Research reveals biology of harmful stress

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Scientists studying caregivers say the effects of chronic stress may last for years.

Taking care of a loved one can be deeply rewarding and has important benefits to society. But it can also place enormous stress on the caregiver, who is usually a woman. Scientists have recently begun to recognize some health risks associated with caregiving. Compared with non-caregivers, caregiving spouses have more depression, hypertension, infectious illness, and heart disease. They're also at greater risk for early death.

Now researchers have located an immune system pathway that links caregiver stress to serious health problems. This mechanism apparently remains active even years after the stress is gone. The new findings contribute to our understanding of how stress can make you sick and why stress reduction may be a lifesaver.

Immune system consequences
As part of a long-term study examining stress and health in older caregivers, Ohio State University scientists followed 119 women and men who care for spouses with dementia, along with a similar number of age-matched non-caregivers. The subjects gave regular blood samples and answered questions about stress, depression, and loneliness.

The findings, published in the July 2, 2003, Proceedings of the National Academy of Sciences Online, focus on interleukin-6 (IL 6), a compound that circulates in the blood and helps regulate the immune system. Excess IL-6 plays a role in muscle atrophy and several diseases of aging. It promotes the production of C-reactive protein (CRP), a risk factor for cardiovascular disease. And both IL-6 and CRP are implicated in type 2 diabetes, osteoporosis, and arthritis.

On average, the caregivers in the study had four times as much IL-6 in their blood as the non-caregivers -- an effect that continued for several years after the spouse had died. According to the researchers, this suggests that chronic stress may have a lasting impact on the immune system.

These results could have broader implications, the researchers say, if other forms of chronic stress cause similar increases in IL-6. The problem may be compounded by some of the unhealthy habits people develop in response to stress, such as smoking, overeating, sleeping too little, and not exercising. These, too, are linked to higher IL-6 levels.

What now?
Whether you're a caregiver or not, it may be time to take a fresh look at your own situation and, if necessary, commit yourself to finding some stress relief:

• If you're caring for someone with dementia, learn how to manage some of his or her difficult behaviors, such as refusing to cooperate or wandering. Your primary care provider may have some advice or can direct you to a training program.

• Get some help with caregiving. Call on friends and relatives. Investigate respite care (a substitute caregiver) so you can get a break.

• Consider psychotherapy or a support group to help you develop coping strategies and problem-solving skills.

• Take care of yourself. Eat a balanced diet, avoid fatty foods, and take a multivitamin. Get enough sleep, limit your alcohol use, and try to fit in some daily exercise.

• Try a mind-body approach to stress management. Activities such as deep breathing, meditation, visualization, yoga, and tai chi can help reduce blood pressure, heart rate, and muscle tension.

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