My Talk at #BaldisHappy on Caregiver Health & wellness

On 10th Feb 2019, I had the opportunity to speak at probably one of the largest events of its kind that India has ever seen, supporting the well being of cancer patients and the topic of Body Positivity.

Although I’ve refrained from talking about this before, 2018 was a rough year for my family and me. We had a few serious medical emergencies that could have easily gone very badly had it not been for the people supporting us and the serendipity that guided us through that difficult time.

And yet the cold, hard reality for some people is that they live with life threatening, debilitating diseases on a daily basis!

Cancer just doesn’t affect us physically, it also brings with it a tremendous amount of stress to not just the patient, but also to their families – especially the immediate caregivers!

Being a caregiver, taking care of our OWN well-being isn’t thought to be a priority.

But then, everything we know about the human body and its relationship with stress tells us otherwise!

It’s only when we take good care of ourselves can we actually give our best to others!

Table of Contents

High Stress leads to poor Self care

Why you should prioritize self care in long term, high stress situations

The Relationship between stress, disease and quality of life

Step 1 to prioritizing wellness – Gaining Awareness

Step 2 – The easiest way to break the stress cycle – Movement

Step 3 – Reduce your standards for success

Step 4 – Drink plenty of water

Step 5 – Unprocessed foods vs processed foods.

Some practical Strategies that you can immediately implement.

High Stress leads to poor Self care.

Fitness has become this thing that is separate from our lives, a thing we do to achieve “fitness goals” like losing weight, toning up, improving cholesterol and other blood work etc.

once I have all other important things in my life in order, then I will start exercising, eating better etc.

said everyone, ever.

Unfortunately, when a high stress situation comes to the forefront, self-care and wellness become the last thing on our minds!

Physical activity is the first to go, followed by eating well, sleep and any form of stress management.

This is especially true if the stressful situation threatens the life of someone close to us, which is the sad case with cancer.

How can I think about taking care of myself at a time like this?

Any form of self-care becomes synonymous with feelings of guilt. The stress itself might prevent us from feeling like eating or sleeping or doing anything positive for ourselves.

Why you should prioritize self care in long term, high stress situations!

Imagine your well being as a seesaw.

On one side is all the stress in your life which may include:-

• emotional & psychological stress from being a caregiver, working a job, a bad relationship etc,
• Physical stress from a lack of sleep, poor nutrition, poor posture etc.
• Traumatic stress, from a traumatic life event.

Any stress activates the Sympathetic part of our Autonomic nervous system which prepares our body for Fight or Flight.

The stress may be short term or long term.

Short term is usually well managed by the body – The body’s fight or flight response evolved for short term stress. However long term stress is less well tolerated as it leaves the body in a perpetual state of low level sympathetic activity ie. the body remains in a state of Red Alert.

On the other side of the seesaw of our well being, is all the things you can do to bring our bodies back to a restful state. This includes:

• Sleep
• Stress management techniques
• Eating nutritious food
• moderate exercise and movement, etc.

Engaging in these activities activates the Parasympathetic nervous system which brings our body into the state of rest and digest, where we can rejuvenate and heal.

Now, what do you think usually happens during High stress situations?

Emotional, psychological, physical and traumatic stress puts your body into a state of fight or flight. On the other end, restful and rejuvenating activities are put on hold.

As a result, your health swings out of balance and you lose homeostasis. If this stress is chronic (long term), you remain in a sympathetic state perpetually.

This is exactly why Self-care during high stress situations should be given more importance, and not less – To manage the delicate balance between sympathetic (SNS) and parasympathetic (PNS) activity in the body!

The Relationship between stress, disease and quality of life

Too much SNS activity leads to high levels of stress hormones (cortisol and adrenaline) in the bloodstream. These hormones inhibit the functioning of the:

• digestive system
• liver metabolism / detoxification
• cellular repair
• immune system
• reproductive system

This is fine for the short term when dealing with immediate threats. But long term this leads to:

• Poor blood sugar management and insulin resistance (increasing risk of diabetes).
• Depression
• Thyroid dysfunction which reduces metabolism (leading to weight gain and associated metabolic diseases).
• Altered sex hormone activity.
• Sleep disruption and deprivation.
• Chronic low level inflammation

Even more concerning is that Poor sleep has been associated with weight gain, increased carb cravings, lower glucose tolerance, insulin resistance, and type II diabetes, lower Thyroid stimulating hormone, increased risk of heart attack, strokes, sudden cardiac arrest, diminished cognitive function and memory!

Chronic inflammation becomes a problem as it activates the immune system and releases chemicals in the body that have been linked to disease, cancer etc.

The relationship between stress, lifestyle, and nutrition is a cyclical one, where one feeds into the other.

Step 1 to prioritizing wellness – Gaining Awareness

So as we’ve come to understand, the cycle of stress is a self-perpetuating one that feeds itself.

That is – if you let it.

The very first step to prioritizing wellness isn’t an overnight life overhaul. Realistically speaking that isn’t even possible for caregivers, or even anyone under regular stress of a job, bills, and family.

The first step is to simply gain awareness of your current patterns in life.

