Caring for another person, especially when they are struggling to care for themselves, such as a family member or close friend, is an admirable and praiseworthy endeavor. Most of us have had individuals in our lives that we’ve been able to turn to when we’ve needed help, and many of us have aspired to provide the same kind of relief to others.
So when we find ourselves in a position to do just that, it can sometimes be jarring and even a bit unsettling when the “warm fuzzies” don’t stick around for very long.
The truth is, providing support to another human being, whether physical, emotional, mental, or some combination of the three…it’s all a form of labor. Family caregivers often experience chronic stress due to the ongoing demands of supporting a loved one. And like any work, we can only withstand so much before our own reserves of endurance and stamina begin to run dry.
The Overlooked Side of Family Caregiving
Serving as a caregiver is something most of us do at various points in life. From looking after siblings, to raising our own tiny humans, to helping out a friend with a nasty flu, there are plenty of opportunities over the years to exert energy and resources on behalf of others.
Some caregiving arrangements come with higher levels of intensity, however. Be it due to lengthy duration, increased physical strain, heightened emotional burdens, dramatic financial obligations, or a host of other concerns, some commitments hit a little harder than others. What’s more, what a given person can handle will vary from one to the next, or even for the same person across different points in life.
All of this is to say, when you agree to provide care, it’s almost always out of a place of genuine concern and affection. But it can be difficult to keep those feel-good emotions in mind when you’re staring down another long night after months or years of long nights, with no end in sight.
We often see this at the opposite ends of the human lifespan: caring for the youngest and the most senior of our communities.
These individuals often have the most extensive support needs, struggle the most with independence and self-sufficiency, and depending on circumstance, may be the most emotionally strenuous to supervise while also being the most unsafe to leave on their own.
Critically, these are also the arrangements where it’s dangerously easy to slip into routines that make it harder for us to trade out with other caregivers to get time to rest. Informal caregiving, which is often unpaid and provided by family members, can make it especially difficult to access respite or support.
Put a bit more poetically, serving as a caregiver often requires us to run a marathon, but at a sprinter’s pace. The weight of caregiving responsibilities can accumulate over time, increasing the risk of burnout and health decline. Eventually, our legs will give out beneath us.
Why Caregiver Mental Health Matters
Stop us if you’ve heard this one: you’re trying to apply the bulk of your energy and mental fortitude toward helping someone else, but you’re starting to feel a straining sensation…somewhere. However, instead of stopping to address the pulled muscle or bone-deep weariness (as the case may be), you tell yourself something like the following:
“I can’t afford to take a break. I need to focus on them.”
Again, it sounds very admirable on the surface. In practice, it’s akin to ignoring the host of trouble code lights on your car’s dashboard. You know the machine needs maintenance, but you put it off, hoping that you can get around to it at a time that’s more convenient for you (and your responsibilities).
Deep down, however, you already know what’s going to happen. You’ll wait, and wait, and wait. That day you’re hoping for never arrives. And instead, the vehicle breaks down or goes up in smoke at the least convenient moment. You knew you could prevent it. You just…never managed to fit it into the budget or the schedule.
Like the metaphor, though, we can become so focused on using the resources we have to meet the needs at hand, that we forget that if those resources break or run out, we won’t be able to meet those needs at all. Maintaining your own health and monitoring caregiver health is essential to prevent negative mental health effects that can arise from ongoing caregiver burden and stress.
Of course your physical health is important to all of this, and things like exercise and diet can have an impact on other aspects of your endurance and frustration tolerance. Neglecting healthy habits can only contribute to poor health and increased caregiver burden.
But mental health issues can be frighteningly subtle. Psychological health and emotional well being are often affected by psychological stress, which can lead to bigger mental health problems if left unaddressed.
A lot of the time, you can tell when you’re going to wake up the next morning with a stiff back. The same is not true for waking up with major depressive disorder. What’s more, because mental “injuries” are not as easy to put a finger on or quantify, it’s also frighteningly easy to dismiss them in the same way that got you into the current mess.
To be clear, these aren’t value judgements, or character indictments. Mental health struggles aren’t anyone’s fault, even if there are steps that could have been taken to avoid or mitigate them beforehand.
Like the car, sometimes accidents happen or things break unexpectedly. And sometimes we’re forced to ignore warning signs for longer than we know is prudent. Declining health status and increased caregiver burden are common outcomes when mental health problems are not addressed in a timely manner.
These things happen, and we just have to respond the best we can.
Common Mental Health Challenges for Caregivers
Responding appropriately is easier, though, when you know what to look for, and where to go for the proper tools when things break.
