By Linda A. Cronin
Providing care for a loved one takes a huge emotional toll on a person. Studies reveal caregivers of a parent experience symptoms of depression twice the rate of the general population, according to the Journal of Public Health. For caregivers of a spouse, the rate is six times higher. Caregivers are too busy taking care of others to take the time necessary to recognize and treat their own symptoms, but self- care is a necessity not a luxury.
“Caregiving doesn’t happen in a vacuum,” said Suzanne Mintz, president and co-founder of the National Family Caregiver Association (NFCA, www.thefamilycaregiver.org ) and a caregiver who has experienced depression. “It happens while life is going on, surrounded by the tension and stress of everyday.”
Mintz explained, “Family caregivers as a rule tend not to reach out” because there is a feeling this is my spouse, parent, or child, I should be doing this. It’s also one thing to ask someone to pick up groceries or watch your children once in a while, but “it’s harder when it’s personal items on an ongoing basis.”
Too often people view depression as a sign of weakness and are embarrassed to seek help. Mintz agrees, “depression has a huge stigma. Too many times depression goes unreported because of the shame and stigma. People feel “they shouldn’t tell because they don’t want it on their record. They believe they should just bear with it.”
According to the National Institute of Mental Health (NIMH), signs of depression include:
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• persistent sad or anxious mood
• feelings of guilt, worthlessness, helplessness, hopelessness and pessimism
• loss of interest in activities once enjoyed
• decreased energy, fatigue
• difficulty concentrating, remembering, making decisions
• insomnia or oversleeping
• loss of appetite or overeating
• thoughts of death or suicide; suicide attempts
• restlessness, irritability
• persistent physical symptoms not responding to treatment
Mintz recommends that if someone experiences symptoms for longer than two weeks, they should contact a doctor who understands depression and who could find appropriate resources. For her, a combination of medication and talk therapy work best, but each person must make their own plan with their doctor.
“It is important to let people know when you are depressed,” said Mintz. “They’ll wonder why you are behaving differently and not doing things. And, knowing people care helps bring you back,” she said.
“Exercise is good for warding off depression as well as during a depressive episode, but it is a catch-22,” said Mintz. “When you’re depressed, you’re tired and don’t want to exercise.”
Researchers have learned that caring for a person with dementia places the caregiver at higher risk of depression. As difficult as watching a loved one deteriorate, often it’s the everyday challenges of caring for someone with dementia that overwhelms the caregivers and makes it more difficult to get assistance.
Women provide the majority of caregiving, and are at higher risk of depression. According to the NFCA, approximately 12 million women experience clinical depression each year, approximately twice the rate of men.
Men have a harder time admitting to being depressed and are more likely to self-medicate their feelings with alcohol or overwork. Men tend not to have many friends to confide in or positive activities outside the home.
Loss of sleep due to caregiving responsibilities can contribute to depression. Caregivers need to consider hiring respite care workers for the night so they can get a good nights rest.
Depression often persists after placement in a care facility. The decision to move a loved one to a care facility can be very stressful. Caregiving does not stop; it simply changes with placement in a facility, added Mintz. “Even after the caregiving stops, it is a couple of years before the caregiving impact wears off.”
“Family caregivers don’t put their own health at any sort of priority,” said Mintz. What they need to realize is “there is no line of people behind you waiting to take over the caregiving. Your own health is the best present possible.”
Family caregivers need to develop community support. Mintz mentioned Web sites such as www.sharethecare.org/ and www.lotsahelpinghandss.com/, about putting together volunteers, or www.carepages.com, a way of sharing information. “But people need to put aside the shame and reach out.”
Friends and neighbors need to be part of your support system. “There are people willing to help but you need to be the one who asks and tells the kind of help you need. Caregiving is more than a one-person job”
Linda A. Cronin is a frequent contributor to Action.