Gaining awareness of:-

• your current stress levels
• your self-talk and internal narrative (the story you tell yourself about your life)
• Your sleep
• the food that you eat
• your activity levels
• how you act
• and how you feel as a result of how you act

This awareness can tell you a great deal about the small actions you could take to immediately reduce stress levels and improve the quality of your life.

Try this –

The next time you find yourself with 10 – 15 minutes of time (whether that’s sitting at home, or waiting somewhere), think actively about the things I mentioned above and write them down. Look for patterns and triggers. Then think of ways you can overcome these hurdles.

Step 2 – The easiest way to break the stress cycle – Movement

If you look at the self-perpetuating nature of the stress cycle, the only way to break it is through Deliberate Action.

In my experience, the easiest way to exercise deliberate Action is through movement.

Here’s what movement does:

• lowers chronic inflammation in the body.
• Supports production of neurotransmitters (such as serotonin which helps with depression)
• releases feel good chemicals called endorphins
• depending on the intensity of activity, it may positively stimulate the immune system.

The feel good effect of movement is the main reason why it can be such as effective way of hijacking the stress cycle and breaking the pattern!

Try this –

Fit in some form of physical movement throughout the week. It may be 10 minutes to 90 minutes long at a time.

The exact amount of time doesn’t matter!

What matters is making it a regular part of your schedule, like you would any other important part of your life.

Outdoor activities like a walk or jog in the park, are great. If you can take part in a group activity, the social aspect of it is likely to be beneficial too!

Step 3 – Reduce your standards for success

Especially during times of high level stress, taking time out for physical activity or eating right becomes very difficult.

Going to the gym, or maintaining a healthy diet becomes impossible. And so, many would think – if I’m not going to be able to keep it up, then why bother?

Either I’m ON my exercise program or I’m OFF it!

Either I’m ON my diet or I’m OFF it!

Right?

Well, this black and white mindset to fitness and self-care might actually be holding you back.

Instead, I’d like to suggest an alternative.

Think of fitness and good nutrition as being something you can practice at many levels. Like a staircase, each step is part of your journey. Whatever your current life situation might be, you can still practice self-care and wellness at a level that is appropriate for you!

Try this –

Finding 1 – 2 hours to go to the gym might not be practical sometimes.

Instead, try doing simple movements at home like push-ups, squats, lunges, pull-ups etc that lasts 20 – 30 minutes. If you don’t feel like doing an elaborate routine that’s half an hour long (which is likely under high levels of stress), Do whatever smallest bit of movement you can.

• If its just one push up / squat / whatever, do it.
• If its just a walk around your building, do that.
• If your going to the grocery store, walk it, instead of using public transport.

Eventually, you will realise that movement begets movement, and it just gets easier and easier to start moving and making movement an everyday part of your life.

Just like the stress cycle, wellness and self-care has a cycle of its own, and movement is the easiest way to disrupt unhealthy patterns and take a step towards a more positive and productive one.

Step 4 – Drink plenty of water

Drinking enough water seems like advice any layman could provide, and something that anybody could execute reliably.

Unfortunately, the reality is that in our fast paced, hyper stressed out world, we often forget to hydrate ourselves properly. For example, one report by CBS said that up to 75% of Americans are chronically dehydrated. I haven’t been able to find reliable statistics on Indian populations, but I would venture to guess that it’s probably similar.

Dehydration has many negative effects on the body and mind –

• It disrupts our cognitive processes, reducing our ability to concentrate, be alert and our short term memory. This makes sense since the brain is about 75% water.

• Disrupts gut health and may cause constipation.

• Impairs kidney function

• Decreases blood volume, and therefore increases the load on the heart to pump more blood.

• Increases the risk of diseases such as kidney stones, high blood sugar in diabetics, exercise related asthma, heart disease, urinary tract infections etc.

The good thing about chronic mild dehydration is it’s one of the easiest things to reverse, with almost immediate, noticeable benefits. W

Try this -

Most people need about 3 Litres of water every day. We receive 1 litre on average from food, which means we should aim to drink at least 2 litres of water every day. That’s 8 – 10 glasses of water.

Water requirements go up in hot or drier climates, like in India, so you may need to add another 2 – 3 glasses of water.

Remember that if you’re feeling thirsty, you’re already dehydrated. Try to have drinks regularly, instead of waiting till you feel thirsty.

Step 5 – Unprocessed foods vs processed foods.

Generally speaking, the more processed a food is, the lower it’s nutrient quality is likely to be and the higher the chances of it containing additives and other chemicals are.

Unprocessed or minimally processed foods like fresh vegetables, meats, dairy, eggs, fish, lentils, pulses, seeds and nuts are generally higher in nutrients, and especially in folates, antioxidants, zoochemicals, phytochemicals, Omega 3 fatty acids that are linked to better mental health.

Therefore eating processed foods runs the risk of developing nutritional deficiencies. Some common ones include:

• Protein deficiency (which is more common in vegetarian populations)
• Vitamin deficiencies
• Mineral deficiencies
• Poor Omega 6 fatty acid to Omega 3 fatty acid ratio, which leads to increased chronic inflammation.
• Less phytochemicals, zoochemicals and antioxidants.

