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Long-term stress erodes memory (sciencebulletin.org)
428 points by upen on Jan 2, 2017 | hide | past | favorite | 155 comments

By the far, the most stressful thing I've ever done is stay with my dad while he died of cancer. For the last two weeks of his life, I stayed at the long-term care facility he was at. I put all my client's projects on hold so I could be with him. I stayed perhaps 18 or more hours of each day. I slept in the chair next to his bed. I did my best to take care of what he needed. When he was in pain I would go out into the hall and plead with the nurses to get more pain medication, though sometimes they were hesitant because he had taken too much (long story there, and I knew nothing about how the system worked then, but apparently you have to say very specific words, which are full of legal meaning, to make clear that a person wants an unlimited supply of pain killers during their final days). When he was lucid we would talk. When he wasn't lucid, I would do what I could to comfort him. I was alone with him in the room when he died.

And after that... my concentration was gone. For a good two years. My ability to write code for 70 hours a week, and think of it as fun, was gone. My mental clarity was gone. It took a solid two years to come back, maybe three years.

My dad was my best friend and losing him hit me very hard. And I learned there are some kinds of emotional stress that take years to recover from.

I was prepared for my lovely Dad to be very ill and/or die, a few years in advance, as I have older parents. Dad went from a cuddly, cognitive sprinter to a husk of a man in six months. We have a big family, be it spread out a bit, so the Duties were also spread, but it took its toll on each of us. Strikingly, it was harder to watch my mother fail to cope with it than watch my Dad die from it. I'm glad you're back. Welcome, we missed you. Thanks for sharing.

Kind of tangentially: my dad's dying, and I'm in the process of forcing him to compile end of life documents. So far it is the most stressful thing. Bank accounts, utilities, titles, living will, power of attorney, retirement funds, medical proxy paperwork, the actual will.

If you're reading this, do everyone in your life a favor and take care of this shit this week and email it to the people who will be cleaning up your life when you're done with it. It's the courteous thing to do.

I'm sorry to hear about your Dad. That you are helping him resolve these outstanding issues is most likely a huge relief for him.

I've been interested in compiling an end of life documents for myself for my family. Have you found any resources that offer some kind of checklist and guidance as to everything one might need to complete for such a process?

The problem with a checklist is it's _highly_ nation and state dependent.

That said, in the US, generally:

1) Last will and testament: what to do with your stuff when you die

2) Living will: what medical treatment you desire while unable to decide for yourself

3) Power of attorney: who handles your accounts if your incapable

Out of curiosity what are those words that need to be said?

I am sorry for your loss. I can totally relate to this. I lost my mom to cancer when I was 19. Long, slow, painful death that myself and my 7 other siblings had to witness. It took years to get over the trauma and I am certain some of my younger siblings (ages 2 to 15) had PTSD.

I was not yet into my career at that age but I am certain it would have heavily affected my concentration and ability.

Thanks for your story - I lost my dad just over a month ago after years in care for an illness which was drawn out over 7 years from his late 50's. Throughout this period I also was very aware of losing my ability to concentrate, as well as my ability to really see much meaning anything around me. His death in a sense has been a relief after so much time and pain, but, I feel it will be a long time until things return for me mentally. Thanks again for sharing.

Sorry for your loss. I lack the words to describe the level of empathy I feel when I read your story. Happy to hear you managed to bounce back.

Any advice for people going though a very tough time you'd like to share?

That really sucks. Thanks for sharing.

Sorry for your loss!

Great. Something else to be stressed about.

Kidding aside, stress is a deadly serious thing. I never took it seriously until it nearly did me in. I can also attest to the memory and other cognitive issues. It can take quite a while to recover.

The most stressful situations are where you are expected to perform, but have little or no control. This could be a job situation or some other situation. Find a new situation or a way to establish more control. Better to lose that job than your ability to work at any job.

The last thing you want to do if you're constantly stressed is to just suck it up. It's one thing to do that for a limited duration to achieve something specific, it's another thing to do that indefinitely with no end in sight.

It seems to be one of those conditions that gradually grinds one down. You know when your leg is broken that you are broken. It's much harder to realise and accept that after years of stress, you are far more broken than a mere broken bone.

A lot of folks are focusing on the title, but I think this is the most interesting part:

> When they gave the mice a chemical that inhibited inflammation, neither the brain-cell problem nor the depressive symptoms went away. But the memory loss and inflammatory macrophages did disappear.

>And that led them to conclude that the post-stress memory trouble is directly linked to inflammation — and the immune system — rather than to other damage to the brain. That type of information can pave the way for immune-based treatments, Godbout said.

To me, it feels like inflammation is the new cholesterol.

Ah, cholesterol plaques in arteries are in fact the ghost of inflammation past, and specifically macrophage-mediated inflammation. In medicine this is far from a departure from the prevailing hypothesis -- it is a consolidation of multiple lines of evidence.

Yeah, whenever we declare all out war on something, it's pretty much a guarantee of future recantations.

A lot of it seems to run along the lines of confusing correlation with causation.

It's an interesting term that seems to mean something when in reality we understand little about the mechanism and effects. But good to keep researching it, i suppose.

Oh what a vicious cycle this is. As someone battling with depression, I tend to take on a lot of side projects and extra work in order to keep my mind busy and avoid those thoughts.

Then I get stressed because I have so much to do.

> avoid those thoughts

Avoiding anything is always the worst option. Get some professional help on how to deal with the thoughts.

