It can be difficult for those who do not live with depression in their household to understand just how all-consuming this illness can become for other family members. It is not just the person with depression that suffers, others around have their lives impacted, and that goes double for anyone who is an active caregiver.
What Is A Caregiver?
A caregiver is anyone who devotes a significant amount of their time to looking after someone who has an illness, condition, or disease. You do not have to be medically qualified or paid to be considered a caregiver, in fact, most caregivers are not paid nor given any training or education to help them cope. Most caregivers are family members, spouses, children or siblings who simply look after their loved one because there is nobody else to do it.
According to The Family Caregiver Alliance, approximately 43.5 million caregivers have provided unpaid care to an adult or child in the last 12 months in the US. These caregivers spend an average of 24.4 hours a week providing care, and those who live in the same house as the one they care for, provide 41 hours or more a week. These services have an estimated economic value of $470 billion (2013 figures), and yet there is little support for people who provide care in this way.
Caring For Someone With Depression
Caring for someone with depression can be especially challenging. Those with significant mental health challenges can refuse to take their medications, reject efforts to help them and withdraw into a dark and dangerous place.
Sometimes you cannot rest properly at night because you are afraid the person for whom you care might attempt suicide. Alternatively, it may be impossible to sleep because they are going through a manic phase and vacuuming at 2 am and putting up shelves at 4 am.
You might stop making social plans because you often have to bail out at the last moment when you are needed at home. You begin to plan every aspect of your life around how well or otherwise the person you care for will cope. Finally, you become physically, mentally and emotionally exhausted and it is no wonder that so many caregivers end up very ill themselves.
The Physical, Emotional And Mental Impacts Of Caring
If you are a caregiving spouse and you are experiencing mental or emotional strain, your risk of dying is 63 percent higher than that of people your age who are not caregivers. Family caregivers have an increased risk for excessive use of alcohol, tobacco, and other drugs and studies show that an estimated 46 to 59 percent of caregivers are clinically depressed.
Caregivers are also more likely to develop chronic illnesses such as high blood pressure, high cholesterol and a tendency to become overweight – with all of the associated health impacts that bring.
Identifying Signs Of Caregiver Stress
There are many warning signs that you are under too much stress, but when you are a caregiver, you typically focus on the person you care for and not on yourself.
Common physical signs that you are suffering from too much stress include:
Excessive fatigue – not just the typical “I’ve had a busy day I need to put my feet up” kind of fatigue but the “I have just got out of bed, and already I feel exhausted. I don’t know how I am going to get through the day” kind of fatigue
Loss of appetite or other changes in eating habits
Difficulty falling asleep or other changes in your regular sleeping patterns
Changes in smoking, alcohol, and drug use habits
Changes in libido
An increased susceptibility to colds, flu, and other common infections
Common emotional signs include:
Feeling unable to cope, helpless or inadequate
An increase in sudden mood swings or anger about your situation
Feeling isolated and alone
An inability to connect with other people
Crying more frequently
Expressing denial about your loved one’s illness
Common mental signs include:
Difficulty making decisions, concentrating or paying attention
Memory issues, especially with short-term memory
Sudden bouts of confusion over what you are doing
An inability to problem solve or complete complex tasks
If you suffer from these issues occasionally, and they are not having an impact on your ability to function, just stay aware of your situation. Remain alert for any additional symptoms that might indicate you are under too much stress.
If you are suffering from a number of these issues and you are suffering for a prolonged period, then you have to take a step back. Look at what you can do to reduce your stress and take care of yourself better.
What Stops You from Taking Care Of Yourself?
There are many personal barriers that prevent a caregiver taking care of themselves. A caregiver often worries about the impact looking after themselves will have on their loved one. Ask yourself the following questions.
Do you think you are selfish if you put yourself first?
Do you feel you have to prove yourself as a good caregiver?
Is it overwhelming to consider your own needs?
Are you frightened of what might happen if you put yourself first?
If you answered yes to any of these questions you are not alone. Most caregivers have the same issues, but when you start to take care of yourself, you will realize these worries are unfounded.
How To Take Care of Yourself
The first steps to self-care are usually overwhelming, but once you begin to look after yourself, you will see that a happier, healthier you actually provide better care for your loved one.
Ask For Help And Accept Help When It’s Offered
How many times has someone asked you how you are and you’ve automatically said ‘fine?’ How often has someone asked if they can lend a hand, but you turn them down because it just seems easier to do things yourself than to show someone else how to do it?
Tips for getting help
Instead of these automatic responses learn to say you are not doing so well. ‘I could be doing better’ is a good answer because it gives the other person the option to pursue the conversation if they want to. That way you can be comfortable that they really are interested and not just being polite.
To accept help more readily, prepare a list of things people could do to help you out. That might be going shopping, cooking a meal, pushing around the vacuum or watching the person you care for while you get some time to yourself. By having this mental list, you avoid the auto-response of ‘no thank you’ because you feel you do not have a chance to organize a suitable task.
If you are going to ask for help try matching the skills of the person you are asking, to an appropriate task. A friend who likes cooking might be happy to prepare some meals to stock up your freezer, and a friend who dislikes going out might be glad to sit with your loved one for a half hour to give you a break.
Make it easy for the person you ask to say yes. Be specific about the task and the time frame involved. This way the person you are asking doesn’t have to worry about getting in over their head. You should also practice asking for help without apologizing. Don’t say ‘I’m sorry to ask you but would you mind helping me out?’ Instead, say something like ‘I have a doctors appointment on Tuesday. Could you stay and watch over Alice from 9:00 am ‘til 10:30 am so I can go on my own?’
