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Deal with caregiver depression

Summary

It is common for caregivers to experience symptoms of depression, which range from feeling sad to feeling unable to carry on. This article lists common signs of caregiver depression, some differences between symptoms of depression and burnout, some causes of depression, and some typical treatments recommended by doctors.  

Symptoms of caregiver depression

It is common for caregivers to experience symptoms of depression, which range from feeling sad to feeling unable to carry on. Between 40% and 70% of caregivers in the United States show signs of depression, and one-quarter to half of these have symptoms of major depression.1

Female caregivers experience depression symptoms more often than males, and caregivers looking after people with dementia are twice as likely to develop serious depression as those looking after non-dementia care recipients.2

Some common symptoms of depression include feeling sad or hopeless, feeling worthless or having low self-esteem, losing interest in things one once enjoyed, or a change in eating and/or sleeping habits.


Feeling sad or hopeless

Crying more than usual, feeling “blue” or “down,” or feeling like there is no hope of things getting better can all be signs of depression. These feelings can reach the point of the person wanting to be dead or thinking about ending their life. Anyone experiencing these sort of feelings should call 988 to reach the Suicide and Crisis Lifeline.


Feeling worthless or having low self-esteem

When a caregiver feels like they have no value or criticizes themselves harshly for doing things wrong or for being who they are, these could be symptoms of depression. Strong guilt feelings can also be a symptom.


Losing interest in things

One of the classic signs of depression is losing interest in things you once enjoyed. A depressed caregiver can feel indifferent to spending time with the people they care for or doing activities that usually bring them pleasure. 


A change in eating and/or sleeping habits

Both eating and sleeping much more than usual (called hypersomnia) can be signs of depression. Alternatively, some people may lose their appetite or develop insomnia. It is a good idea for caregivers to monitor their weight and track their sleep patterns.

Burnout versus depression

Many symptoms of depression are identical to those of burnout, and it is possible for a person to be both burned out and depressed. One key difference between burnout and depression is that burnout is defined as a response to a specific work or life situation, such as caregiving, while depression is an internal state that usually will not go away if the situation ends. 

For example, a person experiencing burnout may start to feel better after a few weeks of vacation time, but a person with depression probably will not, and may even feel worse.3 Similarly, many caregivers who have placed their loved ones in a nursing home may feel as depressed and anxious as they did when they were giving care at home.4

Causes of caregiver depression

Depression is a complex mental illness with many interacting causes. Some of the factors that may contribute to caregivers developing symptoms of depression are stress, self-neglect, and isolation.


Stress

Most caregivers report feeling at least some stress, and nearly 40% say their situation is very stressful.5 Stress can throw the brain out of balance, leading to depression. Depression itself can also be very stressful, creating a harmful stress-depression cycle. Sources of stress include constant worry (about the loved one, money, and disruption to the caregiver’s own life), exhaustion, feeling out of control, disrupted sleep, and difficult interactions with the care recipient.


Self-neglect

Caregivers have a strong tendency to start neglecting their own physical and mental health as looking after the care recipient takes over their lives. Eating and sleeping poorly and getting less exercise can affect brain and body chemistry, leading to depression. 


Isolation

Caregivers often start to withdraw from their friends, family, and the outside world, which is known to worsen mental health. As this happens, they may stop feeling like they can cope with social interactions and isolate even more, making the situation worse.

Ways to treat caregiver depression

It is very important for a caregiver who is experiencing any depressive symptoms to talk to their doctor and get a professional diagnosis. Doctors may prescribe therapy, antidepressants, and/or exercise.


Therapy

Speaking to a trained therapist or counselor is often an effective way to reduce depressive symptoms and learn coping skills. There are many types of therapy, including:

  • Cognitive behavioral therapy (CBT). In this therapy a person works to uncover unhealthy thought patterns.
  • Dialectical behavioral therapy (DBT). In this therapy, a person practices accepting uncomfortable feelings and thoughts.
  • Psychodynamic therapy. In this therapy, a therapist helps the person explore the effect of their childhood experiences on present-day situations.
  • Family therapy. In this therapy, members of a family learn to understand and support each other through times when they might be feeling overwhelmed, sad, grieving, stressed, and so on.
  • Group therapy. In this therapy, one or more therapists guide a number of people (usually about 5 to 15) through discussion topics such as stress, depression, anxiety, and loss. 


Antidepressants

Many doctors will recommend antidepressant medications for patients who have symptoms of depression. There is a wide range of antidepressants that doctors may choose from. Often the caregiver will be advised to take medications and therapy together.


Exercise

Even light activity, such as walking several times a week, can reduce depressive symptoms. Exercise releases feel-good brain chemicals and can take a caregiver who is experiencing depressive symptoms out of their negative mindset for a while.

Related information

Adult day care

Anticipate impacts on your personal life

Avoid feeling alone, isolated, or incapable 

Balance care responsibilities

Create a care plan

Deal with caregiver burnout

Find trusted sources of help

Get help and support

Join a caregiver community

Minimize family confusion, disagreements, and frustration

Take care of yourself emotionally

Take care of yourself physically

End notes

1Caregiver Health. Family Caregiver Alliance.
2Depression and Caregiving. Family Caregiver Alliance.
3How Can I Tell if I’m Depressed or Burned Out?. New York Times.
4Caregiver Health. Family Caregiver Alliance.
5Caregiver Health. Family Caregiver Alliance.

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