Caring For Our Caregivers

According to the National Alliance for Caregiving and AARP, about 34.2 million Americans have provided unpaid care to an adult age 50 or older in the last 12 months. February 21st is National Caregivers Day, and we talked to SIMEDHealth Psychologist Dr. Bernie Marrero about what caregivers can do to take care of their mental health. 


1. What defines a caregiver?

“Caregivers are spouses, partners, adult children, parents, friends, or neighbors that help someone with daily activities and/or medical tasks. Caregivers assist with any aspect of an individual’s needs,” says Dr. Marrero. “Examples include but are not limited to buying groceries, helping their loved ones bathe get dressed, taking them to doctor’s appointments, and handling finances. 


2. That sounds rewarding, so why is being a caregiver such a strain on mental health?

“Being a caregiver can require a significant amount of time, emotional, and/or physical effort. Unless more than one person is assisting with care, caregivers can be ‘on-call’ 24/7,” Dr. Marrero stated. “A lot of times, besides the person they are assisting, the caregivers are alone much of the time. It is ideal to have more than one person taking care of someone or have someone that is able to relieve the primary caregiver for periods of time, but that is not always feasible. Therefore the caregiver experience can be very isolating.”


3. What can a caregiver do to take care of their mental health?

Dr. Marrero explains that it is essential to find “a balance between the caregiver and the person they are caring for. Though it may feel selfish, the caregiver needs to take time for their needs. It is beneficial in the long run and tends to make the caregiver a better caregiver. Also, training, insight, and knowledge are powerful tools. By understanding the requirements of the person they are caring for, it can help reduce anxiety, improve effectiveness, and safety of the assistance being provided.”


4. What are the signs of caregiver stress?

  • Sadness
  • Irritability
  • Insomnia
  • Depression
  • Anxiety
  • Tension
  • Self-neglect
  • Isolation


5. What options are available to help caregivers?

“The American Association of Caregivers was started by two women and has now turned into a national organization with many different chapters for different illnesses. On their website, they have training courses and caregiver certifications. Along with helpful videos and blog posts with tips and advice for resources. 

Locally, there are associations like Elder Options that help patients and caregivers. There are caregiver training, legal assistance, health programs, and caregiver support groups. Educating yourself and talking to people that know what you’re going through can be one of the most beneficial things for your mental health.”


Click here to schedule an appointment with Dr. Marrero or one of our other SIMEDHealth Psychologists.

We Need to Talk About Stress More Often

Stress is something we all experience throughout the course of our lives, but sometimes stress can get out of control and be an all-consuming feeling. As April is Stress Awareness Month, we talked to Dr. Bernie Marrero about what exactly stress is, and what we can do to help deal with it.

What does stress do to your brain?

Stress causes a fight or flight reactions which can cause an increase in heart rate, an increase of adrenaline, and heightened senses. After the stressful event is over, there is a release of a chemical called cortisol. Cortisol is a chemical that is responsible for many things throughout the body including calming the body down after a stressful event. The problem comes in when you are too stressed too often and your body creates too much cortisol. This overabundance of cortisol can wear down the brain’s ability to function at full capacity.

What are some manifestations of sleep that people don’t realize but should?

Sleep. Dr. Marrero stresses the significance of sleep and how much stress can change your sleep. He says, “Not being able to sleep at all or well, onset insomnia, racing thoughts before sleep, fitful sleep, and maintenance insomnia earlier than usual” can all be signs that your stress is much worse than you think. Along with that with the lack of good, quality sleep can make it harder to take on the day and feel motivated. All these feelings can, in turn, lead to more stress.

Stress is often referred to as “The Silent Killer” is this true?

It can be, Dr. Marrero says. Stress can affect every aspect of your body from your cardiovascular system to your immune system. This repeated or chronic stress can manifest into certain problems that can affect your overall quality of life. If you let stress get out of control, there is a risk of it becoming that silent killer.

Can anyone ever really run away from their stress?

