Vania Phitidis
Written by Vania Phitidis
Counsellor & Therapist
Last updated on 30 March 2026
Reading time: 11 minutes

I nearly didn’t write this post.

Not because I don’t have anything to say. If anything, I have too much. But because there’s a version of professional life where therapists are supposed to have it together. Where we speak about hardship from a careful distance, using phrases like ‘when clients experience…’ and ‘research suggests…’

This isn’t that post.

This post is written from inside it. From the 2am wake-ups, the stress hormones coursing through my body before I’ve even opened my eyes. From the nanny cam I check compulsively. From the family WhatsApp where I report every small development, hoping that information will somehow make me feel less helpless. From the hollow ache of knowing that no matter how closely I watch, I cannot prevent what is coming.

I am a counsellor and psychotherapist. I know exactly what is happening in my nervous system. And knowing it doesn’t make it stop.

The sandwich

You may have heard the term ‘sandwich generation.’ It refers to those of us who find ourselves caring for ageing parents while still raising or supporting children. Squeezed from both ends. Stretched thin.

My version has a few extra fillings.

My father is 95. He is extraordinary in how he’s managed till now. Until recently, he was also my mother’s main carer. In truth, he still sees himself as that. She has dementia. She is 88. She’s still very curious about people and the world but can’t really make sense of complex ideas.

My father has been doing this work – the caring, the patience, the daily navigation of a world that has become unfamiliar to the woman he has loved for over sixty years – with a body that is 95 years old. He has had falls. He overestimates what he can do. I understand why. Stopping would mean acknowledging something he is not ready to acknowledge. To be honest, he’s always been a master of denial!

There are four of us siblings, three living reasonably close by. I’m the furthest away of the local ones. We all have different capacities, different lives, different amounts we can give. None of us is wrong. We’re all doing our best. All of it is hard.

On the other side of the sandwich, I have two adult daughters who are not yet fully independent. My older daughter is neurodivergent with additional physical health issues, and requires daily support from me. My younger daughter is finding her feet after travelling last year. Last weekend I drove her to London and helped her move into her new flat. It was a good day. I loved doing that with her and for her. It was also exhausting in a particular way, because it was the kind of day that used to have two of us in it.

The shit in the sandwich

Here is what I haven’t said yet: the thing that makes all of this so much harder is grief.

My husband, Brocas, died three years ago. He was a wonderful person: loving and present and practical and funny. And calm. He was my person.

His absence doesn’t just leave an emotional hole. It leaves a structural one. The things he did, I now do. The things we shared, I now carry alone. He would have done the driving to London. He would have carried the heavy things and made it feel lighter. He would have been there in every way. His half of the load became my load, and then the world quietly added more on top.

Three years on, I am still learning the shape of life without him.

And then, five weeks ago, our dog Queenie died.

I want to say something about this without it sounding small, because it wasn’t. Queenie was my shadow for over 16 years. She followed me from room to room, she was there when I woke up at 2am, she was a warm and constant presence through the worst years of grief. She was anxious – honestly, she probably needed her own therapist – and I had regulated her nervous system so many times that her presence had become regulating for me in return.

When you lose an animal like that, people sometimes don’t know what to say. They offer condolences but with a slight hedge, as though it doesn’t quite count. It counts. When your nervous system has learned to settle around another being’s breathing, their absence is felt in the body.

I name the grief here because I think it matters. Not just for my story, but for yours. A lot of people who are struggling under the weight of caring responsibilities don’t immediately identify grief as part of what’s making it so hard. They think they’re just tired, or failing, or not coping well enough. But grief changes everything. It sits underneath the busyness, underneath the lists and the logistics, and it makes the ordinary weight of life feel unbearable. And grief is not only about death. It can be the slow loss of a parent to dementia – watching someone you love become someone you don’t quite recognise. It can be the expectation that loss is just around the corner – pre-emptive grief. It can be the end of a relationship, a marriage, a friendship, a job. It can be the loss of a version of your life that you had planned on, that you had counted on, that simply no longer exists. If you are in the sandwich and you are also carrying any of that – that is not a small thing. That is the thing.

What it looks like from the inside

Here is what a dysregulated nervous system looks like in practice, in case you’ve ever wondered:

It looks like waking at 2am and lying there while the cortisol does its work, scanning for threats that aren’t in the room but feel very present in the mind. It looks like checking the nanny cam more times than is rational or useful. It looks like writing detailed updates on the family WhatsApp at all hours – not because my siblings asked for them, but because information feels like control, and control feels like safety.

It looks like being unable to stop, because stopping means sitting with the thing I’m trying not to feel.

