Worrying about a loved one’s health could do more harm than good

Concerned, possibly? Spaceodissey

There have been many studies into how our mental health can influence our recovery from illness or trauma - and maybe even help us live longer. But the worries of family and friends could also affect how well we overcome health problems.

It is natural for us to worry when a loved one suffers a serious illness and even more natural that we should want to protect them as they recover. However, our research has found that in patients who have suffered a brain haemorrhage, that worry might not be the best way to support recovery.

Working with colleagues at the University of Liverpool and the University of Erlangen-Nürnberg in Germany, we surveyed 69 patients who had experienced a spontaneous subarachnoid haemorrhage (SAH) and a friend or family member most involved in providing informal support after illness.

A traumatic experience

This type of haemorrhage can occur without warning and is usually a result of a ruptured aneurysm (a balloon-like bulge in the wall of a blood vessel) or arteriovenous malformation (an abnormal tangle of arteries and veins), or trauma, such as a blow to the head. It causes bleeding in a region between the membranes surrounding the brain.

An SAH can increase pressure in the skull, damage or kill brain cells, and deprive the brain of oxygen, causing stroke and lack of neurological function.

It is a traumatic experience both for patients and also those close to them - over a quarter of sufferers die within two days and a third of those who survive may be left disabled.

If an aneurysm has been successfully “clipped” by a neurosurgeon, there’s only a small chance that and SAH will recur - but this can still be worrying for some.

Even though the chance of a recurrence is low, we found that over one year after suffering a haemorrhage, patients and their families and friends were still quite fearful of another bleed. What was particularly interesting was that family and friends were significantly more fearful than the patients themselves. However, both groups were also equally fearful of other illnesses such as lung cancer or heart attacks.

Physical and social restrictions

Our study, published this week in the Journal of Neurosurgery, also found that patients might not recover as well as expected if their partner or friends were overly worried that they might suffer another haemorrhage.

For example, the patients whose family and friends were most worried tended to rate their health as worse and had more limitations in their physical and social activities. This might be because family and friends were overprotective and more likely to restrict activities - even inadvertently.

We tend to look at the needs of those who suffer illness and injury but the emotions and anxieties of family and friends clearly also matter. And the earlier they are included in treatment and rehabilitation the better.

However, simple advice or reassurance that the chances of a haemorrhage happening again are low is unlikely to change how much those close to us react. One sufferer of a SAH said in a study [paywall] that they were aware of the low risk but still fearful: “I felt very very [sic] frightened about it happening again … even though I knew the facts about the chance of recurrence”.

Depends which way you look at it

What is particularly interesting is that the patients and their family and friends in our study didn’t share the same fears. The reason for this may lie in the way that they interpret what the future holds after such a traumatic event.

It’s possible that family and friends see it as a near-death experience - that their loved one “almost died”. If we understand and deal with the source of these fears then the recovery of patients might be improved.

This might also be the case in a wide variety of traumas that people suffer.

We’re currently conducting research that seems to suggest that when people interpret a near miss as an event that “almost happened”, rather than an event that was “successfully avoided”, they are more likely to interpret it negatively as a sign of future vulnerability - that they “might not be so lucky next time”.

Without carers, the life of someone who has suffered a trauma or life-changing event would undoubtedly suffer. But by finding a way to look after them and avoid catastrophic thinking, we could better support recovery.