Mental illness often takes a heavy toll on sufferers both physically and emotionally — in fact, studies have found that it may damage overall public health even more than cancer and infectious diseases.
Caregivers often are overlooked in discussions of mental illness. Nearly half of Americans will suffer from depression at some point in their lives, and about one in 17 currently suffers from a serious mental illness, Scientific American reports. For many people with mental illness — including children and adolescents, the elderly, those too disabled to function on their own and those unable to access formal treatment — caregivers play a major role.
Despite the clear benefits they provide to those suffering with mental illness, caregivers often experience conflicting emotions. Disbelief, anger, frustration and shame are common feelings for someone fulfilling the demanding, complex role of a caregiver. In some cases, caregivers eventually are diagnosed with mental illnesses of their own.
The link between caregiving and mental illness
Research shows that caregivers suffer from depression and stress at a higher rate than other people, according to the American Psychiatric Association. The risk rises as an individual spends more time providing care, and women caregivers suffer the highest risk of depression, poor health, stress and anxiety. A recent study found that a third of individuals who provide care do so even as their own health becomes poor.
Although women caregivers are at highest risk of depression, men can develop the condition as well. The Family Caregiving Alliance reports that male caregivers handle depression differently than women and often are less likely to acknowledge their symptoms. The condition also is less likely to be diagnosed in men, and some tend to self-medicate with alcohol or by working too much. Men who provide care often are more willing than women to hire someone to help, but they also have weaker social networks to provide emotional support.
There’s no disputing that caregiving for someone with mental illness is a source of increased stress and that caregivers suffer a higher rate of depression than the general population. However, recent research has shown that outcomes for caregivers depend on a number of factors, according to a 2014 study from the University of Washington published by Science Daily. Genetics and upbringing play a large role in correlations between caregiving and various types of psychological problems — including anxiety, depression, stress and overall mental health — the research found.
If an individual has battled depression in the past, becoming a caregiver may exacerbate the condition. But for individuals who have not suffered from depression in their lives, they’re no more likely to develop it as caregivers, the research showed.
Genetic disposition appears to play the most prominent role in determining whether an individual caregiver will develop a mental illness. However, the perception of feeling stressed seems to correlate most closely with the environment in which a caregiver grew up. A caregiver from a home in which parents demonstrated high levels of fear relating to illness or unemployment is more likely to feel stressed as a caregiver.
So, while caregiving is not believed to directly cause anxiety, depression, an increased perception of stress and other mental conditions, it certainly can intensify it in people who are predisposed — through genetics or upbringing — to depression and other forms of mental illness.
Warning signs of caregiver stress
Caregivers who are suffering from excess stress and possible burnout may notice warning signs including a decrease in energy, according to the American Psychiatric Association. In addition, caregivers may have trouble unwinding and enjoying relaxation, even when additional help is available.
Even after resting or sleeping, stressed caregivers may feel worn out all the time, and they may get sick more often than most people. Often, caregivers don’t pay sufficient attention to their own needs because they’re too busy, but stressed caregivers may even lose all motivation for doing so. They may find themselves becoming irritable and impatient with the person for whom they’re providing care. And, they may feel hopeless or overwhelmed.
Effects on individuals receiving care
A study published by the American Psychiatric Association found that caregiver beliefs about the reasons the people they care for suffer from mental illness influence patient outcomes. For instance, when caregivers believe depression is due to problems with cognition or attitude, patients are less likely to take their medications as prescribed. In addition, in patients in the study who suffered from bipolar disorder, the amount of stress on caregivers also affected frequency of taking medications as directed.
The study’s authors stress the need to educate caregivers about the impact their beliefs and mental state have on patients’ behavior. They found that having caregivers get involved in treatment can enhance their attitudes about patients with depression and improve outcomes for patients. And they stressed that in determining whether patients took their medications, social support played a large role. That same network of social support would be available to caregivers in such situations.
A 2014 study published by Science Direct noted that social support and stress levels within families affect the health of both caregivers and children being cared for. In addition, the study found, mental and physical health of caregivers influences the quality of care provided and can mitigate negative effects of family stress and lack of social support.
