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Dealing with the Stress of the Middle-Aged Sandwich


With your children becoming teenagers, you might be looking forward to the time when there are less demands for your time and finances. The reality is that for about half of adults age 40 to 59 that still have children at home, they will take on the extra demands of physically and financially caring for an elderly parent or relative. If this scenario seems likely for you, read on for helpful hints on taking care of yourself, and your aging parent(s), during these stressful years.

Most people are more than happy to help their parents and wouldn’t think twice about it. As a matter of fact, Social Trends statistics from January 2013 indicate that 48% of adults age 40 to 59, say they will likely care for an aging parent at some point and 13% already have. Of those same adults, 75% feel it is their responsibility to financially assist an aging parent if needed.  Among all adults, 30% have also given some financial assistance to a grown child in the past year.

Middle-aged adults, especially women,  seem to be more burdened from both ends – dependent grown children and dependent aging parents. These adults are truly the sandwich generation. These same statistics also indicate that 31% of the sandwich generation is overall very happy. However, 31% also feel very rushed or stressed. Today’s fast-paced society can make us feel stressed with, or without the sandwich effect! So what are the effects of the middle-aged sandwich on the caregiver?

A true life example of stress effects on the sandwich generation

I became part of the sandwich generation at the age 30 when my mom had breast cancer some twenty years ago. She developed metastatic cancer of the lungs and bone when she was 57. At that time, I was a single parent, working and going to school to finish my degree. As her health declined and she needed 24 hour care, I gladly traveled to my parent’s home 40 miles away every weekend to help my dad and sister care for her.

The grief of watching her decline and knowing our time with her was near the end was stressful enough. But until you are in that situation, you don’t realize what things must be dealt with, questions to ask and how stressful they are; and how much disagreement there can be among family members. These are just a few of the questions we were faced with:

  • How do you find someone to care for her during the day when everyone is working?
  • How will 24 hour care be paid for?
  • Where do you find medical equipment like a hospital bed, lift chair, shower chair, etc.
  • What did insurance authorize, what did it pay and what is the patient balance?
  • Should she continue treatments?
  • Should she be hospitalized during her last days when it became so difficult to watch her in pain, even though she didn’t want to?
  • Why aren’t other family members helping more?
  • Who is going to make funeral arrangements?
  • How will dad function after she is gone?

Finding resources and the answers to these questions wasn’t necessarily difficult, but it took time. Time was a precious commodity and things to be dealt with seemed never-ending. I knew at the time, I (and everyone else in our family) was under stress but I had no idea the long arm that stress had with such lasting effects. The constant pull of too much to do and not enough time to do it in caught up with me, and my adrenals. I became very short-tempered and certainly not a fun person to be around.

When my mom eventually passed, and we sort of went back to a more “normal” routine, my disposition did not go back to normal. I caught frequent colds and lacked energy. I found it difficult to not think about what things I might have done differently when my mom was still alive. How much more time I could have spent with her, etc. Like many, I made my stressful situation worse.

Years passed and things got better but I believe my adrenal health was never fully restored. Even to this day, after years of eating better and supplementing for adrenal support, there are times when I am much quicker to anger than in my younger years.

Most physicians don’t believe in adrenal fatigue – instead they treat the conditions complicated by adrenal fatigue -depression, fatigue, irritability, insomnia, hypoglycemia, etc. Granted, these conditions may have other root causes. However, Dr. Jacob Teitelbaum, MD and Dr. James Wilson, MD feel that as the adrenal glands are our master regulators of stress, chronic abuse must take a toll on them, just as it does on other parts of the body.

How do you deal with long-term and chronic stress effects on the body?

Part of the answer lies in an attitude adjustment. The title of the book, Don’t Sweat the Small Stuff sounds flippant but it really isn’t. The book offers ideas and inspiration to help put things in perspective and to live in the present moment. The idea of choosing your battles wisely makes you realize you can’t battle or take on everything – choose what you can influence, not what you can’t.

Dr. Teitelbaum suggests when you feel your anxiousness rising in a situation, ask yourself, “Am I in immediate danger?” If the answer is no, remove yourself from the situation that is causing the  anxiety (if possible). For example if the news is airing something disturbing, turn the channel.  Make a conscious effort to try and not get stressed about things that are beyond your control. Believe it or not, your diet can make things better or make it worse! Yes, proper nutrition is the number one key to disease prevention. Here are the basic dietary interventions.