I'm almost certain he meant stave off the depression rather than "avoid" like you are reading it. Staying busy, staying in a routine, can help keep people from getting down.

Telling people to "get help" is really frustrating since the help seldom helps. It's just a blow-off conversation-ender. Don't assume they aren't getting help, don't assume that someone suffering an episode can't fix it on their own given time.

This was one of the main takeaways from a delightful interview about depression with Peter Sagal (https://www.apmpodcasts.org/thwod/2016/12/peter-sagal-opens-...)

"Avoiders" who push themselves into social situations and work they care about will fare better than ruminators.

Point taken (and upvoted). I may have come to a completely wrong conclusion from reading that comment.

that sounds like manic-depression or similarly, but more modern, a bipolar disorder. IANA Doctor, just sympathetic.

I would be interested to know whether or not there is a relationship between stress and lack of sleep as well that could account for some of the memory issues related to stress.

I was in a very stressful relationship in college that resulted also in a lot of sleep loss (although oddly I rarely had problems falling asleep probably because of exhaustion, just got way too little of it), strangely it didn't seem to affect me that much negatively at the time. I managed to get basically straight A's but I had to lose more sleep to do it and finally graduate and then go on to a masters sans relationship, but in the past 3 years I've still had a different and tenuous relationship with sleep and lately I feel like its started to affect me. Despite having a fairly low-stress life (current relationship is low stress, job is low stress, high-maintenance family is kind of taking care of itself), I'm noticing some of the symptoms referenced in the study, but it would have to be either a delayed reaction or more sleep-related than stress-related.

Sleep is physiologically the recovery from stress. Two sides of the same physiological coin - the autonomic nervous system. Sadly, there's little work on how stress affects sleep and vice versa. Typically they've been separate academic or clinical labs.

A hidden source of stress can be a single individual (or two) who causes you ongoing low levels of stress, without you realizing how big a toll it's really taking on you.

I've had it happen, wherein I wonder why I'm feeling anxious, angry, or otherwise. Then, I step back and recognize how a particular person is treating me and realize that a) it's simply wrong/unfair and b) I'm allowing it to happen and allowing it to get to me.

It doesn't mean it's malicious or intentional, but it's no less affecting.

I'd encourage everyone to step back once in a while and objectively consider their relationships, then tweak, manage, or dispose as necessary.

>dispose as necessary I've seen this piece of advice float around quite a bit. I always find it really difficult to understand. If you suspect someone in one of your social groups is causing you a big problem, you can't just eliminate them, they are connected to other people you know too (this might be a family or a workplace).

Then the question turns into, shall I leave and find new social groups? This is such a high risk act.

Depending on the structure of the group, it can definitely be more complicated and can otherwise be somewhat disruptive to the group.

But, there are still ways to put distance between yourself and the source of the problem. And, keep in mind that the distance may not always be physical, but involve other ways to limit contact/interaction.

Also, depending on the type of problems the person is causing you, it's very possible that others in your group are experiencing the same from the person and may also want distance, or at least be supportive of you.

I've unfortunately had to do it with a member of a close group. It was for the same hostile, destructive behavior the person was clearly displaying towards other members of the group and they were well aware of it. I simply told them I was no longer willing to tolerate it, so couldn't be around when the person was. I also explained that I was responsible for my growing family, who depended on me, and I could not afford the additional stress.

It created a rift, but the other members and I still make effort to see each other without this person present. It can usually be done. Virtually any situation can be changed. You just have to decide whether it's worth it. You'll know when it is.

Stress tends to wreak havoc on the entire body, so I'd have been surprised if this weren't the case.

A couple years ago I remember reading an article that bullying in school has strong epigenetic effects in the children given birth to by bullied people. That realization, that by bullying people you don't just break them, but even hurt their unborn children ...

Gives a whole new meaning to "I'm going to hit you so hard, your kids are gonna feel it."

Could you link to article? I would be really surprised if they had some evidence for causation. I would think that theoretically something like bullying might have large confounders. Basically the likable quarterback doesn't get picked on, but the kid that doesn't fit quite fit in does. And at least some of this is probably genetic.

It could merely influence how that segment of the population raises their children thus having a negative effect.

It is actually more logical that the psychological scars linger and go untreated as the damage is not recognized.

do you have a link or source for this? not doubting you just curious to read more

There has been a lot of sloppy epigenetic studies, here is the sceptical view: https://www.theguardian.com/science/blog/2015/sep/11/why-im-...

now a blamed bully might argue that correlation != causation.

My mother is obsessive about not losing her memory as she gets older, paranoid about dementia and Alzheimer's.

I just sent her this article. This probably won't help.

I can also confirm that I've noticed after a very stressful period of over 4 years that my memory was completely shot.

When I entered the workforce, at first I noticed I couldn't remember names at all, I would have to either concentrate on the name while ignoring the conversation in front of me, or I pay attention to the conversation but have an almost certain chance I will forget the name.

I've noticed in general that I had poor short term memory, but I never realised this issue when I was in college.

The worst part was not being able to remember what tasks I accomplished just a few hours before at work, boy that always made me feel good.

It's been driving me nuts for years, I'm unsure how much I have recovered if at all.

Robert Sapolsky has dealt with this field quite a bit and is a plain-spoken and engaging academic concerned with much of what is being discussed in this thread. I highly recommend a documentary he co-produced, "Stress: Portrait of a Killer."