And sometimes it looks like finding yourself mid-Google researching how to care for your new carbon steel frying pan – the seasoning, the restrictions on acidity 🙈😬, the particular attention it requires – and thinking: I wasn’t expecting to be the pan’s carer too!

I know the clinical name for what I’m doing. Hypervigilance. Anxiety-driven checking behaviour. And knowing the name doesn’t make me stop doing it.

There’s something in the counselling world called conditions of worth – the idea that somewhere along the way, we learned that we were most valued, most loved, most secure, when we met certain conditions. When we behaved in the right way, achieved the right things, showed up in the right form. For me, that condition has always been usefulness. Being the one who manages. The one who sorts things out. The one who holds all the moving pieces at once. The one checking that everyone did what they said they would do. Or telling them what is needed… and then checking they did it!

I know this pattern well. I’ve sat with it with my clients for years. And here I am, living it – overgiving, overdoing, measuring my worth by the number of problems I can hold at once. Not consciously, of course – it goes unnoticed until, well, you notice it.

My osteopath saw me last week. He knows my body well. He told me, plainly, that he hasn’t seen me like this since Brocas got ill, and that if I don’t find a way to step back, I will probably get ill.

This is not a metaphor. This is a physical warning from someone who can read it in my muscles, my posture and the tension in my spine.

The well-meaning advice that doesn’t help

Two weeks ago, I took my mother for her dementia review. The nurse was kind. At the end, she looked at me and said: ‘Remember to take care of yourself too. You have a lot on your plate.’

I smiled and said thank you.

What I didn’t say – what I couldn’t say in that moment – was: the systems we are in don’t make that easy. There is no reliable infrastructure for those who need caring, and there certainly isn’t for the people doing the caring. Yes, there are carers support groups and bereavement groups and the occasional offer of respite – a cup of tea, a game, an afternoon with others in the same boat. I don’t want to dismiss those things. For some people, in some moments, they help. But they are not structural. They are saccharin icing on an already inedible cake. They ask the exhausted person to add one more thing to an already impossible list, rather than addressing the conditions that made the list impossible in the first place. There is no one ringing me to offer genuinely helpful support. There is no appointment for the daughter, the bereaved spouse, the overwhelmed mother who is also working outside of those roles. ‘Take care of yourself’ lands differently when the scaffolding that used to support that self-care has been dismantled piece by piece – and when society has no real intention of rebuilding it.

I don’t say this to be bleak. I say it because I think it matters to name it honestly – that sometimes the advice is right and the conditions are wrong, and both things can be true at once.

What I am actually doing

I am trying to get honest with myself about what I can and cannot control. The nanny cam will not stop my father from falling. The WhatsApp updates will not prevent a traumatic ending. The vigilance is my nervous system trying to feel less powerless – and there is compassion to be had for that impulse, even as I work to soften it.

I am asking for help. A cleaner and a gardener will come this week, and I’m asking my daughter’s PA to do more. I’m in discussion with my siblings about how we can restructure our parents’ care. This is harder than it sounds when your conditioning is self-sufficiency and when the person who used to be your first call is no longer there to answer.

I am trying to allow my grief, not just plow on. There is a difference between processing loss and performing coping. I’m trying to be with my grief alongside doing what needs doing. Sometimes I override the one in service of the other. And sometimes that’s what needs to happen.

And I am trying – genuinely trying – to take my osteopath’s warning seriously. Not as a self-improvement project, but as an act of basic sustainability. Because the people who need me, and I include myself in that, need me functioning, not running on fumes and adrenaline.

My client work remains the part of my life where I am fully present – where I get to lay all of this down and just be with someone else’s process. That matters to me. It is, in its own way, restorative. And it is the greatest privilege.

If any of this sounds familiar

You might be in your own version of the sandwich. Maybe with different layers, different losses, different people depending on you. Maybe your 2am looks different to mine, but you recognise the feeling – that particular exhaustion that comes from doing too much or holding too much, and very likely both.

What I want you to know – and what I am reminding myself – is that the hypervigilance makes sense. The overdoing makes sense. We learned these patterns for good reasons. They kept us safe, or kept others safe, or earned us love when love felt conditional. And it’s not ALL about our internal landscape – sometimes the support out there just isn’t out there, and that is a reality.

But we are allowed to put some of it down.

Not all of it. Not forever. Just enough to take a breath.

If you are carrying something heavy right now and you are wondering whether it might help to talk to someone – not for advice, not to be told to practise self-care, but to be genuinely heard – I offer a free introductory call. You can find out more here.

And if you are reading this at 2am while the stress hormones do their work: I see you. You are not alone in this.

With love from Vania