miserable; that’s not good for anyone. Better to give the job to someone who actually wants to (a professional, if necessary).
So, be honest (first with yourself, then with whoever may be necessary) about your own preferences and situation, and take steps to ensure you’re only in a caregiving role that you have the means and the will to provide.
Second: are you out of your depth?
Some people have had a life that’s prepared them for being a carer. Maybe they worked in the caring profession, maybe they have always been the family caregiver for one reason or another.
Yet, even if that describes you… Sometimes someone’s care needs may be beyond your abilities. After all, not all care needs are equal, and someone’s condition can (and more often than not, will) deteriorate.
So, learn. Learn about the person’s condition(s), medications, medical equipment, etc. If you can, take courses and such. The more you invest in your own development in this regard, the more easily you will handle the care, and the less it will take out of you.
And, don’t be afraid to ask for help. Maybe the person knows their condition better than you, and certainly there’s a good chance they know their care needs best. And certainly, there are always professionals that can be contacted to ask for advice.
Sometimes, a team effort may be required, and there’s no shame in that either. Whether it means enlisting help from family/friends or professionals, sometimes “many hands make light work”.
Check out: Caregiver Action Network: Organizations Near Me
A very good resource-hub for help, advice, & community
Third: put your own oxygen mask on first
Like the advice to put on one’s own oxygen mask first before helping others (in the event of a cabin depressurization in an airplane), the rationale is the same here. You can’t help others if you are running on empty yourself.
As a carer, sometimes you may have to put someone else’s needs above yours, both in general and in the moment. But, you do have needs too, and cannot neglect them (for long).
One sleepless night looking after someone else is… a small sacrifice for a loved one, perhaps. But several in a row starts to become unsustainable.
Sometimes it will be necessary to do the best you can, and accept that you cannot do everything all the time.
There’s a saying amongst engineers that applies here too: “if you don’t schedule time for maintenance, your equipment will schedule it for you”.
In other words: if you don’t give your body rest, your body will break down and oblige you to rest. Please be aware this goes for mental effort too; your brain is just another organ.
So, plan ahead, schedule breaks, find someone to take over, set up your cared-for-person with the resources to care for themself as well as possible (do this anyway, of course—independence is generally good so far as it’s possible), and make the time/effort to get you what you need for you. Sleep, distraction, a change of scenery, whatever it may be.
Lastly: what if it’s you?
If you’re reading this and you’re the person who has the higher care needs, then firstly:all strength to you. You have the hardest job here; let’s not forget that.
About that independence: well-intentioned people may forget that, so don’t be afraid to remind them when “I would prefer to do that myself”. Maintaining independence is generally good for the health, even if sometimes it is more work for all concerned than someone else doing it for you. The goal, after all, is your wellbeing, so this shouldn’t be cast aside lightly.
On the flipside: you don’t have to be strong all the time; nobody should.
Being disabled can also be quite isolating (this is probably not a revelation to you), so if you can find community with other people with the same or similar condition(s), even if it’s just online, that can go a very, very long way to making things easier. Both practically, in terms of sharing tips, and psychologically, in terms of just not feeling alone.
See also: How To Beat Loneliness & Isolation
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Hair-Loss Remedies, By Science
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10almonds Gets Hairy
Hair loss is a thing that at some point affects most men and a large minority of women. It can be a source of considerable dysphoria for both, as it’s often seen as a loss of virility/femininity respectively, and is societally stigmatized in various ways.
Today we’re going to focus on the most common kind: androgenic alopecia, which is called “male pattern baldness” in men and “female pattern baldness” in women, despite being the same thing.
We won’t spend a lot of time on the science of why this happens (we’re going to focus on the remedies instead), but suffice it to say that genes and hormones both play a role, with dihydrogen testosterone (DHT) being the primary villain in this case.
We’ve talked before about the science of 5α-reductase inhibitors to block the conversion of regular testosterone* to DHT, its more potent form:
One Man’s Saw Palmetto Is Another Woman’s Serenoa Repens…
*We all make this to a greater or lesser degree, unless we have had our ovaries/testes removed.
