The Whitworths of Arizona, bringing science to you in everyday language.

Thursday, January 31, 2013

The Stress Process

We have blogged about stress before and shared ideas for reducing it. But today, our blog is about how stress happens, with the hope that knowing this process, and the special issues that you and your loved one face, will give you a head start with stress management.

Excessive stress isn’t good for anyone. It is internalized into problems like anxiety, high blood pressure and headaches. Over time, stress greatly increases the risk for most illnesses—heart problems, diabetes, cancer, and much more. The more intense the stress and/or the longer lasting it is, the greater the risk. For Persons with Lewy Body Disorders (PwLBD)* stress is even worse. Without the resources that a healthy person has, they become stressed much easier and quicker.

Reducing stress is one of the most important things you can do for your loved one: more important than drugs, as important as getting enough sleep and fluids, as important as exercise.  Of course, they aren’t necessarily separate entities—all of the above, especially exercise, can also reduce stress.

The healthy body’s normal response to a threat or challenge is to direct the autonomic nervous system (ANS) to prepare for fight or flight:

Perceptual abilities increase so that you can sense what’s happening and respond quickly.

The heart rate (pulse) and breathing speed up, and blood pressure increases, sending more oxygen-carrying blood to the large muscles.

Large muscle tone increases. You can now hit harder, lift higher, or run faster.

The PwLBD can easily misinterpret an event as a threat and even though they may usually be fairly weak, they now they have additional strength to “protect” themselves. That’s what happened when Janie got hit in our Jan 4th blog. That kind of response can happen when the body has the resources to respond. But often, Lewy has compromised the ANS so that the demand for increased performance quickly becomes greater than the body‘s ability to respond, and the stress is internalized—turned into illnesses, and with LBD, increased symptoms. There will be more hallucinations, more delusions, etc.—and even more stress.

 The ANS also decreases resources for  thinking and the immune system, which are less involved with fighting and fleeing:

Thinking. Taking time to think could get the caveman killed by the attacking saber toothed tiger. He had to rely on learned responses. We still do today; our ability to think creatively or see associations during stress is impaired. First response people practice, practice, practice so that they can respond to a crisis without thinking about it. You can see why a PwLBD, whose thinking is already impaired and who already acts from impulse rather than reason, functions poorly during stress.

The immune system. Immunity is a long term process and the body can safely shut it down for short periods so as to have more energy to fight more immediate battles. LBD tends to increase the frequency of infections already. This puts your loved one at even more risk.

All of this makes it imperative for everyone involved, from the PwLBD to caregiver to family to medical community, to maintain a healthy life style and reduce external stress. The earlier you start this process, the better. It can make a huge difference in the progress of the disorder. When external stress is lower, internal stress will decrease as well.

For ways to prevent or reduce stress, see many of our other blogs and our book, A Caregiver’s Guide to Lewy Body Dementia. We also recommend Treasures in the Darkness by Pat Snyder and Living with Lewy Body Dementia by Judy Towne Jennings. You can buy all of these books through the LBD Book Corner on our website. And of course the internet abounds with good articles for basic stress reduction. A couple are 33 Ways to Reduce and Prevent Stress and 50 Ways to Reduce Stress.

*PwLBD: Person/s with Lewy Body Disorders
 PwLB: Person/s with Lewy Bodies: People with LBD, Parkinson’s MCI-LB, or even RBD (Active Dreams).

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