A short interview on the topic: https://www.washingtonpost.com/express/wp/2008/09/23/heres_o...

YouTube: https://www.youtube.com/watch?v=eYG0ZuTv5rs

>>Mice that were repeatedly exposed to the aggressive intruder had a hard time recalling where the escape hole was in a maze they’d mastered prior to the stressful period

This sounds like an extreme level of stress, of course the poor mouse has memory issues. I don't think you need to worry if you have ordinary levels of stress from traffic, mortgage, kids etc... But if you live in Syria and your city gets destroyed by war, then yeah, your brain performance will suffer, but I don't think anyone would be surprised by that result.

This goes back to another discussion that has been had on here though. It's how the stress is PERCEIVED. To someone who has a family to feed, the idea of losing their job may be PERCEIVED by them as being just as bad as the guy in Syria worrying if his house will be bombed.

I don't disagree that the guy in Syria is more justified in his perception of a greater stress, but the soccer dad's body doesn't really care about the guy in Syria or their relative justifications for level of stress.

Everything is relative.

Then it will be a PTSD - a mental illness.

I'm not trying to make a serious point here and I don't know enough about the study to say that it was unethical, but this sounds terrifying and kind of like a bad prison experience.

> This is the first study of its kind to establish the relationship between short-term memory and prolonged stress. In the case of the mice, that meant repeat visits from a larger, nasty intruder mouse.

> Mice that were repeatedly exposed to the aggressive intruder had a hard time recalling where the escape hole was in a maze they’d mastered prior to the stressful period.

As far as I understand, long term stress erodes pretty much everything.

I discovered a short memory loss on myself. It's more like an instant blockage rather than a memory loss.

Whenever I have multiple tasks to cover in a short amount of time, my creativity levels stutter. I find myself unable to come up with quick and creative solutions instantly. I guess I need to learn how to work under pressure although I've read that multitasking is counter productive.

I find short breaks helpful but most of the time I can't afford them because of the urgent nature of the tasks. Writing down helps a lot when I do routine actions, but I still believe that this might not be the best method to incentivize creativity.

So anxiety - aka constant stress also causes a learning disability?

For those that are stressed about stress, Kelly McGonigal has some really interesting research on stress and the picture isn't quite as black and white. Depending on how the person views stress, it can benefit the person instead of harming them.

Her book: https://www.amazon.com/Upside-Stress-Why-Good-You/dp/1101982...

Stress is such a broad term. The first beneficial type of stress that comes to mind for me is exercise.

That explains why my memory improved remarkably after I had half a dozen CBT (Cognitive Behavioural Therapy) for sessions for GAD (General Anxiety Disorder).

It's comforting to find other Hacker News readers who have experienced stress-induced cognitive impairment. A recent mental breakdown eroded my cognitive abilities. One of the worst aspects of this experience is the feeling that I'm no longer good enough for the work, the communities, and the discourses that are the primary passions of my life.

How do you know you're stressed?

I'm a Jr dev who spent a year sneaking into lectures, studying, stealing food before I became employable. I now work 70 hours a week for peanuts and although I feel fine, I am pretty sure I am about to rip my hair out.

Oh yeah, I'm probably pretty stressed.

What do I do about this?

You do not need to work 70 hours a week. You would be more productive if you worked 40 hours a week. Beyond a certain point, more time spent is a net negative, because it hurts your ability to think clearly. Plus, even if it did make you more productive, the cost still wouldn't be worth it.

Thus, whatever is motivating you to work longer hours is mistaken. If it is your own belief, fix it. If it is the belief of the company you work at, either try to work with them to get more reasonable hours or try to find a new job.

actually makes pretty good sense as a coping mechanism I guess. decreased memory function might help erase bad experiences, thereby decreasing stress - unless your job depends on abnormally high levels of recall... probably not a big issue in days gone by.

I used to have an incredible memory, and in general attributed my SHARP decline in recall to just getting a bit older (though I'm only 27 now...). Still, I did feel that this decline helped me a lot for the very reason you mention. I used to get panic attacks a lot -- not so much anymore. I've joked before that it's almost like I've forgotten my triggers, and that my short term memory is so bad that I don't get stuck in the panic feedback loop so easily anymore.

Hope you don't mind me asking - Are you on, or have you taken, SSRIs? I've been interested in them for a while, and one thing I've read fairly consistently is that they can cause short term (and in some cases long term) memory degradation.

No, I've never taken SSRIs. At one point I was taking xanax, but only when I had panic attacks. I hear that benzos like xanax have an affect on short term memory. I only took maybe 30-40 pills over two years. Hopefully such a seemingly cautious dose wasn't enough to mess me up!

I would call this the pathophysiology of burnout. I have lots of personal experience of this.

i wouldn't be surprised to learn that this is not universal, that there are some individuals whose reaction to this sort of stress does not cause the sort of brain damage described in this paper.

I've definitely noticed this with our kid. There are days when I'm using the tracking app no so much to create a long-term record, but to make sure that I've actually fed her recently.

Presumably this happens because the stressful situation or memory repeatedly activates the attention system thereby priming it towards the stressor and making it hard to address any other memory.

I can confirm it from personal experience. I have A.D. and O.C.D.

"This new research focused on the hippocampus, a hub of memory and emotional response."

Hasn't depression research been focused on hippocampus function for some time now?

Pretty much textbook science from animal models. Stress wrecks havoc on typical brain functions including memory, learning, attention, even decision making.

