The Exhausted Mother's Paradox

Written by Haifa Hamdi, Scientist, Nutritionist & Author

Dr. Haifa Hamdi is a research scientist, holistic nutritionist, and author whose work focuses on cancer, autoimmune diseases, and digestive health. She is passionate about helping families embrace healthier lifestyles and inspiring a world where health is joyful and empowering.

---

There is a particular kind of exhaustion that many mothers know very well. You finish a full day of work, perhaps after spending most of it sitting at a desk, answering emails, solving problems, attending meetings, and making decisions. By the time you get home, you feel as though you have run a marathon, even though your muscles have barely been asked to move.

Now imagine adding the responsibility of caring for a child with a chronic condition. There may be medications to remember, symptoms to watch, appointments to schedule, school accommodations to negotiate, meals to rethink, specialists to coordinate, pharmacies to call, and insurance authorizations to fight. Somewhere underneath all of those responsibilities is the thought that rarely completely disappears. Is my child okay?

That exhaustion is real. But I think we need to understand it better, because feeling exhausted does not always mean that the body needs to become even more still.

When the caregiver becomes invisible

When a child develops a chronic condition, the family's attention understandably turns toward the child. Someone begins carrying the timeline of the illness. Someone remembers when a medication changed, notices that breakfast is being left unfinished, keeps track of laboratory results, communicates with the school, and spends an afternoon on the telephone trying to solve an insurance problem that should never have consumed an afternoon. Very often, much of that responsibility falls to the mother.

Research confirms that caring for a child with a chronic illness can carry a substantial psychological burden. A 2013 systematic review found greater anxiety, depression, and parenting stress among these parents compared with parents of healthy children. This does not mean caregiving inevitably makes someone ill, but it does mean that chronic caregiving creates a sustained mental and emotional load that deserves to be taken seriously.

There is another piece of this story that interests me particularly. Many women are carrying these responsibilities during the same decades when protecting their own muscle, bone, and metabolic health becomes increasingly important. Their attention is directed toward keeping someone else healthy at precisely the time when their own body is asking not to be forgotten.

We talk about caregiver mental health, and rightly so. I think we also need to start talking about the caregiver's physical reserve.

You can sit all day and still come home exhausted

One of the mistakes we make is assuming that feeling tired necessarily means our muscles have been physically exhausted. Think about a difficult day at work. You may have spent eight hours sitting in front of a computer and still arrive home completely depleted. Your brain has been working continuously. You have been concentrating, making decisions, responding to problems, perhaps worrying, and regulating your emotions. For the caregiver, concern about a child may remain active underneath all of this.

Mental fatigue and physical muscular work are not the same thing. Mental exhaustion is not imaginary exhaustion. It is a real response to cognitive and emotional demands, but it does not always mean our muscles need more inactivity.

This is why, on some evenings, I think it is worth experimenting before automatically surrendering to the sofa. Change your clothes and move for ten minutes. Walk outside. Do a few controlled squats. Use a resistance band. Put on music and move around the house. Then see how you feel.

Sometimes rest really is what your body needs, particularly after inadequate sleep, illness, or genuine physical exhaustion. But sometimes something surprising happens. Movement makes us feel more awake rather than less. Exercise engages systems involved in alertness and mood, and research has shown that even relatively brief exercise can increase feelings of vigor in some people experiencing fatigue.

In a small controlled study involving sedentary women who reported persistent fatigue, researchers found that a bout of resistance exercise increased feelings of vigor compared with a non-exercise condition. This does not mean exercise cures exhaustion, but it supports an idea worth exploring. The energy we feel is not always a simple reflection of how much physical effort we have already performed.

This changes the familiar sentence, "I will exercise when I have more energy." Perhaps sometimes we should reverse it. I will move, and then see what happens to my energy.

A physical therapist taught me something I never forgot

I once met a physical therapist who told me about a rule he had created for himself when he was a student. Whenever he moved from one room to another, he had to perform some kind of movement first. Before going into the bathroom, he might do ten push-ups. Before entering the living room, he would do squats. Another room meant another movement.

I loved the simplicity of his idea. He wasn't waiting until he had an uninterrupted hour. He wasn't negotiating with himself about whether he had time to exercise. He had attached movement to something that was already happening.

In other words, he had made movement part of the architecture of his day. This may be particularly useful for caregivers because time is often exactly what they do not have. When we imagine exercise only as changing clothes, driving to a gym, exercising for an hour, showering, and driving home, it becomes easy to conclude that exercise does not fit into our lives. But almost all of us walk through doors, go to the bathroom, wait for coffee, prepare food, brush our teeth, and move from one room to another. Movement can live inside those transitions.

