Strategies to Help Deal with Caregiver Depression

Depressive disorders can make one feel exhausted, helpless, and hopeless. Such negative thoughts and feelings make some people feel like giving up. It is important to realize that these negative views are part of the depression and may not accurately reflect the situation.

The National Institute of Mental Health offers the following recommendations for dealing with depression:

1. Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
2. Break large tasks into small ones, set some priorities, and do what you can as you can.
3. Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
4. Participate in activities that may make you feel better, such as mild exercise, going to a movie or ballgame, or attending a religious, social, or community event.
5. Expect your mood to improve gradually, not immediately. Feeling better takes time.
6. It is advisable to postpone important decisions until the depression has lifted.
7. Before deciding to make a significant transition—change jobs, get married or divorced—discuss it with others who know you well and have a more objective view of your situation.
8. People rarely “snap out of” a depression. But they can feel a little better day-by-day by making a few lifestyle changes, including taking medications as discussed with a physician.
9. Remember, positive thinking will replace the negative thinking that is part of the depression. The negative thinking will be reduced as your depression responds to treatment. 
10. Let your family and friends help you.

Direct assistance in providing care for your loved one, such as respite care relief, as well as positive feedback from others, positive self-talk, and recreational activities, are linked to lower levels of depression. Look for classes and support groups available through caregiver support organizations to help you learn or practice effective problem-solving and coping strategies needed for caregiving. For your health and the health of those around you, take some time to care for yourself.

To find support groups: 

1. Call 2-1-1 and ask about caregiver resources likes support groups and education programs.
2. Go to Alz.org which is the Alzheimer’s Association website and look for support groups and education programs.
3. Do a Google search using the words “caregiver support group.”

What does lack of sleep, dementia, and whether you are male or female have in common? Each can contribute in its own way to a caregiver’s increased risk for depression.

Dementia and Care

Researchers have found that a person who provides care for someone with dementia is twice as likely to suffer from depression as a person providing care for someone without dementia. The more severe the case of dementia such as that caused by Alzheimer’s disease, the more likely the caregiver is to experience depression. It is critical for caregivers, especially in these situations, to receive consistent and dependable support.

Researchers have found that a person who provides care for someone with dementia is twice as likely to suffer from depression as a person providing care for someone without dementia. The more severe the case of dementia such as that caused by Alzheimer’s disease, the more likely the caregiver is to experience depression. It is critical for caregivers, especially in these situations, to receive consistent and dependable support.

• Caring for a person with dementia can be all-consuming.
  It is different from other types of caregiving. Not only do caregivers spend significantly more hours per week providing care, but they also report more employment problems, personal stress, mental and physical health problems, less time to do the things they enjoy, less time to spend with other family members, and more family conflict than non-dementia caregivers. As stressful as the deterioration of a loved one’s mental and physical abilities may be for the caregiver, dealing with dementia-related behavior is an even bigger contributor to developing symptoms of depression. Dementia-related symptoms such as wandering, agitation, hoarding, and embarrassing conduct makes every day challenging and makes it harder for a caregiver to get rest or assistance in providing care.
• Women experience depression at a higher rate than men.
  Women primarily wives and daughters provide the majority of caregiving. In the United States, approximately 12 million women experience clinical depression each year, at approximately twice the rate of men. A National Mental Health Association survey on the public’s attitude and beliefs about clinical depression found that more than one-half of women surveyed still believe it is “normal” for a woman to be depressed during menopause.

The study also found that many women do not seek treatment for depression because they are embarrassed or in denial about being depressed. In fact, 41% of women surveyed cited embarrassment or shame as barriers to treatment.

• Men who are caregivers deal with depression differently.
  Men are less likely to admit to depression and doctors are less likely to diagnose depression in men. Men will more often “self treat” their depressive symptoms of anger, irritability, or powerlessness with alcohol or overwork. Although male caregivers tend to be more willing than female caregivers to hire outside help for assistance with home care duties, they tend to have fewer friends to confide in or positive activities outside the home. The assumption that depressive symptoms are a sign of weakness can make it especially difficult for men to seek help.
• Lack of sleep contributes to depression.
  While sleep needs vary, most people need eight hours a day. Loss of sleep as a result of caring for a loved one can lead to serious depression. The important thing to remember is that even though you may not be able to get your loved one to rest throughout the night, you can arrange to get much-needed sleep. Hiring a “respite” or non-medical aid to be with your loved one while you take a nap, finding a daycare center, or scheduling a stay over with another family member for a few nights are ways to keep your caregiving commitment while getting the sleep you need.
• Depression can persist after placement in a care facility.
  Making the decision to move a loved one to a care center is very stressful. While many caregivers are finally able to catch up on much-needed rest, loneliness, guilt, and monitoring the care a loved one receives in this new location can add new stress. Many caregivers feel depressed at the time of placement and some continue to feel depressed for a long time after.

People assume that once caregiving is over, the stress from providing hands-on care will go away. Yet, researchers found that even three years after the death of a spouse with dementia, some former caregivers continued to experience depression and loneliness. In an effort to return their life to normal, former caregivers may need to seek out help for depression as well.

by Zanda Hilger, LPC