Somehow crying helps deal with stress. Stress manifests itself in various ways for different people, but crying or going for a run helps me.

I think the notion of letting stuff out in general helps with stress. Socially, it's somehow unacceptable to show even righteous anger or other "negative" emotions.

Letting those build up definitely hurts.

So what can you do? How can you escape it?

I don't know if this is for everybody but I've found a love of Muay Thai. It's taken me away from the computer and almost feels like I'm 'levelling up'. +10 stamina +10 agility.

The other things I'm trying: - Daily meditation - Regular sleep routine. - Got rid of my smartphone - Ignore all social media - Unitasking with one screen, one task at a time

This is some of the stuff I've been doing to help alleviate the stress that I put on myself. Might work for some, might not.

I found that learning how and when to say 'no' to your boss is a great start.

Is there some good reference on how might I do that?

My general tips (not always possible or applicable, but hey):

- Highlight the cost of doing what he says. There is always a cost, but either you or him/her may be misunderstanding or miscalculating it.

- Ask why it needs to be done.

- Offer alternatives.

- Keep in mind he/she has more to lose than you if the conversation goes bad.

- Stay polite.

Mindfulness meditation has helped me to to become more resilient to stress.

Also learning to say no politely is of great help.

I used to often say yes before I really knew what I was agreeing to.

Kelly McGonigal has a great book that talks about not escaping it but instead embracing it. I really recommend it. https://www.amazon.com/Upside-Stress-Why-Good-You/dp/1101982...

People rush to confirm from "personal experience" what has been observed in mice?

And mostly bring up sleep deprivation instead of stress.

Possible, though generally stress also caused very clear memories, called traumas...

acute vs. chronic stress

Notice that this article was posted May 20, 2016. Why was it posted today (January 2, 2017) on HN?

The "News" in Hacker News can be interpreted as a bit of a misnomer. The idea that it's only for newly-published material is a mistaken one. It's for anything that "gratifies one's intellectual curiosity"[0]. It'd be a shame to prevent submissions only because they weren't discovered recently enough.

[0]: https://news.ycombinator.com/newsguidelines.html

we need reminding


Sadly I can confirm this from personal experience. I was under a lot of stress for the past three years.

Before stress started I had almost photographic memory. I was not very smart software developer. But ability to recall patterns and documentation fast, made me very productive. I worked at CS semi-research position and spoke at conference every other month.

Now it takes mental effort to recall what I did 4 hours ago. I can only program if I strictly follow my TDD routine and design notes. Recently I could not even pass job interview for trivial entry level position :(

Stress is mostly gone now, but it will take about one year to recover. It is very weird period. People, who do not know me well, think I actually improved over past three years. I fixed my health, lifestyle, social interactions...; I took every advantage I could to compensate for damage caused by stress.

Now, I can feel improvements every week, and I am basically starting from scratch. Once I get my old memory back and combine it with new things I learned to cope, I will be unstoppable :)

Same here. Photographic memory; could draw lifelike depictions of people I'd met a single time hours or even days later, could recall what position on a page a paragraph was on months or years after reading something, etc. However, after a coworker killed himself and dumped a RPG/AS400 job on my lap several months before a major calc/billing, I couldn't even recall the beginnings of sentences by the time I'd completed them.

May I ask what stressed you out like this?

new child

Interesting. This immediately put me in mind of the birth of my own child. While no where near as bad as you describe, my short term memory did kind of go to crap after she was born. I blame it mostly on sleep deprivation, which is a kind of stress, I suppose.

Interesting... I'm having the same issue. In my case my daughter was born 5 months ago and the lack of sleep and sometimes the bad sleep is causing a direct effect on my memory. Before that, I was able to remember a lot of things, but I guess I'm too tired now. Even reading a book is challenging and I have thousand of books. In our case our daughter was born with hip dysplasia and I was under a lot of stress.

One thing my wife and I did that was kind of idiotic with our first child was to both try and deal with the baby at night "as a team".

Once we realised that being a team was better visualised as taking on different roles, we functioned way better. As she was on parental leave for a year, it made more sense for her to deal with the baby at night, and for me to get a good night's sleep so I could function during the day at work. She could catch up on some sleep in the day when the baby slept. If you have a spare room then use it if you are both happy with that.

That's great, thanks for sharing it. Another thing that has pros and cons is the fact that I work from home, so I'm always worried if she breaths, sneezes and if she moves :).But I like the idea of working as a team, thanks for the advice!.

Similar experience: twins born at 35 weeks, they're 4 and very healthy now, but I don't remember 2013. At all.

I'm having first child in few months. I'm stressed out as it is, can't even imagine what will happen when he is born. Even worse, I'm working from home.

Reading all the replies on this thread on the stress(es) of childbirth, I think a large part of it can be mitigated by having the grandparents around. This is how it usually is in my country (India), though it is changing slowly with younger couples migrating to urban centers.

Anecdotally, my sister-in-law has 3 young sons and while both the parents are stressed out more than couples without children, they get a welcome break over the weekends and many weekdays because one of the grandparents is often around to help with taking care of the children. This allows for a lot of freedom and more importantly, the freedom to think that you can get away from it all, even if it is for a few hours. I think (I don't have children myself) that the thought that this young human is completely and totally dependent on you all the time can be extremely discouraging, even if its your own child.

Always be cautious of advice as every child is different, and any one person's experience may be different from yours.

