Stress can build up over time. You may feel like you’re on a never-ending roller coaster with no opportunity to step off. Many caregivers experience “caregiver burnout,” a state of mental and emotional exhaustion caused by prolonged stress and lack of self-care. Burnout can increase anxiety and may be an early sign of depression.

Think critically about your expectations. If they’re unrealistic, adjust them. When you fall short of your goals, cut yourself some slack. Nobody’s perfect. Even the best caregivers get impatient, stressed or frustrated. These feelings can be cues that you need time to yourself. They’re not signs of failure.

Grief is a normal reaction to loss — including the loss of your plans, expectations and carefree lifestyle. Caregivers are sometimes confused or frustrated by their grief, but it is a healthy, natural response.

Journaling can provide a safe, low-energy outlet for you and your loved one to express and process feelings.

While it is important to plan for a wide array of possible scenarios, don’t spend time dwelling on your loved one’s prognosis.

“You can’t base your day on thinking ‘how much time she has here,’ ” a caregiver says. “Let it be more like, ‘Where should we go out to dinner today?’ ”

When possible, leave the house to do activities you both enjoy.

“It’s very easy to give up everything that’s important to you and give all your energy to the PH patient,” a caregiver says. This can lead to extreme stress, physical fatigue and even anger. Try to find a few hours each week that are just for you.

Go for a walk, take a morning or evening exercise class, attend activities at your place of worship or meditate.

Getting away from stressful situations, even for short periods of time, can help. Even five minutes can be enough to help you reset. Try these quick stress relief exercises whenever you need a boost:

• Breathe deeply and slowly, in through your nose and out through your mouth. When we’re stressed, we breathe poorly and receive less oxygen. Breathing exercises increase our oxygen intake, which helps us relax.

• Yoga can be a relaxing break that’s easy to do in your office or living room.

• Take a brisk walk. Movement helps reduce physical tension.

• Share a laugh with a friend. Nothing resets your mood like laughter. Or hop online and find your favorite comic strip or sign up to receive a daily joke via email.

Set goals and put them into practice. Your goals can include taking a break, getting help with your caregiving tasks and doing things that promote your own good health.

Start with a small goal, such as taking five minutes at lunchtime to practice breathing, or a larger goal, such as taking a night off or planning a vacation. Either way, lay out action steps to make your goal attainable. Put your break on your calendar or call a friend to schedule your night out.

Consider joining a support group or visiting a therapist to learn new ways to manage stress.

Family, friends and other caregivers can all play an important role in managing stress. Schedule coffee dates and phone chats with people you enjoy, and encourage your loved one to do the same. Friends and family can be an important source of support when you and your loved one need a break from PH.

People want to help, but they need to know how. Here’s how to get better results when you ask:

• Consider the other person’s abilities, interests and availability.

• Don’t ask the same person for help repeatedly.

• Prepare a list of things that need to be done and let the other person choose what suits them best.

• Accept “no” gracefully. If the person seems open to helping in the future, ask again another time.

• Be clear about what you need, how much time it will take and why it matters.

Ask your neighbors to add a few items to their grocery list for you, to take your trash cans to the curb or to double a recipe so half of it can go into your freezer for a busy week.

Longtime caregivers advise taking breaks when you can. It’s not always easy bit it’s essential. Depending on your situation, you might qualify for professional respite care, which provides temporary relief from caregiving. Find respite programs near you.