As a caregiver there are going to be many moments when it feels as if you couldn’t bear to face one more day, one more piece of bad news, or one more setback in your loved one’s health. These feelings are not because you don’t care deeply about your loved one. It’s simply because being a caregiver is hard. I don’t want to be trite about these moments. They really suck. It really does feel like you can’t go on. But it’s a lie – you can keep putting one foot in front of the other.
I’ve recently been interested in endurance athletes. How can Ironman triathletes swim almost 4 km, bike 180 km, then run a full marathon? How can ultra-marathoners race for over 300 km? There must be so many moments during the race when they feel like giving up. Being a caregiver or spouse of someone with a chronic illness is, of course, very different than competing in these competitions, but it certainly takes a great deal of endurance. So please indulge me this seemingly off-topic discussion of endurance athletics – you will soon see the relevance.
As a psychology major, I hate the phrase “it’s all in the mind” – as if to say something isn’t really that challenging if you’re “mentally strong”. Humans are much more complex than divisions into neat “mental” or “physical” categories. But a counter-intuitive (and somewhat controversial) finding of research into endurance athletics is that, despite the huge stress these events put on the body, strictly physical limitations are rarely why people quit.
You may say, well, sure, but these are professional athletes who know how to take care of their bodies. But researchers have tested taking away “necessary” ingredients in sustaining athletic performance and even then, when the athletes give up it is almost never because they physiologically “give out”. Physiology undoubtedly has something to do with it, but there are ways to trick people into enduring when they would otherwise give up.
As author Alex Hutchinson discusses in his great book, Endure, because of the dangers of both too much (hyponatremia) and too little (dehydration) water consumption there has been a raging debate among experts about how much one should drink in an endurance event. Gatorade and sports drink manufacturers have led a push for many years to make the standard recommendation that one should drink as much as one can during an event. However, a string of hyponatremia deaths, and athletes such as Haile Gebrselassie, who lost as much as 10 pounds of water while still setting world records in the marathon, led to questioning of this prevailing wisdom.
One study (Figaroo & Mack, 1997) used a nasogastric tube to either send water into the stomachs of athletes but not down their throat, or down their throat but not into the stomachs. It turned out that the feeling of thirst was quenched more effectively for the group that had the water only go down their throat, which is strange if the body was using thirst to remedy impending physiological dehydration. Another study (Arnaoutis et al., 2012) showed that this feeling of water down the throat, even without relief of dehydration, caused improvement in athletic performance. In other words, you can trick your brain into not being thirsty, and this improves performance because, usually, when you’re thirsty you’re not actually dehydrated.
Hutchinson discusses similar ideas regarding other seemingly physiological barriers: oxygen, heat, nutrition, muscle exhaustion. Barring extreme environmental conditions, such as being in the desert for weeks or at the top of Everest, you almost never hear of anyone going past what their body can handle in these regards. And with no shortage of happy masochists pushing their bodies as hard as they can, you’d think you’d hear about people pushing themselves to death if physiological limitations were remotely easy to reach.
This is all part of Hutchinson’s argument that the feeling that you “can’t go on” is, if not “all in the mind”, heavily influenced by the messages your mind is sending your body as a kind of buffer. It’s a warning sign against getting close to reaching your physiological limit. But because your brain is really good at keeping you alive, it sets this buffer really far from your actual limit. This is why when you hear yourself say, “I can’t go on”, you should often respond with, “you’re a liar”. This can be as true in the marathon of caregiving as it is in running marathons.
Now, please don’t mistake what I am saying. I am not saying don’t drink water when you’re exercising, or keep pushing when you’re physically injured or exhausted. Of more relevance, I am not saying if you feel immense caregiver stress and the onset of mental health issues, you need to push on and not seek help. In this case you should talk to someone, probably a professional counselor. I am also not saying that you should neglect taking care of your physical health day to day. If you haven’t been eating and exercising properly, you need to start doing that. But if you are doing the basics to take care of yourself and you are still feeling like you can’t continue to be a supportive caregiver, there are few things you can do to “trick your mind” and get back to being the best support you can be.
- Smile more – This may sound trite but studies show you can smile to trick yourself into having more energy and happiness. So do it even if you don’t feel like it!
- Hang out with people who smile a lot – Smiling and laughing are contagious.
- Take nature walks – The vitality of nature can give us a boost of energy.
- Listen to energetic and happy music – Music has an impact on how we feel.
- Buy something fun you can use with your loved one – Combination of “retail therapy”, generosity and having something new and fun to do. Suggestions: board game, movie, puzzle, flowers to plant, a goldfish.
- Pray or meditate – Getting in touch with your spiritual side is one of the best things you can do to take on whatever comes.
- Time out from “sick talk” – Have an hour or two each day where you can’t talk about the illness or anything related to it. It’s the focus of almost everything you do so it’s nice to have a break and be forced to do or talk about other things.
There you have it. It’s not ever easy to be a caregiver. And you can’t do it without proper help, and proper self-care. But when you just need a boost, sometimes a little mental trickery is in order so you can finish the race you have run so well for so long.
References
Figaro, M Kathleen & Mack, Gary. (1997). Regulation of fluid intake in dehydrated humans: Role of oropharyngeal stimulation. The American journal of physiology. 272. R1740-6. 10.1152/ajpregu.1997.272.6.R1740.
Arnaoutis G1, Kavouras SA, Christaki I, Sidossis LS. Med Sci Sports Exerc. 2012 Jan;44(1):175-9. doi: 10.1249/MSS.0b013e3182285776.
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