Finasteride
Finasteride is a 5α-reductase inhibitor that performs similarly to saw palmetto, but comes in tiny pills instead of needing to take a much higher dose of supplement (5mg of finasteride is comparable in efficacy to a little over 300mg of saw palmetto).
Does it work? Yes!
Any drawbacks? A few:
- It’ll take 3–6 months to start seeing effects. This is because of the hormonal life-cycle of human hairs.
- Common side-effects include ED.
- It is popularly labelled/prescribed as “only for men”
On that latter point: the warnings about this are severe, detailing how women must not take it, must not even touch it if it has been cut up or crushed.
However… That’s because it can carry a big risk to our unborn fetuses. So, if we are confident we definitely don’t have one of those, it’s not actually applicable to us.
That said, finasteride’s results in women aren’t nearly so clear-cut as in men (though also, there has been less research, largely because of the above). Here’s an interesting breakdown in more words than we have room for here:
Finasteride for Women: Everything You Need to Know
Spironolactone
This one’s generally prescribed to women, not men, largely because it’s the drug sometimes popularly known as a “chemical castration” drug, which isn’t typically great marketing for men (although it can be applied topically, which will have less of an effect on the rest of the body). For women, this risk is simply not an issue.
We’ll be brief on this one, but we’ll just drop this, so that you know it’s an option that works:
❝Spironolactone is an effective and safe treatment of androgenic alopecia which can enhance the efficacy when combined with other conventional treatments such as minoxidil.
Topical spironolactone is safer than oral administration and is suitable for both male and female patients, and is expected to become a common drug for those who do not have a good response to minoxidil❞
Minoxidil
This one is available (to men and women) without prescription. It’s applied topically, and works by shortcutting the hair’s hormonal growth cycle, to reduce the resting phase and kick it into a growth phase.
Does it work? Yes!
Any drawbacks? A few:
- Whereas you’ll remember finasteride takes 3–6 months to see any effect, this one will have an effect very quickly
- Specifically, the immediate effect is: your rate of hair loss will appear to dramatically speed up
- This happens because when hairs are kicked into their growth phase if they were in a resting phase, the first part of that growth phase is to shed each old hair to make room for the new one
- You’ll then need the same 3–6 months as with finasteride, to see the regrowth effects
- If you stop using it, you will immediately shed whatever hair you gained by this method
Why do people choose this over finasteride? For one of three reasons, mainly:
- They are women, and not offered finasteride
- They are men, and do not want the side effects of finasteride
- They just saw an ad and tried it
As to how it works:
Some final notes:
There are some other contraindications and warnings with each of these drugs by the way, so do speak with your doctor/pharmacist. For example:
- Finasteride can tax the liver a little
- Spironolactone can reduce bone turnover
- Minoxidil is a hypotensive; this shouldn’t be an issue for most people, but for some people it could be a problem
There are other hair loss remedies and practices, but the above three are the heavy-hitters, so that’s what we spent our time/space on today. We’ll perhaps cover the less powerful (but less risky) options one of these days.
Meanwhile, take care!
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What is PMDD?
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Premenstrual dysphoric disorder (PMDD) is a mood disorder that causes significant mental health changes and physical symptoms leading up to each menstrual period.
Unlike premenstrual syndrome (PMS), which affects approximately three out of four menstruating people, only 3 percent to 8 percent of menstruating people have PMDD. However, some researchers believe the condition is underdiagnosed, as it was only recently recognized as a medical diagnosis by the World Health Organization.
Read on to learn more about its symptoms, the difference between PMS and PMDD, treatment options, and more.
What are the symptoms of PMDD?
People with PMDD typically experience both mood changes and physical symptoms during each menstrual cycle’s luteal phase—the time between ovulation and menstruation. These symptoms typically last seven to 14 days and resolve when menstruation begins.
Mood symptoms may include:
- Irritability
- Anxiety and panic attacks
- Extreme or sudden mood shifts
- Difficulty concentrating
- Depression and suicidal ideation
Physical symptoms may include:
- Fatigue
- Insomnia
- Headaches
- Changes in appetite
- Body aches
- Bloating
- Abdominal cramps
- Breast swelling or tenderness
What is the difference between PMS and PMDD?