There is no “running away” from stress, but there is a way to determine the good stress from the bad stress which can help you control it instead of running away. Good stress or Eustress, keeps us motivated, alert, and challenged. Dr. Marrero says,” Without it, we can’t succeed at big challenges, or move towards growing personally.” The opposite is distress, which bad stress. Distress is overwhelming and we view it as something we will never be able to get over. When we have distress, we view ourselves as small and incapable. Recognizing the differences in stress can help you deal with the stress at hand.

What are some ways to cope with chronic stress?

Dr. Marrero says, is to recognize how stress affects you. What are your triggers? When those are revealed, you can start moving towards coping with it. Coping methods include different types of strategies and distractions like slow diaphragmatic breathing and taking a walk around the block.  There are also counterproductive strategies that will only make your stress work like drinking alcohol and doing drugs.

How does Dr. Marrero treat patients with anxiety or chronic stress?

He says he works with the patient to recognize what is reality and what is perception during these moments of high stress. It is important to take the irrational beliefs and try to transform them into a true perception of reality. Stress is an emotional and physical reaction, creating ways to work through that emotional reaction can help cease that physical reaction.

If you feel like you have anxiety that you can’t control, click here to schedule an appointment with Dr. Marrero today!

Understanding Post Traumatic Stress Disorder

Post-Traumatic Stress Disorder (PTSD) is becoming a household name. Although this condition is most associated with those who have served in the military, anyone can have PTSD.  This condition affects 7% of the U.S. population (roughly 300 million people). PTSD develops after experiencing a traumatic event, such as a hurricane, car accident, physical or sexual abuse, serious injury, threatened death or a near-death experience.

“This condition has tremendous attention right now because it shows up in so many ways in our society,” said Dr. Bernie Marrero of SIMEDHealth Psychology. 

 “PTSD manifests in many different ways. It can be persistent or a one-time event. It leaves a marked effect on the person’s emotional sense of wellbeing that remains persistent in their overall state and sense of security and safety,” he said.

Even though you are physically safe, you may feel that you aren’t or may experience flashbacks during a situation that reminds you of a traumatic event, Dr. Marrero said. For example, hurricane survivors may have a PTSD experience during strong winds or rain even though it is not hurricane season.

Symptoms of PTSD are different for everyone who experiences it. This includes heightened anxiety, feeling vulnerable, disassociating from your surroundings and from social life, being hypervigilant or aware of your surroundings, exaggerated startle response and substance/alcohol abuse.

“We understand PTSD a lot more now than we have in the past,” Dr. Marrero said. “We know PTSD is related to the limbic system in your brain which is responsible for producing a sensation of fear, anxiety, and distress when needed for our fight or flight response.”

When adrenaline is released during our fight or flight response, our heart rate increases, our breath shortens and we have a heightened sense of fear. Without proper treatment, these symptoms can begin to affect other areas of your health as well. PTSD can affect your cardiac health and lead to insomnia, a weakened immune system, lack of concentration, lack of memory, irritability and in some cases may affect the digestive tract. Before symptoms progress to that level, it’s important to provide support for those in need, Dr. Marrero said.

“You can be emotionally supportive just by listening. You shouldn’t feel the need to rescue them, but this person should feel they can share their feelings, fears, and concerns. This can help them to not feel so alone and threatened by their thoughts,” Dr. Marrero said.

“It’s important to gain that person’s trust and help them understand that they should receive the help they need to improve their quality of life,” he said.

So when is the right time to receive that help? Right after a traumatic event, Dr. Marrero said.

If someone with PTSD does not receive the help they need it can not only lead to worsening physical symptoms but patterns of self-medicating, turning against one’s support system and general fears that expand beyond a traumatic event.

“At SIMEDHealth, we have therapists who are aware of the needs of our community. We’re able to properly diagnose PTSD, its side effects and find the right clinical treatment plan,“ Dr. Marrero said.

Once within the SIMEDHealth network of integrated services, no matter how your PTSD manifests, you’ll get the support you need, he said.

Click here to learn more about SIMEDHealth psychology and click here to request an appointment.