Your home does not have to be a gym

You can live in a small apartment and still create an environment that invites your body to move. A sturdy chair can remind you to perform controlled sit-to-stands. A kitchen counter can support modified push-ups. A resistance band occupies almost no space. A telephone call can sometimes become a reason to walk rather than sit. If stairs are available and appropriate for your physical ability, they already ask your body to work against gravity.

Even resistance does not necessarily have to begin with sophisticated equipment. Body weight can be resistance. As strength improves, appropriately selected dumbbells or resistance bands can add load. Some stable household objects may sometimes be used safely, but I would not encourage people to start lifting random heavy objects simply because they are available. Strength should be developed progressively and with good technique, particularly for anyone with osteoporosis, joint problems, balance difficulties, or another condition affecting exercise safety. The goal is not to turn the house into a gym. It is to stop designing movement out of everyday life.

Science is paying attention to small movements too

What I find fascinating is that research is increasingly examining what happens when prolonged sitting is interrupted by remarkably small amounts of activity.

Controlled studies have interrupted sitting approximately every 30 minutes with short periods of movement. Researchers have tested activities such as chair stands, calf raises, half-squats, and other simple resistance movements and have reported improvements in post-meal metabolic responses in some populations compared with uninterrupted sitting.

For example, a 2016 randomized study involving adults with type 2 diabetes compared uninterrupted sitting with sitting interrupted by brief periods of walking or simple resistance activities. These resistance movements included half-squats, calf raises, gluteal contractions, and knee raises. The researchers found improvements in post-meal glucose and insulin responses when prolonged sitting was interrupted.

This does not mean that ten squats every 30 or 45 minutes will prevent diabetes, heart disease, or osteoporosis. There is no magical number of squats and no magical 45-minute threshold. But there is an important principle underneath those studies, one echoed in global guidelines on physical activity and sedentary behavior. Prolonged stillness and movement are biologically different states.

Instead of asking ourselves only, "Did I exercise today?" perhaps we should occasionally ask another question. How long have I been sitting?

If 45 minutes works as a reminder for you, use it. Stand up, walk around the room, perform several controlled squats or chair stands, stretch, and then return to what you were doing. The 45 minutes is not the medicine. It is simply the cue.

Do we lose muscle because we age, or age because we stop using it?

I often think about a simple reframe. We don't lose strength because years pass. We lose it when our muscles stop being asked to work, and over time, we start calling that aging.

Scientifically, I'd add some nuance to that reframe. Aging does bring biological changes that can contribute to declining muscle mass and strength. But inactivity and periods of muscle disuse can accelerate those losses dramatically. A position statement from the National Strength and Conditioning Association describes resistance exercise as one of our most powerful tools for counteracting disuse-related muscle loss.

This is an idea I strongly agree with. We should stop treating weakness as though it were an unavoidable identity that arrives with another birthday.

One of the studies that changed how scientists thought about this question was published in The New England Journal of Medicine. Researchers studied frail nursing home residents with an average age of approximately 87 years and found that progressive resistance training produced substantial improvements in muscle strength and physical performance.

Think about what that means. If skeletal muscle can still respond to training in people approaching 90, what should those of us in our forties and fifties be doing now?

Perhaps the question should not be, "How much muscle am I destined to lose as I age?" A better question may be, "What am I doing today to tell my body that I still need this muscle?"

Muscle is not about looking younger

This is where I think women, especially, deserve a different conversation about muscle. We have spent decades discussing women's bodies primarily through weight, dress size, and appearance. Muscle deserves to be understood as something much more important.

Muscle helps determine whether we can carry groceries, climb stairs, rise easily from the floor, travel independently, and continue doing ordinary things without needing assistance. Skeletal muscle is also metabolically active tissue and plays an important role in glucose metabolism and overall metabolic health.

Resistance training therefore becomes less about creating a certain appearance and more about preserving physical capacity.

As women move through midlife and menopause, this becomes increasingly important. We should be thinking about the body we want to inhabit twenty and thirty years from now while we still have decades in which to build and maintain it.

Our bones are part of this conversation

The same philosophy applies to bone. Nutrition matters alongside movement. Adequate protein, calcium, and vitamin D are important for musculoskeletal health, while hormonal changes, genetics, medications, and medical conditions can all influence bone health. Appropriate weight-bearing and resistance activity provide another important stimulus to the skeleton.

