Many of the carers I know are incredibly stoical but the last few years of Covid have really tested almost all of our resolve, including mine, and so for this blog I wanted to write about ‘stress’ particularly making you more aware of some of the horrible feelings you might be experiencing but also the many things we can do to improve your resilience and better support you with the incredible work you do for your loved one and also wider society.
Feeling ‘stressed’ can be quite a vague term and has been described as a really horrible pressure which can be hard to recognise. It is a catch all term for different symptom groups including both physical and mental elements and these can combine to impact how we behave. Some of the mental symptoms of stress include being more forgetful, worrying a lot, a feeling of being overwhelmed, trouble concentrating and finding it hard to make decisions. Physical symptoms include chest tightness and palpitations, tummy problems, feeling tense in the shoulders and neck, headaches and dizziness and sometimes sexual problems. These mental and physical symptoms can combine and affect how people come across including being more irritable and snappy, sleep disturbance, appetite changes and sometimes drinking more or smoking.
It is one thing to recognise your feelings of stress and another thing to be able to act on those feelings – reassuringly there is much we can do to support you. Whilst many of the support mechanisms to help you cope better and to ease your ‘stress’ are not medical, it is important to know that there are several things we can do at the practice including helping you recognise your ‘stress’ and also assess you for underlying depression and anxiety. Many of you will know about e-consult, a way to alert your GP about your symptoms and this has a really helpful anxiety and depression questionnaire where you can score your symptoms. The PHQ-9 scores your depression symptoms whilst the GAD-7 scores your anxiety symptoms and this is helpful giving us a ‘measure’ of how bad things are for you. Below are links to the two questionnaires:
If you do have depression or anxiety, then a powerful medical treatment that can really help are anti-depressants. These are not addictive and help people cope better with their predicament. They usually take a few weeks to kick-in and help those difficult thoughts leave your mind quicker and this helps the underlying feelings wash over you better. Most people stay on this treatment for a period of months to years whilst they make other changes to their lives with a view to coming off them as their situation improves. Hand in hand with anti-depressants I signpost my patients to ‘counselling’ and many people respond positively as it gives them the time and space to identify and explore the origins of difficult feelings and then come up with strategies to better cope with the challenges they face. The NHS provides talking therapies telephone counselling called ‘Let’s Talk’ which many of my patients have positively benefitted from and your GP can refer you. Other people decide to see a counsellor privately and again this is totally confidential and generally very effective.
There are numerous other simple non-medical things you can do to support your mental health. In the practice, we also recognise that we can ‘over medicalise’ people’s challenges and we are taking steps to address this with something called ‘social prescribing’. This is such a simple and yet amazing support where we refer you to someone within the practice who is connected to all the other community supports in your neighbourhood that can help you cope and which us clinicians may not know about. Some of my patients have had great care through this offer and our social prescribers are valued members of our wider team and help us support you so much better. Carers have reported to me other simple yet helpful supportive measures that improve their resilience and these include things like getting respite perhaps through a regular break such as going for a walk, having a coffee with friends or even a night or two away to recharge the batteries. Other really simple things include relaxation and mindfulness apps which can help people relax and better cope.
In this blog I have set out to give you insight into your difficult feelings of ‘stress’ and I came across this helpful video which might be of interest to you:
Please be kind to yourselves as it is not a sign of weakness to get the help you deserve if you are feeling stressed perhaps with symptoms of underlying depression and anxiety. You have always provided amazing love and care to your loved ones but the past 2 years of the pandemic have been so difficult of all of us, particularly for you as you (and your loved one) may have been even more socially isolated and lonely then normal. As I have set out in this blog there are many things we can do to better support you, but we need you to identify your feelings of stress and share them. I have set out some medical interventions like anti-depressants and counselling, but also other simple yet effective non-medical interventions like social prescribing, respite and mindfulness. If things are really bad, you can always speak to someone at The Samaritans on 116 123.
Finally, there is much information and support from my lovely colleagues at the Gloucestershire Carers Hub to help improve your resilience and below is a link to their many resources.
Thank you for the amazing work you do for the person you support– we are here for you.