Both PMS and PMDD cause emotional and physical symptoms before menstruation. Unlike PMS, PMDD causes extreme mood changes that disrupt daily life and may lead to conflict with friends, family, partners, and coworkers. Additionally, symptoms may last longer than PMS symptoms.
In severe cases, PMDD may lead to depression or suicide. More than 70 percent of people with the condition have actively thought about suicide, and 34 percent have attempted it.
What is the history of PMDD?
PMDD wasn’t added to the Diagnostic and Statistical Manual of Mental Disorders until 2013. In 2019, the World Health Organization officially recognized it as a medical diagnosis.
References to PMDD in medical literature date back to the 1960s, but defining it as a mental health and medical condition initially faced pushback from women’s rights groups. These groups were concerned that recognizing the condition could perpetuate stereotypes about women’s mental health and capabilities before and during menstruation.
Today, many women-led organizations are supportive of PMDD being an official diagnosis, as this has helped those living with the condition access care.
What causes PMDD?
Researchers don’t know exactly what causes PMDD. Many speculate that people with the condition have an abnormal response to fluctuations in hormones and serotonin—a brain chemical impacting mood— that occur throughout the menstrual cycle. Symptoms fully resolve after menopause.
People who have a family history of premenstrual symptoms and mood disorders or have a personal history of traumatic life events may be at higher risk of PMDD.
How is PMDD diagnosed?
Health care providers of many types, including mental health providers, can diagnose PMDD. Providers typically ask patients about their premenstrual symptoms and the amount of stress those symptoms are causing. Some providers may ask patients to track their periods and symptoms for one month or longer to determine whether those symptoms are linked to their menstrual cycle.
Some patients may struggle to receive a PMDD diagnosis, as some providers may lack knowledge about the condition. If your provider is unfamiliar with the condition and unwilling to explore treatment options, find a provider who can offer adequate support. The International Association for Premenstrual Disorders offers a directory of providers who treat the condition.
How is PMDD treated?
There is no cure for PMDD, but health care providers can prescribe medication to help manage symptoms. Some medication options include:
- Selective serotonin reuptake inhibitors (SSRIs), a class of antidepressants that regulate serotonin in the brain and may improve mood when taken daily or during the luteal phase of each menstrual cycle.
- Hormonal birth control to prevent ovulation-related hormonal changes.
- Over-the-counter pain medication like Tylenol, which can ease headaches, breast tenderness, abdominal cramping, and other physical symptoms.
Providers may also encourage patients to make lifestyle changes to improve symptoms. Those lifestyle changes may include:
- Limiting caffeine intake
- Eating meals regularly to balance blood sugar
- Exercising regularly
- Practicing stress management using breathing exercises and meditation
- Having regular therapy sessions and attending peer support groups
For more information, talk to your health care provider.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, upset, or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.
This article first appeared on Public Good News and is republished here under a Creative Commons license.
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Dark Calories – by Dr. Catherine Shanahan
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You may be wondering: do we really need a 416-page book to say “don’t use vegetable oils”?
The author, who was a biochemist before becoming a family physician, takes a lot of care to explain in ways the non-chemists amongst us can understand (with molecular diagrams very well-labelled), exactly why certain seed/vegetable oils (both of those names being imprecise and unhelpful as umbrella terms) cause metabolic problems for us, when in contrast olive oil, avocado oil, and even peanut oil, do not.
Understanding is, for many, the root foundation of compliance. We are more likely to abide by rules we understand the logic behind, than seemingly arbitrary “thou shalt not…” proclamations.
So that’s an important strength of the book, demystifying various fats and how our body responds to them on a biochemical level, not just “is associated with such-and-such, based on observational population studies”. This kind of explanation clears up why, for example, seed oils correlate with obesity more than calories, sugar, wheat, or beef—having as it does to do with affecting our body’s ability to generate and use energy.
She also offers practical tips/reminders throughout, such as how “organic” does not necessarily mean “healthy” (indeed, many poisonous plants can be grown “organically”), and nor does “organic” mean “unrefined”, it speaks only for the conditions in which the raw product was first made, before other things were done to it later.
We learn a lot, too, about the processes of oxidation, the biochemistry behind that (more diagrams!), and of course the inflammatory response to same (an important factor in most if not all chronic disease).
