Managing stress and the caring role

Carers usually find life begins to revolve around the person with a brain injury. The workload often leads to stress and frustration, along with dramatic changes in lifestyle and roles as they access community services, provide health care and look after the family as well.

When the caring role is a long-term one, it is very important to manage stress as it can lead to health problems, depression, anxiety and reduce your capacity to be an effective carer.

You will probably use coping strategies that you have used for difficult times in the past. This is useful, but often the caring role is so difficult it makes sense to experiment with new ways of dealing with stressful situations.

Researchers have asked people how they have coped with a brain injury occurring within the family (Willer et al 1991). While every family member is different, here are some strategies that other family members have found helpful:

• Look after yourself
• Find support groups either face-to-face or online
• Maintain a sense of humour
• Be assertive about your needs
• Try to see things realistically
• Be careful not to blame everything on the injury
• Redefine roles and responsibilities for yourself and the family.

Taking a few moments to relax can help you be more ready for the things you need to do. Learning to relax is not easy – even when you rest at the end of a long day, you are probably thinking about what you need to do tomorrow or how to solve a problem. Here are some techniques to train your body and mind to relax. Find the ones that work best for you.

Focused breathing

Your breathing becomes quick and shallow when you are stressed, instead of breathing deeply from your diaphragm (the muscle between the chest and abdomen). Taking full breaths from your diaphragm puts your body in a relaxed state. Try this exercise several times a day:

• Lie down on your back in a comfortable place
• Put your hands just below your belly button
• Close your eyes and imagine a balloon inside your abdomen
• Inhale fully (but not too deep), and imagine the balloon filling with air
• Exhale slowly, and imagine the balloon collapsing.
• Muscle tensing & relaxing

This helps you to understand the difference between how your muscles feel when tense and relaxed.

• Lie down on your back in a comfortable place and close your eyes
• Curl and tense the toes of one of your feet as you breathe in
• Relax your toes as you breathe out and note the change in tension
• Repeat this with the toes of your other foot
• Repeat this exercise with other body parts.
• Use a focus word or phrase

This clears your mind of negative thoughts and stress. Choose a focus word or phrase – it can be something with a positive meaning like “peace” or just a word that is easy to remember such as “one”. Take full deep breaths from your diaphragm. Say the focus word to yourself each time you breathe out.

Visual imagery

Lie down and imagine yourself in a place where you feel calm and relaxed. It can be a real place you’ve visited, or somewhere you have imagined. For example, imagine yourself on a beach lying in the cool sand – feel the sun on your face, the sand against your skin, and listen to the surf.

We all respond differently to difficult situations – some people take in their stride while others will barely be able to cope. Much of this comes down to how we choose to see the situation, as irrational responses usually lead to stress.

For example, the person with a brain injury yells at us. A rational response would be “emotional outbursts are common after a brain injury so this could be due to fatigue, anxiety or feeling unable to cope”.

An irrational response is “how rude, and after all I’ve done as a carer, I feel so unappreciated and don’t deserve to be put down like this”.

Irrational responses and will lead to unpleasant emotions that prevent us from responding in a healthy way. Most of our irrational responses will stem from one of these attitudes:

• I must do well and win the approval of others
• Others should treat me the way I want them to
• People should be punished if they don’t act the way I want them to
• I should get what I want quickly, easily, and without hardship
• The world is a horrible place and bad things keep happening to me.

Remember, learning new ways to think and cope takes time. Be kind to yourself, allow yourself the chance to make mistakes. Focus on your successes no matter how small. Coping effectively is like any other major challenge. It requires tenacity, endurance and commitment for change.