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

Friday, January 10, 2014

LBD and Stress, Part 1

Stress is not necessarily bad. It keeps life interesting and fulfilling. It is only dangerous when it exerts more pressure than there are resources to deal with it. Excessive stress is a risk factor for almost all illnesses. LBD attacks the autonomic nervous system (ANS) and lowers the threshold for stress while adding the pressures of living with a progressive disorder. Therefore, stress management becomes a priority for anyone dealing with LBD—or any other degenerative disorder. It will slow the disorder’s advancement and decrease its symptoms.

In response to a threat or challenge, the autonomic nervous system (ANS) prepares 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-rich blood to the large muscles.

Large muscle tone increases. A person can hit harder, lift higher, or run faster.

A PwLBD who misinterprets an event as a threat may use their additional strength to “protect” themselves physically, striking out and even hitting the caregiver. More often, 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, digestion and the immune system, which are less involved with fighting and fleeing:

Thinking takes time that a crisis does not allow. Therefore, it is not given top priority by the ANS and one’s ability to think creatively or see associations during stress is impaired. Instead, we depend on learned responses. You can see why a PwLBD, whose thinking is already damaged and who already acts from impulse rather than reason, functions poorly during stress.

Digestion is an ongoing process that can be sacrificed during times of crisis to provide extra energy for more needed functions. That’s why a person may feel nauseous or constipated, or have diarrhea when frightened. Lewy also compromises this system, with increased results 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 the PwLBD at even more risk.

One way to manage stress is to increase its threshold—the amount of stress a body can tolerate before feeling overwhelmed. A healthy lifestyle builds up the body’s reserves and raises the stress threshold. This means getting lots of exercise, eating a healthy diet (9/5/13 blog), drinking enough water and getting plenty of sleep. This is true for caregiver and loved one alike. Staying healthy allows the body to use its resources to deal with the stress instead of the infections or other illnesses.

Controlling the body’s responses preserves one’s resources. We can choose how to respond to the events in our lives. Techniques like acupuncture, acupressure, massage or even gentle touch (6/21/13 blog) help you to respond to potential stressors with less anxiety and agitation. Deep breathing and a variety of meditation methods also use the brain’s power to send calming messages to your body.

Another way to deal with stress is to decrease the amount a person has to deal with. Controlling the environment limits stress by eliminating triggers, and decreasing pain, fear, or other discomforts. Find the triggers, change the situation, and stress-related behavior will usually stop. However, as communication becomes difficult, this is not always easy.

Recognizing behavior as communication helps caregivers to identify stressors. As verbal communication decrease and damaged thinking skills keep a person from understanding what pains them, behavior often becomes the major mode of communication.

In the next few weeks, we will discuss stress management and viewing behavior as stress related communication.

Find more about LBD in The Caregiver's Guide to Lewy Body Dementia available on in the LBD Book Corner.

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