That said, the first three months will almost convince you that you can do it. Babies may only sleep 2 or 3 hours in a row (we were lucky and got four consecutive hours at nighttime), but they sleep a lot in total. If you can handle the sleep disruption, you will actually be left with a lot of time for work. From four months onward, they start to be awake a bit longer and they start to get very interested in what you are doing. It will then begin to get very difficult to work with them around. You might need to find an alternate place to work and/or begin to make alternate child care arrangements.

Youll be immensely happy! And exhausted. And fighting a lot. Know that it's all normal.

Work early on to get the child a proper sleep routine and don't get them used to sleeping in the big bed, that's what most people do wrong and what pays 'dividends' aka bad sleep for a long time.

Also with one child the beautiful thing is that you can split times. So each parent can get some time completely off. But this requires that you get active early on. Start changing diapers on your own and bathing the child early on, so that neither mom nor you ever have doubts that you can handle things alone. It is TERRIFYING but oh so fun and better do it right from day one so you can enjoy it from then on and you are an equal couple from early on. Too many couples hey a bad dynamic where is only the cheap replacement mom never lets go completely, leading to stress for everyone involved.

Ideally she will breastfeed at least a few times a day for 6-12 months but even then after a few weeks she can start pumping milk and you can bottle feed, or from some point you can give formula. Remember that while you'll be exhausted she'll be even more so, it's best for your relationship and mental health if mom gets some breaks as well. believe me on that, i only learned that on the second child, when things are anyway more stressful...

I also worked from home when my kids were born. Personally I think you should see it as an opportunity as you can spend time with your child whenever you want to/have a moment during the day. Might even help with the stress. I do think it's important to have an understanding with your partner that you can not be expected to help out when working, and some good headphones can be helpful. And yes, I don't remember what I was going to say 5 minutes ago but I hope that improves when paternity leave ends.

You need to get yourself a place to work outside of home.

Was the stress primarily because of sleep deprivation/multitasking with a new baby? I am just trying to understand.

Not the poster you're asking, but have 3 kids.

Stress factors include:

1) Getting very, very poor sleep, which can last anywhere from 2-12 months depending on your kid and your parenting technique.

2) Higher monthly expenses, plus a potentially-giant bill for the birth, on top of a year of smaller but still substantial bills for various things. This will be worse if the pregnancy is split over two years of insurance deductible (probably irrelevant in countries with medical coverage systems that aren't totally broken, but very relevant in the US)

3) Having your free time (including kid-free time that you have to use to keep the house in something that resembles order if you squint at it really hard) drop to ~25-30% what it was pre-kid. (you can gain a bit more by making your sleep even worse, though. Hooray?)

4) Your house will be kinda messy and gross even if you try hard to keep it clean, which is discouraging and stressful.

5) Leaving the house and getting out of the car now being A Whole Thing instead of something that barely takes any time or effort at all. Everything you do that isn't sitting at home in your pajamas is much more difficult. Even that is, in a way.

6) You no longer actually have time off, ever. Not in the sense you did before kids.

7) If you're a woman and want to breast feed... oh god. It's bad. Even worse sleep, and you'll have either a baby or a noisy milking machine attached to you seemingly all the damn time, which is incredibly inconvenient if you need to do anything else at all ever.

Go ahead an multiply the stress of the above by a factor of 10 if your new kid has serious health issues.

> potentially-giant bill for the birth

It boggles my mind that we consider the US a first-world country when I read things like this.

Also not sure I agree about the breastfeeding being so bad. Sure, it's a bit of a chore, but most mothers I know (including my wife) found it to be a positive experience that increases attachment.

And the leaving the house/car part I also don't follow. You have one more person to dress and one more item of luggage to carry; it's hardly an exponential increase.

Otherwise I agree, esp. about stress if kid has serious health issues. (We have two kids, aged 1.5 and 4).

> It boggles my mind that we consider the US a first-world country when I read things like this.

We had a hospital stay before the birth, emergency c-section (the cord was around my son's neck), hospital stay after the birth, and about 2 weeks of him staying in the neonatal ICU. I think the bill came to around $30,000 (covered by insurance), and I think we paid a couple of $20 copays.

> And the leaving the house/car part I also don't follow.

Exponential? No, but I don't think anyone claimed that. But compared to a couple going out, a couple and a child takes several times more time to do each step. Everything takes more planning, and nothing is completely spontaneous.

> We had a hospital stay before the birth, emergency c-section (the cord was around my son's neck), hospital stay after the birth, and about 2 weeks of him staying in the neonatal ICU. I think the bill came to around $30,000 (covered by insurance), and I think we paid a couple of $20 copays.

If you that's the case and you hadn't already hit a larger yearly out-of-pocket-max through other bills, then your insurance is uncommonly good to put it mildly. If you additionally didn't have to fight with insurance to get that stuff covered so completely then you have ZOMGWTF good insurance.

I don't think everyone realizes just how much worse health insurance has gotten in the past couple years for many of us. When my kids were born (10+ years ago), I'm sure the whole pregnancy and birth was covered by just one co-pay. Now, with a $5k deductible on the best plan we can afford, it would be a different story.

My wife actually handled the bills and tends to have a better memory for this stuff than I do.

There was a stress-related stay in the hospital for her for several days with a $250 copay, around late January. Then the whole birth+surgery+NICU+breast pump rental was judged as one incident, with a $250 copay.

Individual doctor visits are $20. Hospital stays are $250. Medication is heavily subsidized, and most of it that we've ever gotten had a copay under $10.