We’ve done a similar article about some of these specifics, and we won’t rehash the full details here, but there are a number of key risk factors that long-term caregivers are forced to deal with, and the emotional and physical exhaustion can lead to negative mental health outcomes down the line.
Caregiver and care recipient dynamics, as well as the presence of mental illness, can increase the risk of caregiver depression and psychiatric morbidity among caregivers:
- Heightened stress levels, and sustained periods of elevated stress
- Exposure to significant caregiver stressors, including emotional stress, physical stress, and psychological symptoms
- Poor sleep hygiene, including broken sleep, shorter sleep periods, and accumulating sleep debt
- Difficulty adhering to healthy diet and exercise practices, leading either to reduced quality or preventing improvements
- Feelings of isolation, loneliness, resentment, anger, jealousy, overwhelm, and more
- Increased risk of caregiver burnout and physical illness, especially when caring for someone with complex needs
- Limited access to recreation, positive social interaction, and self-care activities
Any of these on their own, or even all of them and more could be handled under different circumstances, at least temporarily. But when taken together with an indeterminate period of caregiving, there’s no finish line to push toward, and that’s when things start to get dangerous.
Studies have shown that caregiver depression and other mental health problems are prevalent among those supporting individuals with serious illness or mental illness.
Signs of Caregiver Stress, Burnout, and Compassion Fatigue
At first, things will be small, and hard to notice. Things that were endearing become tolerable at best, and things that were tolerable become explicitly irritating. There will be feelings of confusion and disorientation that come and go. And formerly pleasant or exciting things will begin to lose their appeal.
Caregiver health studies have documented the physical morbidity effects and health decline associated with prolonged caregiver stress and burnout.
Over time, things will escalate. Previously, certain annoyances could be addressed calmly and patiently, albeit with effort. Now, that level-headedness is harder to come by, so you either avoid the trigger as much as possible, or risk losing your cool.
Food and sleep become problematic. Maybe it’s too much. Maybe it’s not enough. Maybe it swings back and forth. And maybe you’re getting a reasonable amount, but the quality is so bad as to remove almost all value.
Eventually, simply going about normal, daily activities becomes a slog. Routine hygiene and self-care tasks start to feel like entire ordeals on their own, and some days you struggle to muster the strength to perform them.
Getting out of bed is often the worst moment of your whole day. And the looming threat of another day is almost too much to bear.
You may have slightly different experiences. You may experience some but not all of the above, or these symptoms may have very different presentations. But as things reach their worst, there are a few major red flags to watch for:
- You find yourself running “power save mode,” cutting all non-mandatory activities or process steps out of your day
- Non-negotiables suddenly become near-impossible to maintain (e.g. you always showered daily, but now bathe once a week at most)
- You lose all interest in personal hobbies and interests, and find yourself procrastinating even things you normally enjoy
- Your mental fog has deepened, and you find yourself experiencing periods of full dissociation (e.g. your mind takes a vacation, even as your body goes through the physical motion of regular tasks)
- Finally, you hit “compassion fatigue”—your prolonged exposure to the hardships of those you care for has made you numb to them, and potentially even angry when they mention their distress or discomfort
This isn’t simply about being tired, or lazy, or irritable, or weepy, or standoffish. And again, this isn’t your fault, and it’s not theirs. But these are signs that you need help. And if you’ve reached some of the most extreme symptoms, you need urgent help, both for your well-being and for those you care for.
Independence Is a Virtue, but Isolation Is Not
Human beings aren’t meant to deal with the trials of life on their own; not indefinitely. That’s the whole reason we stepped in to provide care in the first place. We wanted to help.
It’s just all too easy to forget along the way that we, too, need and deserve help.
Many community organizations and health and human services agencies offer support services and resources for caregivers, including respite care, support groups, and access to health care, health insurance coverage, and community living programs.
It is kind to try to shoulder the burden alone, to spare others the difficulty or hardship. But it’s not sustainable, and we risk doing more harm than good.
When needed, it is important to seek help from a mental health professional to access mental health services to support your well-being.
After all, you’re not just a vessel for providing care to your charge. You’re also a person with a life of their own. Supporting caregivers is a public health priority, and organizations like the Family Caregiver Alliance and Alzheimer’s Association provide valuable resources, psychosocial interventions, and caregiver support groups to help you manage stress and maintain your health.
You owe it to yourself to make sure the car can handle the next leg of the journey. There’s still plenty out there for you to see. Connect with a support group, seek respite care services, and reach out to a friend or family member for additional support as you continue your caregiving journey.
Learn more at inhomecare.com where you’ll find diverse resources, practical solutions, and compassionate guidance tailored to the needs of seniors and caregivers.
