Taking Care of Yourself While Caring for Others

How Can I Stay Emotionally and Physically Healthy?

A traumatic brain injury (TBI) can lead to changes in a person. As you, the caregiver, come to terms with these changes with your family member, you may move through a series of emotional stages. In the first couple of months, for example, you may feel happy your loved one is alive and hopeful that he or she will recover fully and quickly. You might think a full recovery would happen faster, if only he or she would work harder at it. You might feel discouraged and depressed, or even feel guilty.

Knowing what other families go through as they adjust to life after TBI can help you realize that your feelings are normal; however, it can be harmful if you focus all your attention on your service member/veteran.

If you are feeling discouraged or worn out, here is what you can do:

• Find a friend or family member to talk to about your feelings or join a support group with other families affected by TBI. Talking with someone can relieve stress and reduce anxiety because you will learn that you are not alone
• If your stress, sadness or anxiety begins to feel out of control, seek professional help from a counselor, therapist, religious/spiritual leader or social worker
• Consider counseling for military/veteran family members affected by TBI

Stress

Stress is the mental and physical reaction to events that upset our balance in life. Chronic stress that doesn’t go away can lead to serious health problems over time.

Symptoms of Stress

• Headaches
• Neck and shoulders tighten
• Fatigue
• Trouble sleeping
• Weight change
• Stomach upsets
• Increased use of alcohol, drugs, tobacco
• Fear and worry
• Mood swings
• Crying spells
• Irritability
• Depression
• Forgetfulness
• Poor concentration
• Low productivity
• Negative attitude
• Confusion
• Weariness
• Boredom
• Feelings of isolation
• High blood pressure

How to Cope with Stress

• Practice deep breathing and other relaxation methods
• Exercise
• Improve time management
• Meditate
• Accept help from friends and family
• Keep a sense of humor
• Keep up personal activities that are important to you
• Reward yourself
• Stay in touch with friends
• Set limits
• Join a support group
• Contact a therapist
• Read a book
• Listen to music that lightens your mood
• Seek counsel from a chaplain or provider

Anxiety

Anxiety is excessive worry about life. It is a reaction to stress and can lead to depression.

Symptoms of Anxiety

• Ongoing worry and tension
• Viewing problems as overwhelming
• Restlessness or a feeling of being “edgy”
• Bad temper
• Muscle tension
• Headaches
• Sweating
• Difficulty concentrating
• Nausea
• Needing to go to the bathroom often
• Being tired
• Trouble falling or staying asleep
• Trembling
• Being easily startled

How to Cope with Anxiety

• Talk to a friend or family member
• Exercise
• Eat a balanced diet
• Avoid caffeine
• Write in your journal
• Counseling and/or medications can treat anxiety
• Seek counsel from a chaplain or provider
• If symptoms persist, seek professional help

Sadness and Depression

Sadness and grieving are normal responses to the loss of life as you once knew it. Sadness and grieving can lead to depression.

Symptoms of depression are a combination of symptoms that interfere with a person’s ability to work, sleep, study, eat and enjoy once pleasurable activities.

Major depression is disabling and prevents a person from living normally.

Symptoms of Sadness and Depression

• Feeling blue
• Withdrawing
• Irritability
• Constant sad, anxious, or “empty” feelings
• Feelings of hopelessness
• Feelings of guilt, worthlessness and/or helplessness
• Bad temper, restlessness
• Loss of interest in activities, hobbies or sex
• Tiredness and decreased energy
• Trouble concentrating
• Trouble remembering details and making decisions
• Inability to sleep, early–morning wakefulness or too much sleeping
• Overeating or appetite loss
• Suicidal thoughts
• Suicide attempts
• Constant aches or pains, headaches, cramps or stomach problems that do not ease, even with treatment

How to Cope with Sadness and Depression

• Talk over your feelings with others, e.g., in a support group
• Keep a journal to explore your feelings.
• Give yourself a break by asking for help in caregiving
• Try to rest your body and your mind with yoga and meditation
• Find someone who can listen without giving advice or making comments
• Focus on positive relationships in your life — family, friends and pets
• Seek counsel from a chaplain or provider
• If symptoms persist, seek professional help. Counseling and/or medications have proven effective in treating depression
• Seek counseling immediately from medical care staff if you have thoughts of suicide
• If you are thinking of suicide, call the National Suicide Prevention Lifeline at 1-800-273-8255(TALK)

How Can I Take Care of Myself?

Healthy behaviors can keep you well and help you cope with the stress of life while you care for a loved one with a TBI. This section contains some healthy lifestyle tips. The more you take care of yourself, the better you will feel.