There was an with a demand for payment for the entire bill+interest. A series of calls to their billing department led to them finding the mistake in their system and sending us the bill for just the copay.

I'm positive that we fall under the "uncommonly good" category.

> I'm positive that we fall under the "uncommonly good" category.

For comparison, my wife and I are on a marketplace plan, and out of a total of $60k in expenses for our newborn daughter, we were responsible for ~$12k.

We want to have more children, but I would move from the US to a first world country to do so.

I know you're making a joke, but first/second/third refers to political affiliation in the cold war and is not to do with economic prowess.

First = US/W.Europe + Allies

Second = Soviet Union/China + Allies

Third = Non-aligned

I find your comment an important reminder of the original sense of the phrase, but I disagree that third world has nothing to do with economic prowess. You are referring to both the etymology and formal definition of the phrase "third world" country. Political journals will generally use third world in this restricted sense, and dictionaries may even list the original definition first. Nonetheless, in modern parlance it has everything to do with economic prowess. It is used--in developed countries at the very least--as the pejorative analog to "developing country".

As a first world resident I am not sure about the prevalence of this usage in developing countries. I know I would not be thrilled to have my country--and, by extension, culture--referred to as "third world". I wouldn't be surprised if it is common in developing countries to note this original sense to both blunt the pain of being dissed by denizens of rich countries and to establish a sort of reverse superiority by insisting on and noting the original sense of the word.

My wife and I have had 3 kids (now 8,6 and 1), all 3 were C-sections with extended hospital stays and all 3 births were covered, in their entirety, including pre-birth obstetrician visits, my wife's follow-up visits and initial pediatric appointments for the kids with zero co-pays. Literally we paid nothing to the doctors or hospitals for the entire year. We've had various flavors of Blue Cross/Blue Shield "HMO Blue" Massachusetts. This is not even the top tier plan Blue Cross offers from my employer - that's the "PPO" plan which has significantly better out of network coverage.

Medical billing in the US is a nightmare. Even if an insurance looks very good on paper, the entire health industry finds ways to screw the patients. Claims are rejected that should've been covered and it requires endless forms and phone calls (and the phone calls always have long wait times) to correct the issue. It's all a big mess.

> And the leaving the house/car part I also don't follow. You have one more person to dress and one more item of luggage to carry; it's hardly an exponential increase.

It's mainly that something so easy you barely think about it becomes something you do have to think about. It's a vanishingly tiny value being acted upon such that it is many times larger than it was, though still not huge. It does get worse with older kids—newborns are in many ways very easy, sleep and constant feedings aside—and I understand that some people have lots and lots of trouble with the process, though for us it's not that bad, just a non-issue that is now a once-or-more-a-day minor issue.

Yes, getting an older child out of the house can be like a hostage negotiation.

Michael McIntyre explains the leaving the house/car part perfectly: https://www.youtube.com/watch?v=4GO2xz0L9gQ

(Edit: The full presentation is pretty relevant to the topic too if you are interested: https://www.youtube.com/watch?v=j1cFt2tWsI4)

Well, you might have one more person to dress but it might be a person screaming and crying and not wanting to be dressed.

And when you're all finished and ready to get into the car, the person has a full diaper that needs to be taken care of, so when you've done that you're back to square one.

Just to make sure those wanting to become parent don't get things too wrong. Having a child is a choice most of the time (if you are OK with contraception). Therefore, since it will effectively replace yourself by your child in your life equation, be sure you want the little kid. If you want it, then it'll feel much easier (but not completely easy nonetheless, the OP is right about 75% of your spare time disappearing :-)). If it's a choice for you and your lover, then it'll be ok and bring a lot of satisfaction. But having a child is usually not the good time to start this new business you dreamt off :-)

Right, totally, and I've got three of the little devils so clearly I'm not entirely down on the experience, but having a kid could well be the single most stressful (and possibly expensive—childcare or having one partner stay home is really really expensive) event/decision in an HNer's life for a variety of reasons that aren't always obvious to non-parents. It's no picnic.

Damn! Three ! You must love that :-) I'm more than happy with 2. And besides, 3 means that there are more kids than adults in the family :-) It's like playing a football game with on player excluded :-)

(but as I say, if one chooses it and feels like being a parent, I can guarantee a hell of satisfaction, those kids are just marvelous eyes openers)

> 2) Higher monthly expenses, plus a potentially-giant bill for the birth,

The toll on household finance and peace of mind of the US insurance system is incredible. The births of two daughters, including a couple of days at the hospital, peridural, pre-birth prep and post-birth followup, cost us a grand total of 30€. Of course nothing is free, we pay it through other means (taxes), but not having to think about cost at that moment is so relieving.

Taxes and insurance contribution taken from your salary.

But the actual cost reduction is that the system is not a bloated for profit world with what resembles monopoly powers (well, you are free to not go to the nearest hospital...) but instead a public good, serving the people not the shareholders.

In reasonable prices a birth in western Europe will cost something like €2000 including a few days stay and possibly pre- & post-natal care. That's the amount paid by the insurance to the hospital. In the US you easily get to $30000 for a normal birth, of which then anything up to the full amount might be billed to the patient.

If you to real cost you could calculate eg the amount of taxes that pay for tuition free medical degrees, lots of pharmaceutical research, or similar things that would in the US be part of the justification for the huge cost (high tuition -> need for high earnings for doctors -> need for high prices). But in the end it's just absurd and the US system should be a warning to anyone who thinks that such a vital public service would be better if privatised.

