Understanding Caregiver Stress Syndrome

When the demands of caregiving affect you on all fronts, it’s important to seek help.

A woman dealing with stress; Getty Images

This article is based on information provided by Philips Lifeline.

The responsibilities of family caregiving can easily drain the reserves you rely upon to battle stress. Yet, because you’re so focused on your loved one’s needs, you may ignore signs that these demands are taking a toll on you. When physical, emotional and mental stress symptoms consistently manifest together, it’s called Caregiver Stress Syndrome (CSS).

If you have any of the symptoms, it can help to discuss them with a skilled healthcare professional. Symptoms of CSS are:

  • Isolating. Licensed marriage and family therapist Colleen Mullen, PsyD, LMFT, of San Diego describes this as “withdrawing from your normal activities and avoiding others so you don’t have to keep talking about your life.” Learn more about dealing with caregiver isolation.
  • Sleep difficulties. You may have a hard time falling asleep or remaining asleep due to hypervigilance, back and shoulder pain, or getting easily frustrated or angered, etc., according to Iris Waichler, MSW, LCSW, author of Role Reversal: How to Take Care of Yourself and Your Aging Parents. Rather than awaking rejuvenated, you’re still tired when you get out of bed.
  • Trouble processing. The capacity to focus, organize, prioritize and manage your day-to-day life (referred to as “executive functioning”) is negatively affected. “Sometimes when we become overwhelmed, we don’t even know where to start to ask for help or who to ask,” explains Houston-based Amy Rollo, MA LPA, LSSP, LPC-S.
  • Compassion fatigue. “Compassion fatigue is often described as a loss of caring about those you are serving, often to a degree of feeling irritated by their problems,” Rollo says. “Everyone is susceptible to burnout, only those giving of themselves as helpers and caregivers experience compassion fatigue.” Experiencing this symptom is not an indication that you can no longer feel compassion. Rather, this ability may simply be overwhelmed by the continual responsibilities you have as a caregiver.
  • Anger and frustration. As a caregiver, you may begin to depersonalize, “becoming cynical and sarcastic about the person you are caring for and/or flying off the handle over small things the person you are caring for does,” notes Jill Johnson-Young, LCSW, of Central Counseling Services in Riverside, Calif. Some caregivers experience what’s known as reduced accomplishment. This is “a sense of hopelessness or pointlessness – ‘why bother cleaning it up, it’s just going to happen again’ or ‘does any of this really matter?’” according to Johnson-Young. This is frustrating. Read about dealing with conflict.
  • Guilt. “Guilt, which often arises when a person feels that they have done something wrong, insufficient or socially inappropriate, can create a great deal of stress” explains clinical psychologist Carla Marie Manly, author of Aging Joyfully. “Feeling guilty does not necessarily mean that anything wrong or inappropriate has been done, only that one feels—or is made to feel by others—that guilt is an appropriate response. In general, a greater sense of feeling guilty will result in a greater level of stress.”
  • Physical maladies. These can include diminished appetite, increased alcohol and substance abuse, and weight changes. According to Waichler, caregivers may also develop medical issues such as high blood pressure, headaches and intestinal trouble. Back problems are another serious issue for caregivers who move or lift the people they care for.
  • Mental health issues. If the above physical and emotional symptoms of caregiving go untreated, they can lead to mental health conditions, like anxiety and depression. Anxiety is characterized by feelings of worry and tension, and can cause high blood pressure, as well as other medical problems. Signs of depression include loss of interest in and enjoyment of life, decreased energy, trouble concentrating, dramatic changes in weight or sleep habits, and feelings of worthlessness or guilt. Therapy may be needed to treat any of these serious conditions. See more about depression in Alzheimer’s caregivers.

It’s important to pay attention to any one or two of these symptoms. “I’ve seen caregivers get so wrapped up in their role that they skip their own doctor’s appointments and neglect their own medical health,” Michael Bobrowski, director of social services for United Hebrew of New Rochelle. “Caregiving can be emotionally draining and physically taxing. Ignoring our own stress can be harmful to our health, and potentially, the health of the loved ones we are caring for.”

If you’re experiencing any symptoms of CSS, you may tell yourself you can handle them by yourself. You may feel you’re too busy or lacking in resources to get the help you need. But it’s important to speak with a nurse or doctor about what’s going on and to be open to any assistance they provide. Even if you initially feel self-conscious or embarrassed, remember that you matter, and are just as deserving of care as your loved one is!

If time and money are tight, set aside a few minutes to talk to the nurse at your physician’s office. Nurses can be an excellent resource for a wide array of information. They can often give you pointers on how to access programs that minimize costs or reduce time, like prescription drug discounts, online therapy services, affordable health clinics and community resources for you, as well as for your older family member.

Reaching out for help doesn’t mean that you’re weak. On the contrary. When you make good choices on behalf of yourself and your loved one, it shows that you’re strong. Addressing your needs on all levels—physical, emotional and mental—will make you a better caregiver. When the going gets tough, even the strongest of us need a helping hand!

Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be suffering from a healthcare condition.

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