Stress Busters

• Practice deep breathing. Take a deep breath, hold it for a few seconds, and then let it out. Continue to breathe deeply until you feel yourself calm down.
• Relax your muscles. Lying down, begin by tensing your toes, then relaxing them. Then tense your ankles and relax. Continue up your body to your forehead, tensing and relaxing each set of muscles. Then lie quietly for a few minutes, letting your body melt into the floor.
• Try meditation. Select a quiet spot in the house and a time when you can be quiet for 15 minutes. Sit down and rest your hands in your lap. Close your eyes. Clear your mind. Breathe in deeply, then let your breath out while you say a word such as “one.” Repeat continuously. Try to clear all thoughts from your mind as you do this. It takes practice.
• Manage your time effectively. Plan ahead so that you arrive on time. Plan your day or week sensibly, so that you are not trying to do too much in too little time.

Exercise

Exercise can relieve stress, reduce depression, make you feel better about yourself and help you maintain your weight and strength.

Try these tips to begin an exercise routine.

• Make your plan fit your life. It doesn’t have to be strenuous; even brief exercise reduces stress. A 30-minute walk on most days is usually enough. You can break the 30 minutes into shorter 10-minute segments, if that’s all the time you have.
• Be consistent. Doing weights once a month or stretching once a week won’t make much of a difference. Whatever your workout, make sure you do it at least two to three times a week.
• Use the buddy system. Find a friend or relative whom you like and trust, and exercise together. Use this as an opportunity to enjoy one another’s company and as an outlet to deal with stress.

Nurtition

The food you eat can have an impact on your overall health, energy levels and ability to deal with stressful situations in an effective way. Follow these healthy eating tips:

• Eat a variety of nutrient-rich foods. A healthy diet is one that is low in fat; high in fiber from whole grains, fruits, and vegetables; and includes lean cuts of meat, poultry, eggs and other protein sources.
• Drink plenty of water. The intake of water is essential to the reduction of toxins within our bodies and protects the body from infection.
• Eat moderate portions. Try to eat six small meals a day, or three regular meals and two snacks.
• Eat regular meals. Skipping meals can lead to out-of-control hunger, stress and a weakened immune system.
• Eat healthy snacks. Snacking between meals can help curb hunger, so choose healthy options such as raw carrots or a piece of fruit.

Sleep

If you don’t get enough sleep, you are likely to be tired and irritable during the day. You also may find it hard to concentrate. Most adults need seven to eight hours of sleep per night.

Try these tips for getting a comfortable night’s sleep:

• Establish a routine for when you go to bed and when you get up every day. This can reinforce your body’s sleep-wake cycle.
• Establish a relaxing bedtime routine. Take a bath, read a book, or find another activity that helps you shift from your busy daytime life to restful sleep.
• Go to bed when you’re tired and turn out the lights. If you can’t fall asleep within 15 to 20 minutes, go to another room. Keep the lights dim and do something relaxing, but avoid using the TV, computer or phone.
• Do not rely on sleeping pills. Check with your doctor before taking any sleep medications, as they can interact with other medications or a medical condition. You may have an underlying sleep disorder that requires treatment.
• Don’t exercise within three hours of bedtime. It may make it harder to fall asleep.
• Avoid caffeine-containing foods or drinks — such as chocolate, energy drinks and soda — at least 6 hours before bedtime.
• Avoid alcohol, nicotine, heavy meals and drinking a lot of liquids close to bedtime.

If You Have Sleep Problems...

Create a sleep diary to keep track of any issues you are having and any medications you are taking. Make note of the types of sleep problems you are having, including inability to fall or stay asleep, or excessive sleepiness during the daytime. If problems continue, discuss the sleep diary with your doctor. There may be an underlying cause, and you will want to be properly diagnosed.

Tobacco Use

If you don’t use tobacco products, don’t start. Find other ways to cope with stress.

If you do use tobacco products, stress may increase your use. It may be difficult to quit, especially when you are learning to care for someone with TBI.

Your goal right now may be to not increase the number of tobacco products you use each day. Later, you may want to start cutting down on the number of tobacco products and then quit altogether.

The nicotine in tobacco is addictive. Most smokers find it takes several attempts to quit before they are successful.

Ask your doctor about medications or programs that can help you quit.

Alcohol and Other Drugs

When life is stressful, some people turn to alcohol or other drugs to help them relax, which tends to make problems worse.

Using alcohol or drugs to make you feel better in the short term can be dangerous. You can become dependent on these substances. This will interfere with your responsibilities to your family.

If you drink, do so in moderation. Find other ways to relieve stress and reward yourself.

Routine Medical Care

Getting routine medical and dental care, such as preventive screenings (mammograms, blood pressure checks), helps keep you strong and healthy.

It’s okay to have your family member with TBI sit in the waiting room while you see the doctor, dentist, or other provider if he or she is able. Otherwise, make plans for someone to care for him or her while you are at your appointment.

If you become sick, worn down or burned out, you will not be able to provide good care to your family member.

The more you take care of yourself, the better you’ll feel.