> Go ahead an multiply the stress of the above by a factor of 10 if your new kid has serious health issues.

3 years ago our then-19 month old was diagnosed with type-1 diabetes - and we haven't had a decent night's rest since. For anyone not aware, type 1 diabetes is a condition where your body stops producing insulin and as a result unable to process carbs into energy. This is not type-2 diabetes that is a result of not taking care of yourself.

Our son could die in the middle of the night from his body not having enough glucose in his system and as a result starving his brain of the energy it requires - ('dead in bed syndrome.') We're up at least 3-4 times in the middle of the night to make sure he's OK.

As a software developer I've been fortunate enough to be able to "afford" the best insurance ($20,000/year (our share) + more than 3-4k/year in out of pocket costs) which affords us the latest and greatest technology - insulin pump with integrated glucose monitor. The tech is ancient by my standards, relative unreliable (his glucose monitor can get a 'weak signal' for seemingly no reason and as a result could fail to report potentially fatal blood glucose levels.

In an ideal world the tech would be more reliable, better connected, services to monitor his blood glucose levels 24/7 would alert us by phone/emergency services/etc when at critical levels.

The stress levels are high because we never have a moment 'off.' In effect we are human, manual versions of a thermostat for his glucose levels. If it's too high he faces the long term consequences of diabetes (loss of vision, neuropathy, etc.) If it's too low he can die.

Next year the stress gets even worse - we have to trust that the school system will be able to manage his diabetes. Up until now he's always with my wife or myself, 24/7 (and occasionally with my parents, who can keep an eye on him for a couple of hours with text messaging as a 'support system' as needed.)

Needless to say there are situations that are much worse than ours, and we're thankful to be able to take care of our son in the interim until technology catches up to make his situation more manageable for him as an adult.

The stress and sleep deprivation have certainly taken their toll. Weight gain, short term memory, etc.

Your insurance premium is $20k/year plus $4k/year copay? That would for me probably be a reason to try and emigrate to a country with good public healthcare. As a programmer youll likely earn a bit less outside the US but with this cost your cash in hand and quality of life would probably still improve. A place like Berlin or London would probably make you happy with as little as possible adaptation pain.

Good luck with your son. On the positive side hopefully trusting the school system can at least give you some time off of this stress :-/

on 7) there are lots of different experiences amongst the women I know, breast feeding can be an incredibly positive aspect of having a baby, while it's not easy for all, most get the hang of it (babies and mums), and their are numerous health benefits for both that extend well beyond the period of nursing, so, if you're supporting someone who is trying, keep flying the flag and make sure they know you're supporting them to do something well worthwhile, as a mum if you cannot then I feel for you, yet that is how it is, don't miss the opportunity to get close while you nurse and the magic will be there :)

This is why I got a vasectomy.

No, my wife had complications and was misdiagnosed. Long story, it is over now.

Hope things are better now. Yes, this is totally understandable. Coping with a new baby is difficult, but any other complication just makes it super difficult.

There's a lot of people on here discussing the stress of a new child.

I don't think they are differentiating between stress, that this study discusses, from lack of sleep, which also affects memory.

I find getting too little sleep very stressful. I'm required to keep doing the same things, but less able to handle those demands. When I don't get enough sleep, I've got worse health, constant headaches, and neck aches. It's its own stressor, as well as having separate negative effects.

Yes, but that's a specific physical stressor, resulting in mental stress. It's not what is being examined in the article and modeled in the experiment.

That doesn't change the fact that lack of sleep is a stressor. I was replying to your statement:

> "I don't think they are differentiating between stress, that this study discusses, from lack of sleep, which also affects memory."

In practice the two will be impossible to tease apart at any rate. Stress and lack of sleep make a feedback loop. The more you feel like you're drowning, the harder it gets to find sleep. Adding nighttime feedings just throws gas on the fire.

From a fine grained point of view, yes, stress causes sleep problems.

However, stress is a result of, and not the cause of the sleep deprivation that comes with nursing and changing a child throughout the night.

It's called Baby brain.

Would you mind elaborating a bit on the "took every advantage I could to compensate for the damage caused by stress."

In a similar position and would be good to learn what worked for you.

At start I dropped everything non essential, then fixed it one thing at a time. Key was to establish routine and patterns, which does not drain mental energy and time from me.

For example I have simple exercise routine I do every evening. It is just stuff I do before shower and bed. I also stopped driving in narrow city roads, I leave a car at motorway exit and walk last mile.

Forget self-help stuff. It is really just basics; fix your sleep, health, sex, community you live in...

For programming I follow simple TDD routine (and other simple best practices). And I do not do anything else at computer except making money. Today is an exception, I have 2 hours a week for facebook and news ;-)

as someone that's suffering from these symptoms rightnow, I'd be happy to listen to any advice you could offer. My memory used to be very very good, but these days I forget things easily and have a hard time recalling details from stories that may have happened years ago. For me, i bootstrapped a startup for a long time (4 years) and ultimately failed and walked away from it and have been picking myself up since then.

Invest time in your mental health, ie give your brain time and the possibility to truly rest. Meditation, walks in the woods (no headphones!), a fun (!) book at a rekaxing place. Or if that's too much at least start by not filling every minute. No smartphone on the toilet, no music or podcasts while walking to work, swim rather than gym, walk or public transport where possible rather than the car, not every evening a beer "to relax" but instead just a warm drink, smartphone away when playing with the kids, ...

