Feature Archive

Spousal Stress

Are women burdened more when illness strikes a couple?

WebMD Feature

March 13, 2000 (Philadelphia) -- Fern Zeigler, head of a chapter of a national support group for caregiving spouses and partners, knows why the women in such support groups are stressed out. She's been there. "As a woman, I expect to be able to handle everything myself -- work, home, husband, kid," says Zeigler, who directs the King of Prussia, Penn., Well Spouse Foundation. "I find it difficult to ask for help. I think that I should be strong and not burden anyone else."

Zeigler's pattern -- asking too much of herself and not enough of others -- is hardly unusual. A recent study suggests that many women who face illness, whether their own or that of a spouse, feel a sense of overwhelming responsibility. And that?s one reason why women tend to suffer emotionally more than men when serious illness strikes.

When Women Take On Too Much

The study, published in the January 2000 issue of Social Science and Medicine, looks at the ways couples adjust during the first year after surgery for colon cancer. It found that women who have colon cancer or who care for spouses with the same ailment suffered greater emotional upset and felt less satisfaction in their marriages than men in the same situations. The study's authors -- Laurel Northouse and colleagues at the University of Michigan School of Nursing -- noted that women who took care of a partner reported even greater stress than women who were sick themselves and receiving care from a spouse.

The reason? Northouse and her co-authors suggest that though women are more comfortable disclosing their emotional distress to others, they are already stretched thin by their day-to-day activities both inside and outside of family life. When illness is added to the load, it can easily become too much. Because women are generally expected to be responsible for the care of others, the findings suggest, they also have greater difficulty seeking and accepting help from family and friends when they are thrust into the roles of either patient or caregiver.

Experts on how families adjust to illness say their observations mirror the study's findings. "Caregiving fits with female role socialization, and therefore many women take to it quite a bit more naturally than do men," says Susan McDaniel, Ph.D., of the departments of family medicine and psychiatry at the University of Rochester School of Medicine and Dentistry in Rochester, N.Y. "They are in danger of serious burnout because others step back and let them do all the work themselves, and because they tend to reject help from others."

The Road Back From Burnout

The perceptions of friends and family also may determine how much help is extended to people of either gender. "Because men who do any significant kind of caregiving are often seen by family and friends as heroic, they are more likely to be offered social support and tangible assistance by them," says Carol Levine, M.A., Director of the Families and Health Care Project of the United Hospital Fund of New York City and the long-time caregiver for her neurologically impaired husband. Women, says Levine, may feel "abandoned and isolated" in comparison.

The solution for women, whether they find themselves in the role of caregiver or patient, comes down to learning to share the burden. There are many useful strategies for dealing with emotional pain and frustration and for relieving some of the stress (see Tips to Help Women Cope). Zeigler, for instance, says she has reached out to friends and other support communities to help pull her through the difficult times. Although women living with illness may feel isolated and alone, she says, helpful resources are out there, and they don't have to go it alone.

Barry Jacobs, PsyD, a clinical psychologist and family therapist, is the Associate Director of Behavioral Sciences for the Crozer-Keystone Family Practice Residency Program in Springfield, Penn., and specializes in treating families coping with medical illnesses.

Julie Mayer, PsyD, is a clinical psychologist in private practice in Media and Bala Cynwyd, Penn., and specializes in psychotherapy for women struggling with eating disorders and sexual trauma.

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