  1. Eliminate sugar and refined carbohydrates. Sugar and refined carbs promote hypoglycemia and unstable blood sugar which is aggravated by adrenal stress. If you need a little energy boost, treat yourself to a small amount of dark chocolate. The mood-boosting power and antioxidants of dark chocolate make it a better choice. Since it does contain caffeine, use in limited amounts.
  2. Eliminate coffee, colas, and caffeinated teas. About 2 cups of caffeinated coffee may cause a noticeable rise in blood sugar levels in someone with diabetes or hypoglycemic issues, according to Mayo Clinic. Unstable blood sugar contributes to anxiety.
  3. Eliminate alcohol – alcohol contributes to unstable blood sugar and insulin. Alcohol also helps deplete many nutrients that are needed by the nervous system.
  4. Eat plenty of vegetables and fruits to help promote a healthy pH balance. An acidic environment promotes stress and vice versa.
  5. Avoid stress-eating. We usually want comfort foods when stressed. Comfort foods tend to be high in fat, carbohydrates and or sugar – all dangerous in large quantities. Instead, choose a protein with some healthy fats for feelings of fullness and reduced cravings.

Even with a really good diet, constant stress will still take a toll. Constant stress depletes certain nutrients faster – to the point that even perfect food choices will still not replenish those nutrients. Nutrients depleted faster during stress include the B Vitamins B5 and B6, Vitamin C, Magnesium and Zinc. These nutrients play an important role in adrenal health too which is why they are part of the primary supplement recommendations.

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Primary Supplements during times of Stress

  • B-Complex – A B-Complex will supply B5 (pantothenic acid) and B6 and the other B vitamins which are important in nearly every bodily function. The thing to remember is that since B vitamins are water-soluble, they don’t stay in your system very long. This is true whether they are present in food or taken in supplement form. So taking a B-Complex once in the morning is better than nothing, but may not be enough.
  • Vitamin C – Vitamin C is also water-soluble meaning that it is excreted from the body and regular intervals so overdosing is nearly impossible. The current recommended daily allowance of  90 mg is woefully inadequate, in my opinion. The adrenal glands contain a higher amount of Vitamin C than any other organ in the body and at times of stress, release the vitamin and adrenal hormones into the blood. 1000 to 1500 mg in divided doses, is suggested at times of stress.
  • Magnesium is one of the most common mineral deficiencies, especially in the U.S. Magnesium is needed for nerve impulses and muscle contractions. A deficiency in magnesium may affect central nervous system activity. Supplementation of 400 to 500 mg is suggested for adrenal support.
  • Zinc is another common mineral deficiency though not usually severe. 15-30 mg daily will support adrenal health as well as the immune system. It is possible to take too much zinc so only supplement when necessary. A good bone health supplement will contain 10-15 mg of zinc to support bone health and that is probably sufficient for most people. The exceptions will be vegetarians, alcoholics, and those with gastrointestinal issues such as Crohn’s disease.
  • Ashwagandha is an adaptogenic herb used in Ayurvedic medicine for anti-stress activity. Try doses of 500 mg, three times daily for stress support. Ashwagandha may also mimic activity similar to the relaxing neurotransmitter GABA.
  • Eleuthero Root, also known as Siberian Ginseng, is another adaptogenic herb which helps to modulate stress and improve performance. A daily dose of 200 mg of Siberian Ginseng (standardized to .5% eleutherosides) could be used as a tonic during times of fatigue.

The supplements listed above would be considered generally helpful for anyone involved in a chronic stress situation in my book. There are certainly combination adrenal formulas that include many of the above nutrients too that may be an easier option. Rather than trying to get several different things, choose a formula that has many of the above ingredients. You can probably get by with just a couple things – simpler is better when you’re stressed.

In addition to these, there are several other supplements that can be supportive in a chronic stress situation like the middle-aged sandwich. Some of those include licorice root extract, phosphorylated serine,  rhodiola, cordyceps, holy basil, chamomile, skullcap, passion flower, hops and valerian. Another consideration for those experiencing panic attacks is inositol.

Know that you are not alone

With the increasing incidence of Alzheimer’s alone,  I bet you can name at least two or three friends or acquaintances that are somehow caring for an aging parent. As the statistics above indicate, about 50% of middle-aged adults will end up in a physically and/or financially caring role for a parent or elderly relative. Unfortunately, it will most likely be at the same time they are also caring for their own children.

The most important thing you can do is take care of yourself during this time. If you don’t and you become ill, the situation will only be worse and add undue stress. The internet and widespread computer access now make finding more resources available to assist with elderly care. One such resource is the Eldercare Locator for help in finding community programs and resources in your area. Best wishes go out to those in this situation. Remember, don’t sweat the small stuff!

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