If you really want to go bold, one of the best decisions in my life was to do a ten day silent meditation (i did one of those of dhamma.org; free courses where you of course donate according to your means at the end).

Idle time is an investment in your brain. We don't need constant information or entertainment.

This is something I would really like to read more about. No pressure, but this would be excellent subject for a blog post.

I second this, I would love to hear more

Not the person you're asking to hear from, but, there was a good Ask HN thread recently on the topic of routines/habits that you might be interested in: https://news.ycombinator.com/item?id=13095595

Specific books mentioned in the thread I can vouch for:

The Power of Habit (popular science) http://www.goodreads.com/book/show/12609433-the-power-of-hab...

Superhuman by Habit (actionable, no-bull, if somewhat introductory) http://www.goodreads.com/book/show/23206969-superhuman-by-ha...


Epictetus' Enchiridion. A cheap, used Dover Editions copy off Ebay is all one needs.

Also, if a Christian, morning and evening prayers by candlelight using the 1928 Book of Common Prayer.

Enchiridion is free online: http://www.gutenberg.org/ebooks/45109

hesychasm -- the most underrated aspect of christian spirituality, sadly expelled by most reformation and counter-reformation traditions.

A good exercise is to just sit quietly in a dark room, and completely empty your mind. Think no thoughts -- whether you believe them to be good or bad. This simple thing turns out to be so incredibly difficult, that many monks on the Holy Mountain have mastered. I myself can barely go a minute before a stress or a worry about my day or job or family comes into my head, but cool thing is you do eventually get better.


That's called meditation these days, but it's not about thinking no thoughts. It's about sorting your thoughts until there are no more worries. Everyone should be doing this.

Not quite, it's so much different from meditation. What you are referring to is more of the western concept of "quietism" which is pretty synonymous with meditation. But in either case, I agree, everyone should be practicing this.

Meditation is so broad that it includes what both of you are talking about.

It certainly sounds like one of you is talking about the meditating by using your thoughts as an object (sorting thoughts obviously makes no sense once you stop identifying them as "yours"), while the other is talking about simply doing it object-free.

Both are taught by many of the same traditions, with neither being necessarily better or worse, though usually the object-free version is taught later because it's hard to do without something to focus on when you're first starting.

I personally find the prior more useful when I'm trying to process a specific problem or stressor and the latter to be more useful after I've done some preprocessing. They are often done sequentially for this reason, as well as because meditating briefly with a specific focus helps prepare you mentally for the more general focus-free meditation where you simply rest in the experience of existence. But other preparation meditations with focuses can also be used to help you mentally prepare, such as focusing on body sensations, breath, vision, sounds, etc. Thoughts are just another thing you can observe.

EDIT: I'd note that the Wikipedia article on Hesychasm describes it as asceticism and "blocking off", so in retrospect I'd describe it as a different class of meditation than those that involve resting in experience. More like visualization practice or some of the scarier death practices. But they're talking about the "advanced" version there, and such things are easy to misconstrue because the language for describing it is poor. But I'd still call it a meditation.

> with neither being necessarily better or worse

sorry, I think this is where the confusion is coming from. My original expansion on the comment with heyschasm was in response to kingmanaz. If you are a Christian, the heyechastic practice is markedly better than simply meditating. I was trying to differentiate between modern renditions of what meditation looks like, with the christian ascetical discipline of heyschasm, and I concluded by saying both are beneficial in any case, to someone who is under extreme long term stress.

You'd love vipassana meditation.

> hesychasm -- the most underrated aspect of christian spirituality, sadly expelled by most reformation and counter-reformation traditions.

Hesychasm is alive and well in the Orthodox Church. Mostly practised by monks, but well known outside monasteries.

May I ask you kindly, to the extend you want to share, why having a new child caused such high level of stress? I mean, having two daughters, I can totally relate to sleep deprivation and everyday chores. But unless there is a medical emergency or financial distress, I am under the impression that most parents find enough joy to compensate for the stress? It's like we're onto drugs :-) Again, that's true only if the baby is in good health, which I wish you from the bottom of my heart

Not OP, but my experience is that it's immensely fun but also immensely exhausting. Apart from sleep loss and new duties to fit into busy days there were also stressors, eg like many couples we moved houses when the second one was born. Timing was suboptimal as things got delayed and suddenly much too much had to happen at the same time.

Otherwise for me stressful was in particular to lose/reduce large parts of my social life (eg Toastmasters or going out to talks and discussions, theater, for beer with friends, ... Before children i was out 4-5 evenings a week, now maybe 2/month). Your life structure changes, which may or may not be easy for everyone to adapt to depending on the before & after. I have no regrets, but i do miss what used to be couple- or me-time and relaxing and simulating activities.

YMMV but if you're willing to experiment I'd recommend looking into nootropics, specifically Noopept and Pramiracetam helped me.

Not sure why this was downvoted, but I would say the most promising candidate is Dihexa [1]

[1] https://nootropix.com/dihexa-story-science-experience/

Before you try these probably best to first try and try natural methods, eg meditation. Just to be clear, I'm not making any assumptions about you, but for most that should be the first step. Don't try to change your brain if you haven't even tried to get to know it.

You have to at least tell us the cause.

He already did, new child

Mods, can we change link to https://news.osu.edu/news/2016/03/02/long-term-stress-erodes...

The linked article is full of popups, ads and dark patterns.

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