Caregivers’ need for social support
A 2015 study published in the American Journal of Community Psychology found that social support protects the mental health of caregivers. The study found that improved social support for caregivers also improved psychosocial outcomes for individuals in South African communities.
The 2014 University of Washington study corroborates this finding, noting that the ways in which caregivers respond to excess stress depend largely on their support network — including their financial status, coping skills and availability of social support.
How caregivers can manage stress
Caregivers can reduce stress using a number of methods, WebMD advises. Biofeedback can help a caregiver — working with a professional — make physical changes to their bodies that assist with relaxation. Biofeedback sessions involve using electrodes to track heart rate, muscle tension, blood pressure and other indicators of stress, then learning intentional relaxation techniques to control the markers.
Guided imagery can help achieve a calm mental state as a caregiver considers peaceful mental pictures such as beloved places. Caregivers also can achieve changes in their thoughts and behaviors by sharing feelings, practicing active listening and becoming more assertive.
Various relaxation techniques also can help caregivers achieve a peaceful state of mind. For example, a simple two-minute relaxation involves being aware of breathing, loosening areas of the body that feel tight, rolling shoulders and rotating the head as pleasant thoughts flow through the mind.
The American Psychiatric Association advises that in addition to making use of techniques for reducing stress, caregivers should ensure that they take time to exercise regularly, get enough rest and eat well. They also should take time for themselves and participate in activities they enjoy.
Caregivers should seek the support of other people and accept it when it’s offered, the association advises. If needed, they should seek out professional counseling services, and they should set and work toward their own personal goals.
Because caregivers have a higher risk of developing mental health problems than the general population, the American Psychological Association recommends being screened. Even when caregivers do not believe they have issues with mental health, screening can be beneficial in identifying elevated risk factors, the association notes.
Seeking support
Providing care to a loved one suffering from mental illness is a taxing, demanding role that leaves some caregivers stressed and others suffering with their own mental illnesses. Although caregiving does not directly cause mental illness, it can result in decreased attention to the caregivers’ physical and emotional needs and can cause feelings of anger, anxiety, isolation and guilt, the Family Caregiver Alliance notes.
The strain of providing care on a daily basis takes a toll on just about every caregiver at one time or another. Before feelings of negativity, overwhelm or exhaustion become overpowering, caregivers should set aside time to care for themselves, seek out social support and enlist professional help when needed. Furthermore, when professional help is required, it is important to carefully choose the best option for your loved one suffering from mental illness. It is critical to obtain an accurate diagnosis and to match that it with a program that specializes in that specific diagnosis.
At Pasadena Villa, an individual is considered a candidate for residential treatment when the needed therapy services are too great to integrate into the family’s life pattern or, the impact on the family is just too disruptive for successful treatment if they were to remain at home. Residents admitted are selected on the basis of individual diagnostic assessments and must be medically and psychiatrically stable.
The primary consideration in each case is the determination of an applicant’s ability to benefit from the therapeutic program offered. The choice of residential treatment is made when there is a wide range of severe disturbances and it is necessary to protect development; the severity and complexity of these disturbances require constant supervision within a structured, therapeutic setting.
Pasadena Villa creates a comforting and therapeutic environment for those suffering from mental illness. We believe in treating all residents with compassion, and our programs are designed in ways that preserve and protect their dignity. We do common activities that many families do. Our staff and residents learn and model appropriate social and communication skills, from daily mealtimes, to many enjoyable social and recreational activities.
Our mental health professionals work directly with residents. They observe them in actual social situations and incorporate these observations directly into the resident’s ongoing treatment plan. This individual, real life personalized attention makes the Pasadena Villa treatment experience more appropriate and beneficial for each of our residents, especially when compared to any other available adult residential treatment mental health services.
Pasadena Villa’s Smoky Mountain Lodge is an adult intensive psychiatric residential treatment center for clients with serious mental illnesses. Our outpatient center is located in Raleigh, North Carolina. We also provide other individualized therapy programs, step-down residential programs, and less intensive mental health services, such as Community Residential Homes, Supportive Housing, Day Treatment Programs and Life Skills training. If you or someone you know may need counseling on mental health services, please fill out our contact form or call us at 407-215-2519 for more information.
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