The style is mostly very easy-to-read pop-science, though if you’re not a chemist, you’ll probably need to slow down for the biochemistry explanations (this reviewer certainly did).
Bottom line: this is more than just a litany against vegetable oils; it’s a ground-upwards education in metabolic biochemistry for the layperson, and what that means for us in terms of chronic disease risks.
Click here to check out Dark Calories, and learn what’s going on with these oils!
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Why Zebras Don’t Get Ulcers – by Dr. Robert M. Sapolsky
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The book does kick off with a section that didn’t age well—he talks of the stress induced globally by the Spanish Flu pandemic of 1918, and how that kind of thing just doesn’t happen any more. Today, we have much less existentially dangerous stressors!
However, the fact we went and had another pandemic really only adds weight to the general arguments of the book, rather than detracting.
We are consistently beset by “the slings and arrows of outrageous fortune” as Shakespeare would put it, and there’s a reason (or twenty) why many people go grocery-shopping with the cortisol levels of someone being hunted for sport.
So, why don’t zebras get ulcers, as they actually are hunted for food?
They don’t have rent to pay or a mortgage, they don’t have taxes, or traffic, or a broken washing machine, or a project due in the morning. Their problems come one at a time. They have a useful stress response to a stressful situation (say, being chased by lions), and when the danger is over, they go back to grazing. They have time to recover.
For us, we are (usually) not being chased by lions. But we have everything else, constantly, around the clock. So, how to fix that?
Dr. Sapolsky comprehensively describes our physiological responses to stress in quite different terms than many. By reframing stress responses as part of the homeostatic system—trying to get the body back into balance—we find a solution, or rather: ways to help our bodies recover.
The style is “pop-science” and is very accessible for the lay reader while still clearly coming from a top-level academic who is neck-deep in neuroendocrinological research. Best of both worlds!
Bottom line: if you try to take very day at a time, but sometimes several days gang up on you at once, and you’d like to learn more about what happens inside you as a result and how to fix that, this book is for you!
Click here to check out “Why Zebras Don’t Get Ulcers” and give yourself a break!
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What causes food cravings? And what can we do about them?
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Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard?
High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods activate the brain’s reward system because in the past they were rare.
Now, they’re all around us. In wealthy modern societies we are bombarded by advertising which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering an intense urge to eat them.
Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods.
What causes cravings?
A food craving is an intense desire or urge to eat something, often focused on a particular food.
We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt.
Something that reminds us of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to crave it.
The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control.
What else influences our choices?
While the effect of cues on our physical response is relatively automatic, what we do next is influenced by complex factors.
Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals.But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the pleasure of eating, over one that’s delayed or abstract – including health goals that will make us feel good in the long term.
Stress can also make us eat more. When hungry, we choose larger portions, underestimate calories and find eating more rewarding.
Looking for something salty or sweet
So what if a cue prompts us to look for a certain food, but it’s not available?
Previous research suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol.
But our new research has confirmed something you probably knew: it’s more specific than that.
If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy.
Food cues and mindless eating
Your eating history and genetics can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is hard for almost everyone.
Food cues are so powerful they can prompt us to seek out a certain food, even if we’re not overcome by a particularly strong urge to eat it. The effect is more intense if the food is easily available.
This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we eat. Sometimes we use finishing the packet as the signal to stop eating rather than hunger or desire.
Is there anything I can do to resist cravings?
We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in.
- Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit.
- Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle.
- At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment.
- Make sure your goals for eating are SMART. This means they are specific, measurable, achievable, relevant and time-bound.
- Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.
Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University and Justin Mahlberg, Research Fellow, Pyschology, Monash University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Statins and Brain Fog?
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It’s Q&A Day at 10almonds!
Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!
In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!
As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!
So, no question/request too big or small
❝I was wondering if you had done any info about statins. I’ve tried 3, and keep quitting them because they give me brain fog. Am I imagining this as the research suggests?❞
If you are female, the chances of adverse side-effects are a lot higher:
As an extra kicker, not only are the adverse side-effects more likely for women, but also, the benefits are often less beneficial, too (see the above main feature for some details).
That’s not to say that statins can’t have their place for women; sometimes it will still be the right choice. Just, not as readily so as for men.
Enjoy!
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