How to keep caregiver strain from snowballing into depression
Being the sole or primary caregiver of an ailing loved one can be rewarding, but it can also be extremely stressful. The tasks and challenges involved—from bathing, toileting, and feeding to managing medications and doctors' appointments and coping with difficult behaviors—are frequently overwhelming.
Caregivers also often sacrifice their own physical and emotional needs in an effort to provide the best possible care for their loved ones. The resulting anger, anxiety, sadness, isolation, and exhaustion—as well as the guilt for feeling this way—exact a heavy toll that can lead to depression.
The Burden of Caregiving
More than 50 million Americans are caregivers for a family member, and seven million are taking care of someone age 65 and older who needs assistance with daily activities because of a stroke, Parkinson's disease, Alzheimer's disease, or cancer. Unfortunately, research also indicates that 40 to 70% of family caregivers of older adults have symptoms of depression, with between one quarter and one half of them meeting the diagnostic criteria for major depression. Those who care for individuals with dementia are at especially high risk.
And it's a vicious circle, because being depressed or under heavy emotional stress is known to have a negative impact on the well-being of the person being cared for—which in turn puts a heavier burden on the caregiver.
How to Ease Caregiver Stress
Following are strategies for taking care of yourself while you're caring for someone else.
Don't go it alone.
Being the only person in charge of someone's care is overwhelming no matter how devoted you are, and it's unrealistic to believe you can handle everything yourself. Sharing the burden is essential to living a balanced life, which will ultimately benefit your loved one, too. Start by thinking about what kind of help would be useful to you. What do you need most? Is it someone who can clean the house and shop for groceries on a weekly basis or watch your loved one once a week so you can have a day to yourself? Or do you require assistance with specific tasks such as bathing or feeding or with coordinating medical care? Then ask other family members when and how they can pitch in.
If family and friends can't cover all the bases—or if family relationships are strained or family members live far away—consider hiring a professional caregiver for one or more days of the week. For example, respite care programs can send a healthcare professional to your home to care for your loved one, or you can arrange for your loved one to spend some time at an adult daycare center. (For more information on finding respite care, go to www.helpguide.org/elder/respite_care.htm.)
If managing your relative's healthcare is too burdensome, consider hiring a professional care manager. The National Association of Professional Geriatric Care Managers has a directory at www.caremanager.org.
Don't forget about emotional support. Social isolation is common among caregivers and it can feed on itself, leading to depression. Research has shown that caregivers who have emotional outlets or support from family and friends struggle less with the physical and mental challenges of caregiving than those who don't.
In-person or online support groups designed specifically for caregivers offer you the opportunity to express concerns, feelings, and frustrations and help you make difficult decisions about your loved one's care. For example, check out the online support groups offered by the Family Caregiver Alliance at www.caregiver.org.
Other avenues for emotional support include religious organizations or individual psychotherapy. Simply socializing with friends on a regular basis can also relieve stress, improve mood, and provide distraction and perspective.
Get enough exercise.
Studies have repeatedly shown that exercising prevents and combats depression in a number of ways: It increases the flow of oxygen throughout your body, stimulates the nervous system, and affects levels of brain chemicals like serotonin, all of which relieve tension, induce calm, and make it easier to handle anxiety and stress.
Plus, taking care of your body bolsters self-confidence and imparts a sense of self-control, which is crucial for well-being. Arranging for respite care or help from family or friends will allow you to carve out time for exercise.
Get enough sleep.
It can be hard to get the rest you need, especially if the person you're caring for doesn't sleep well or needs attention during the night. Disrupted or inadequate sleep can lead to increased tension and irritability.
And while insomnia can result from depression, a growing body of evidence suggests that poor sleep may actually contribute to mood and anxiety disorders. One study showed that lack of sleep causes the amygdala, the emotional part of the brain linked to depression and other psychiatric conditions, to react more intensely to negative stimuli.
If you can't sleep well when you're on duty as a caregiver, arrange to get the sleep you need by hiring a respite worker or asking a friend or relative to relieve you overnight once in a while.
See your doctor regularly.
It's easy to get so caught up in meeting your loved one's healthcare needs that you forget about your own. But physical and mental health go hand in hand. Keep on top of your own doctors' appointments and medications just as stringently as you monitor your loved one's care.
If you continue to feel overwhelmed or find that you just can't seem to shake the sadness, tell your doctor. He or she can thoroughly evaluate your symptoms and decide on the best course of treatment, which may involve antidepressant medications, psychotherapy, or both.