One study said eating a lot of nutrient sparse foods could increase chances of becoming depressed by 60%.

Nutrient deficiencies can mimic the symptoms of various health problems. Therefore, by simply eating more unprocessed foods which are high in nutrients, we can immediately get rid of a lot of these symptoms.

Try this –

Go for unprocessed, home cooked, food whenever possible.

Cooking balanced meals at home may not always be an option though. So, when grabbing food on the go try as far as possible to pick unprocessed foods.

For example: A homemade cookie is usually better than a prepackaged one. A prepackaged cookie made by a local baker with locally sourced ingredients and a smaller shelf life, is usually better than a mass produced cookie with a long shelf life, etc.

Some practical Strategies that you can immediately implement.

In this section, I’m going to give you some practical, simple ‘DO THIS’ type strategies, that can really go a long way to helping you manage your health and wellness during times of stress:

#1 Minimum sustainable dose AKA the “Just one” tactic to movement

This is specifically for people who have a harder time motivating themselves into doing regular physical activity.

Make a commitment to yourself that you will regularly engage in a physical activity. Make sure the commitment is small one – Small enough for you to be able to sustain over long periods of stress. Even if its:

• Just one push up
• Just one squat
• Just one pull up, etc.

That’s all you’re looking for!

As long as you make a commitment to do it and follow through every day. Don’t be afraid to adjust your physical activity level down (or up) if you need to fit it into a particularly stressful day.

As long as you sustain it, you can feel accomplished about the fact that you did it.

No matter, how bad things get, this tactic will allow you to create a habit of incorporating some form of movement into your daily life.

#2 Breathing exercises & Meditation

We talked about sympathetic vs parasympathetic nervous system activity earlier. Meditation is a great way to stimulate the parasympathetic nervous system, bringing your body into the rest and digest state, that is vital to managing stress.

Any form of meditation can help, but a simple one that anyone can do at any time is focusing on the breath.

Simply focus on the feeling of your breath as it enters and exits your body. Really zone into the physiological feeling, of your chest and abdomen expanding, how the insides of your nostrils cool as the breath enter them, and how the chest collapses as the breath exits.

You can even try counting 1 – 10 with each breath if you prefer.

Inevitably, worrisome thoughts will enter your mind.

This is normal and expected.

To complete the meditation practice, simply bring your attention back to your breath.

And that’s it! Congratulations, now you know how meditation works. There is nothing magical or esoteric about it. It is simply the practice of directing your attention where you choose to, instead of where you’re compelled to.

You could do this for 2 minutes, 5 minutes, 10 minutes or even 20 minutes at a time, however often in the day as you like.

#3 Super Shakes

Super shakes sound like something an extreme fitness enthusiast or a bodybuilder would do, but they’re a great way for anyone to consume nutrient rich foods when they’re short on time to create an elaborate meal.

Here’s a template for making a Super shake:

• A base liquid – Water, milk, almond milk, soy milk, plain yogurt or iced green tea.
• 1 – 2 portions of fruit – Apples, bananas, strawberry, pineapple, mango etc.
• 1 – 2 handful of a dark green leafy vegetable like spinach or kale.
• 1 – 2 Tbsp of Nut butter – peanut butter, almond butter etc.

Optional:

• 1 scoop of protein powder
• You can also add a Tbsp of honey if you prefer a sweeter taste.

Supershakes are basically liquid meals that take less than 10 minutes to prepare and consume. They were a regular part of my daily routine when my mother was in the hospital.

#4 Nuts & Seeds

Nuts and seeds like almonds, pistas, walnuts, sunflower seeds, pumpkin seeds, cashews are high in protein, mono & polyunsaturated fatty acids (the good fats), fibre, minerals and vitamins. They’re a nutrient powerhouse, and also very satiating.

Carrying a small bag with you (a ziplock bag that you can stuff in your pocket or purse, will do), is always a good decision. Instead of buying processed junk or eating from questionable food stalls, you now have some nutrient rich, unprocessed food that you can eat, till you have the opportunity for a proper meal.

Unsalted nuts are better than the salted ones, especially if you have trouble consuming large amounts of water (to balance out the salt), or if you have high blood pressure issues.

#5 Supplementation

Although I’am not a big fan of supplementation (mainly because the research says nutrients from supplements may not be absorbed in the bodies as well as those from real foods), if there ever is a time to consider them, its when life is tough and time is a precious commodity.

This is when careful supplementation can help us meet our minimum nutritional requirements.

Some important ones to consider are:

• Omega 3 fatty acids, found in Fish oil and algae oil.
• Vitamin D3
• Vitamin C
• Protein Powder
• Probiotics
• Fiber supplement

Remember to do your homework on the brand and the quality of the supplement. A poor form of a vitamin, or insufficient amounts of it are difficult for the body to absorb.

In Conclusion

Dealing with stressful situations is always going to be a challenge. However taking care of your own well-being, doesn’t have to be.

Do you any questions on managing stress and wellness? Any particular situation that you are facing that’s left you stumped? Feel free to leave a comment below and I will get back to you.

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