Depression and Family Caregiving

Date:

January 30, 2018

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by Zanda Hilger, LPC

Everyone has negative thoughts or feelings that come and go over time, but for family caregivers, the feelings may become more intense and leave you drained of energy, tearful or irritable towards the person they care for. These feelings may be a warning sign of depression. Concerns about depression arise when the emptiness and crying don’t go away, or when those negative feelings are unrelenting. Ignoring or denying your feelings will not make them go away.

Acknowledge and recognize the symptoms of depression. People experience depression in different ways. Some may feel classic symptoms, like sadness and hopelessness. Others may have signs such as extreme fatigue or irritability. The type and degree of symptoms vary by individual and can change over time. Consider these common symptoms of depression. Have you experienced any of the following for longer than two weeks?

  • Feeling sad, tearful, empty, hopeless
  • Changes in eating habits—weight loss and no appetite or cravings with weight gain
  • Changes in sleep—too much sleep or not enough
  • Feeling tired all the time, difficulty being motivated to do anything
  • A loss of interest in people and/or activities that once brought you pleasure
  • Feeling numb
  • Becoming easily agitated or angered
  • Feeling that nothing you do is good enough
  • Increase in alcohol or drug consumption
  • Excessive time on the Internet
  • Trouble focusing, thinking, or planning—as if your head was filled with fog
  • Neglecting your physical well-being and appearance
  • Thoughts of running away, or escaping from the situation
  • Thoughts of death or suicide, ideas of how to end your life
  • Ongoing physical symptoms that do not respond to treatment, such as headaches, digestive disorders, and chronic neck and back pain

If you see yourself in these symptoms, what do you do? Visit your primary care physician. Ask for a complete physical evaluation, including blood work, and take the list of symptoms above that you identify. Some doctors have assessments that they can do in the office, including the standardized Patient Health Questionnaire – PHQ-9.

Some people are surprised when they find out that primary care doctors can prescribe medications to treat depression. Most people are prescribed one of many choices of SSRIs (selective serotonin reuptake inhibitors). SSRIs are a class of drugs that are typically used as antidepressants in the treatment of major depressive disorder and anxiety disorders. Other medications may be used, based on your health and history.

The best outcome for treating depression is a combination of antidepressant medication and psychotherapy (also referred to as counseling, mental health therapy, and talk therapy). These treatments may be used alone or in combination with one another.

Medications

If drug therapy is recommended, a certain amount of trial and error is necessary to find the right type and dosage of medication, and it may take several weeks before you might feel significantly better. Good communication between you and the doctor is important. Older adults should be especially careful to watch for medication side effects caused by too high a dosage or interactions with other medications. Psychiatrists often treat patients who are not responding to medications prescribed by the primary physician or if the person has a complex health history, such as multiple chronic diseases.

Psychotherapy and Counseling

Discussing your situation with a therapist gives you a chance to talk candidly about your situation as a caregiver. Therapy can help you make self-care a priority and develop balanced and healthier lifestyle practices. Exercise, improved nutrition, and learning stress management can significantly improve the quality of life for you as a caregiver. And the healthier you are the better you are able to care for a loved one.

When choosing a therapist, read their profiles online or ask about their experience working with family caregivers. Do they have an understanding of caregiving-related stressors? Having experience working with older adults is also a plus.

Find a therapist by using your health insurance behavioral health benefit. The phone number is on the back of your insurance card. Your insurance company will have a list of providers, probably online, to learn about therapists provide information to the insurance companies about their practice.

Medicare also provides behavioral health benefits. 

Doesn’t it make sense that the healthier you are the better your caregiver situation?

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