I would never tell a woman that eating correctly and doing squats guarantees she will never develop osteoporosis. Biology does not offer those guarantees. But we can create better conditions for maintaining muscle and bone as we age. That is very different from waiting until something has already been lost and then asking how to get it back.

Why aren't we caring for the caregiver at the clinic?

Here is a question I think our healthcare systems should begin asking. When a mother brings her child to a pediatric gastroenterology appointment, an infusion center, or another chronic care clinic, we rightly focus on the child. We monitor disease activity, adjust treatment, review laboratory results, and discuss the next steps. But what if part of that visit also created an opportunity for the caregiver to take care of herself?

Imagine pediatric chronic care centers offering caregivers a brief, optional physical activity session, a supervised introduction to safe resistance exercises, or access to a physical therapist who could help them design a realistic movement routine. While a child is receiving care, a parent might have an opportunity to learn how to protect her own strength rather than spend the entire visit sitting in another chair.

We already ask parents to participate actively in managing their child's condition, often expecting them to become experts in medications, nutrition, symptoms, and care coordination. Perhaps healthcare should recognize that maintaining the caregiver's own physical health is part of sustaining that care. A few minutes of guided movement, education, or access to appropriate exercise support during a child's appointment could be a meaningful first step.

Of course, such programs would need to respect the child's needs, supervision requirements, privacy, and the caregiver's willingness to participate. They would not replace clinical treatment or solve the structural pressures placed on families. But the idea deserves exploration.

We already recognize that family-centered pediatric care involves more than treating a diagnosis. Why not extend that thinking to the caregiver's physical health?

A parent who spends years coordinating medical care should not have to become physically depleted before anyone asks how she is doing.

This is not about adding another responsibility to her schedule. It is about making support available in a place where she already has to be.

The caregiver does not need another impossible assignment

There is an important caution here. I do not want this article to become another demand placed on women who are already carrying too much.

Caregivers hear enough advice about what they should be doing. Exercise should not become another reason to feel guilty. The point is almost the opposite.

If you cannot find an hour, use ten minutes. If you cannot leave the house, use the house. If you cannot follow a complicated program today, attach one movement to something you already do.

Perhaps the bathroom door becomes your reminder to squat. Perhaps making coffee reminds you to do calf raises. Perhaps an insurance call becomes a walking call instead of a sitting call. Perhaps, before collapsing onto the sofa after work, you give your body ten minutes of movement and then decide whether what you really need is rest.

Small actions do not replace a well-designed exercise program. But they can change the relationship we have with movement, and sometimes that is where a program begins.

Give your body some of the attention you give theirs

Parents of children with chronic conditions become remarkably skilled observers. We notice changes in appetite, sleep, energy, symptoms, mood, and behavior because we love our children and because sometimes those changes matter. I think caregivers deserve some of that observation too.

Notice how long you sit and whether your strength is changing. Pay attention to what happens to your energy after movement, whether you are nourishing yourself adequately, and whether stress is pushing your own health permanently to the bottom of the list.

You may not be able to remove the medical appointments. You may not be able to eliminate the insurance battles. You cannot simply switch off the part of a parent's mind that worries about a child who is unwell. But you can leave small reminders throughout your environment that your body exists too.

The physical therapist I met understood something important when he was still a student. He did not wait for movement to conveniently fit into his life. He built his life so that movement kept finding him. Perhaps that is one of the simplest things caregivers can borrow.

We do not need to fear getting older. But neither should we surrender our muscles to inactivity and call it aging. Perhaps our healthcare systems can learn something from that simple principle too. If we want caregivers to remain strong enough to sustain years of care, we should help make their health part of the conversation rather than another problem they must solve alone.

Sometimes we wait for energy before we move. Perhaps, on some days, we should move first and allow the energy to follow.

Follow me on Facebook, Instagram, LinkedIn, and visit my website for more info!

Read more from Haifa Hamdi

---

Haifa Hamdi, Scientist, Nutritionist & Author

Dr. Haifa Hamdi is a research scientist, holistic nutritionist, and author dedicated to advancing health and wellness. After earning her Ph.D. in Immunology, she built an international career across Europe and North America, contributing to the development of cell therapy protocols to treat cancer and autoimmune diseases in patients. Her research includes more than 15 peer-reviewed scientific publications, with expertise in lung cancer therapies, immune tolerance, and innovative approaches to inflammatory and infectious diseases. She is also collaborating on new strategies for managing and treating inflammatory bowel disease (IBD). Her mission: to inspire a world where health is seen not as a burden, but as a joyful and empowering journey.