Make The Doctor Your Friend
Building a relationship with your family doctor makes it much easier for you to receive help both for the person you care for and for yourself. This enables you to share some of the responsibility you feel for your loved one’s needs, with a professional you can trust. It will also allow your family physician to care for you more easily.
Tips for building a relationship with your doctor
Book the first appointment of the day or the first appointment after lunch. This will minimize waiting times and allow you to feel less rushed.
Make a list of questions or concerns ahead of your appointment. This way you are less likely to feel overwhelmed by trying to remember everything.
When you make your appointment ensure you say what you want to see the doctor about so you can be allocated enough time.
Take someone with you. If you feel uncomfortable explaining that you are having difficulty coping or if you are likely to downplay the seriousness of your condition, it may help to have a trusted friend convey the reality of the situation.
Listen To Your Emotions
When you are caring for somebody with depression, it can be particularly challenging to keep on an emotionally even keel. Not only do you have all of the issues that other caregivers have but you have the added challenges that depression brings.
A loved one with depression may be unable to get out of bed at all, or they may have sudden mood swings doing and saying awful things while they are unable to cope with their emotions.
This can lead you to have conflicting feelings about yourself, your role in life, and your loved one. Your emotions are messages to which you need to listen. They are conveying information about what is happening in our lives, and both positive and feelings have their place. Your emotions could be telling you:
You are grieving for the life you used to live or the person your loved one used to be
Your stress levels are increasing beyond what could be healthy for you
There is a change required in your caregiving situation
You need to put yourself first
Tips for listening to your emotions
Do not try to push your feelings aside. You may not be able to deal with them when they occur but take the time to examine them at a later date.
Think about what you are feeling and be specific about what emotion you are experiencing.
Do not try to judge your feelings or yourself for feeling them. Just accept them.
Write down the strong feelings you have and try to make a note of what was happening before those emotions arose.
Do not minimise ‘small feelings’ By pushing things aside because you do not think they are important you can build up a significant accumulation of negative emotions.
When you have identified your emotions take steps to deal with them.
Set Personal Goals
To begin with, you can think about some of the things you might want to do in the next three to six months. There do not have to be complicated, just important to you. Some examples could be:
Go and watch a movie
Have a weekend off from caregiving
Get help with your caregiving
Eat more healthily
Get some exercise
Once you have set yourself one or two personal goals you can make a plan that will allow you to take little steps at a time, for example:
Goal: Get some exercise
Have a checkup at the doctors to make sure exercise is safe for you.
Identify the best time of day to take a fifteen minute break.
Go for a ten-minute walk once a week, gradually increasing to three times a week.
Try different solutions
Once you have set yourself a goal and broken it down to bite-sized pieces, look at ways you can make it happen. List all of the possible solutions to the roadblocks, no matter how unlikely you think they are to work. If you need to make a doctors appointment for yourself you might try:
Making an appointment and taking your loved one with you
Calling your doctor’s office and asking if there is a way for you to be in an appointment privately while your loved one is watched over in the waiting room
Asking a friend or family member to watch your loved one while you go to the doctors
Contacting a paid caring service to look after your loved one for an hour
Asking local caregivers organizations for help
And so on
Instead of deciding before you start that none of that will work try each one, starting at the top of your list and work your way down.
After you have tried each solution assess how effective it was and if it did not work move onto the next one. If none of the solutions work promise yourself, you will revisit that goal in three months and move onto a different goal.
Simple Goals To Aim For
Take a break every day. This is not two minutes in the kitchen while the kettle boils. A proper break (should be) at least 15 minutes away from the person you are caring for and anything to do with their care.
Enjoy a good book. Take the time every, or every other day to read a book that has nothing to do with depression or treatments. Choose a book into which you can escape and carve out the time to read at least a couple of chapters at a time.
Take a bath. Plan a long, luxurious soak. Get yourself some special bubble bath or bath oil, some scented candles and a bottle of wine. Whatever would make it a special, indulgent event for you. Make sure you relax into it and pamper yourself.
Go to a movie. Plan ahead of time and buy your ticket online, so you are less likely to cancel at the last moment.
Exercise. You could schedule this with a friend so that you won’t cancel. If you can exercise outside the fresh air and the sun will energize you. If you are unfit, then start with something that will make you feel more relaxed, such as Tai Chi, yoga, or walking.
Eat Healthier. It will take a few days for the difference to begin to kick in, but as soon as you start eating healthily, you will have more energy, feel better physically and have a more positive mental outlook. If someone offers to help, ask them to prepare some healthy snacks that will keep in the fridge for several days. This way you will have a healthier alternative on hand, even when you are exhausted.
Take care of your own health. Caregivers often neglect their own health and end up becoming sick or injured. Take a visit to your family doctor and have a physical. If you are sick rest and look at the other suggestions on this list to help you lead a generally healthier life.
Get better sleep. Stick to a sleep schedule if you can, going to bed at the same time every night and getting up at the same time every morning. Try to take the time to wind down before you go to sleep. Do not eat or drink anything with caffeine, eat a large meal or drink alcohol for four hours before bed. Make sure your bedroom is dark, quiet and cool and if your sleep is interrupted then try and nap during the day.
Stay social. You may feel that nobody understands what you are going through or that you no longer have the energy for friends. Having a good support network has been proven to improve your health and your outlook on life. If you feel that getting out to socialize is too much to start with reach out to someone by telephone or have a chat on social media.
An accidental at home Mom of 5 and lover of all things she can do without leaving the house, Patricia Barnes works tirelessly to raise a family that thrives despite mental illness. When she isn't resisting social events she can't attend in pajamas, she brings hard-earned experience and practical advice to Sad Runner so that others know how common mental illness is.