Categories: In Brief

How stress affects seniors and how to manage it

Harvard Health Letters

We all experience a little stress from time to time. It’s not so hard to handle when we’re young. But as we age, coping with stress isn’t as easy anymore. “We tend to have less resilience to stress, and older adults often find that stress affects them differently now,” says Michelle Dossett, M.D., an internal and integrative medicine specialist at the Benson-Henry Institute for Mind Body Medicine.

Changes in response

What’s different about coping with stress when we’re older? “Our cells are aging. Heart fitness and lung capacity decline, especially if you’re sedentary,” says Dossett. That keeps us from adequately accommodating the body’s natural stress response (see “What does stress do to your body?”).

If you have a chronic disease, which is already a burden on the body, it’s even harder to bounce back physically from the toll the stress response takes.

You may also feel a difference mentally. “Normally when we’re stressed, our brains get flooded with stress hormones, the midbrain takes over, and the front of the brain — which controls concentration, attention and decision-making — works less well. Stress hormones in the brain can also contribute to short-term memory problems that are unrelated to dementia or age-related memory loss. Restorative sleep helps to flush stress hormones from the brain. However, many older adults have sleep problems. Stress may make it more difficult to fall back asleep, and the inability to clear these stress hormones from the brain during sleep means that the cognitive effects of stress can worsen over time,” says Dossett.

Changes in triggers

When you were younger, your stressors may have been a busy day at the office or a crying child. “Stressors that tend to affect seniors are the loss of a loved one; too much unstructured time on your hands; a change in relationships with children; or a loss of physical abilities, such as vision, hearing, balance, or mobility,” says Dossett.

Symptoms of stress may include tension headaches, indigestion, heart palpitations, poor concentration, sleep difficulties, anxiety, irritability, crying, or overeating. If any of these symptoms are interfering with your quality of life, Dossett suggests that you seek help.

What you should do

If you’re feeling stressed, Dossett recommends talking about your concerns with loved ones, and getting a physical check-up. “Stress may be having a physical impact on you that you’re unaware of,” says Dossett. Treatment may include addressing an underlying condition, such as high blood pressure. Eating a healthy diet and getting plenty of exercise are also important, as is nurturing yourself by pursuing activities that bring you joy, and making time to socialize.

A big part of stress management focuses on triggering the opposite of the stress response: the relaxation response, which helps lower blood pressure, heart rate, breathing rate, oxygen consumption, and stress hormones. Techniques to elicit the response include yoga, tai chi, meditation, guided imagery, and deep breathing exercises. “One breathing exercise is to inhale slowly, mentally counting 1-2-3-4, and then exhale slowly, silently counting 4-3-2-1,” says Dossett. Another treatment for stress is cognitive behavioral therapy, which helps you identify negative thinking and replace it with healthy or positive thoughts. “These are great skills, but they often don’t work right away. So you may need medications, such as antidepressants, as a bridge,” says Dossett.

When the brain senses danger or a need to fight, it sounds the alarm for action: it tells the muscles to tighten and signals the adrenal glands to release stress hormones — such as adrenaline and cortisol. Those hormones make you breathe faster, getting more oxygen to your muscles, and they trigger the release of sugar and fat into the blood, giving your cells more energy. To accommodate these needs, your heart beats faster and your blood pressure goes up. These physical changes are all part of the stress response, which is helpful if you need to jump out of the way of danger. Once the brain senses safety, body function returns to normal.

This routine isn’t harmful if it occurs once in a while. But if you put your body through those paces frequently, or even constantly, you may suffer a cascade of dangerous and sometimes lasting effects such as high blood pressure, a weakened immune system, anxiety, depression, insomnia, heartburn, indigestion, and an increased risk for heart disease.