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Managing Your Worrying, And Why This Might be a Worthy Goal


By , Staff Writer, Nevus Outreach

Health psychologist Elissa Epel, PhD.

Health psychologist Elissa Epel, PhD, is an associate professor at the University of California in San Francisco.

In December 2004, a landmark research study was published in the Proceedings of the National Academies of Sciences that linked psychological stress to premature aging for the very first time. Specifically, health psychologist Elissa Epel, PhD, and her colleagues, made the stunning discovery that the telomeres in the cells of chronically high stressed women were about 13 years older, on average, than the telomeres of low stress women.

According to Epel, associate professor, Department of Psychiatry, University of California, San Francisco, this study compared 39 healthy moms raising a chronically ill child with 19 healthy moms raising a healthy child.

“Importantly, this study found that prolonged stress affected moms by damaging their DNA — the most fragile part called the telomere at the tip of the chromosome,” says Epel. “Like caps on the tip of shoelaces, the telomere promotes genetic stability. They also determine the health and lifespan of a cell.”

Epel says that each time a cell divides, telomeres shorten. But an enzyme called telomerase typically plays a role in normal cell function by replenishing the telomeres. Life stress, the perception of life stress, and lifestyle behaviors, however, lower telomerase activity in the cell. Telomeric DNA dwindles away and cells soon die — along with whatever tissues those cells may form. The findings from these studies offer insight, at the cellular level, as to why stress is a risk factor for cell aging and, ultimately, for disease.

Reflections — not ruminations

One of the key findings of this 2004 study, Epel says, is that not all caregivers of chronically ill children had shortened telomeres, because these moms had learned to manage their stress and worry.

What Epel calls thought stress, in fact, is the most common form of chronic stress, she says, because worry is about being stuck thinking about something. We might be reliving events that have already happened (rumination). Or we might be worrying about things that only may happen — and may never happen (worry). Regardless, our thoughts can keep stress alive in our bodies.

“The fact is that being a mom of a child with special needs or health issues means you are going to worry, because there’s simply more to worry about,” says Epel. “So, I think, the first step in managing stress is to accept that you are going to have more worry in your life than the typical mom. There is a level of acceptance about your child’s condition that is helpful and even necessary, in order to feel any sense of peace.

“Wishing that your child did not have this condition, or comparing your child to a healthy child, is the kind of thought that tortures moms and makes our bodies respond in a really stressful way. In fact, a recently published study found that one of the biggest predictors of daily unhappiness was mind wandering and wishing you were somewhere else,” Epel says.

But there are aspects of worry — called reflections — that can be constructive. Reflections describe thoughts we can put into the category of planning, such as what to do next in situations A, B, and C.

Exercise as a buffer

Epel and her post-doctoral student Eli Puterman, PhD, have also published research that shows that exercise is an excellent buffer to high stress. In a study that looked at the effects of stress on women giving care to their husbands with dementia, Epel found that the relationship between chronic stress and shorter telomeres existed only in sedentary women.

“Caregivers who exercised and were under high stress, did not have significantly shortened telomeres,” says Epel.

Focus on short-term goals

“Another thing we have learned from other caregiver studies is that simply changing your goals helps you to cope in the short run. In other words, if you are going to be spending the next year dealing with surgery and recuperative care, temporarily giving up your long-term goals is very adaptive. You don’t have to do everything at once. Tell yourself: ‘This is only a stage that I will get through.’”

Support groups and other strategies

Slow mindful breathing, with longer exhalation than inhalation, is a key to immediately damping down stress arousal, too, says Epel. And yoga helps in the long term, because it changes the balance of the neurosystem toward a more peaceful restorative mode. But one of the most important stress-easing things for moms to do is to join a support group and chat online, or by phone, with this group of people with whom you have a lot in common.

Getting fully absorbed in an enjoyable activity is wonderful for the brain and body and another strategy for easing stress. Such activities are a necessary break from the daily rush of the “to do list.” This activity could be anything you may enjoy, such as knitting, or cooking, or walking — as long as your mind is with your body, paying attention to the activity at hand.

Dads bear a heavy burden of stress too, Epel says. More often, moms do more caregiving, while dads work hard earning extra money, because of all the medical issues. But sometimes the burden of care is equally shared and sometimes the dad is the primary caregiver. Regardless, having ongoing medical issues in a family puts an extra strain on the parents' relationship with one another. Couples need respite from dealing with their child's health. They need to make time for dates, so they can return to what brought them together in the first place.

“Maybe the most important message for caregivers under chronic stress is to look into mindfulness training. Mindfulness-based stress reduction teaches skills about responding constructively — rather than reacting hotly — to the many different triggers and stressful events throughout the day. Religious faith, prayer, and community help caregivers cope, too. Having religious faith appears to be protective. You can’t force it, but if you have it, you are lucky.”

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