When you live with someone who is clinically depressed, there will be days when you’ve got it as tough as they do. Taking care of a loved one—whether it’s a child, partner, relative, or friend—can leave you just as debilitated, in pain, and wracked with frustration as they are. Having a hard time while your loved one is dealing with mental health issues can be like a guilty secret: it’s there, but no one wants to acknowledge it. Unfortunately, in many cases there aren’t a lot of resources available to caregivers. That might make you try to hide your discomfort, which only makes it worse.
For the person living with depression, life may be a constant fight. What looks from the outside like giving in often feels on the inside like consistent effort—when you’re depressed, it can take great exertion just to get out of bed, get dressed, and go to the grocery store. For the person who hopes to care for the sufferer, it’s hard to figure out how best to help. Your great ideas to motivate and distract your loved one might feel too difficult for them, and might even be seen as pushing too hard or having expectations they can’t possibly meet.
Many times, your day will be dictated by their mood, which may leave you feeling some of the same symptoms. If they wake up feeling bright, you can breathe a sigh of relief that your mood may be similarly light. If they come home from work in a funk, you may feel your night is ruined. Consumed by tracking their emotional temperature, they can feel like a tide that sweeps you away.
The hardest part is this: Because you aren’t the one who has the diagnosis, you aren’t supposed to be in pain. Not only are you given little attention or help, but you might call yourself selfish or petty when you feel your own symptoms. When that happens, it’s adding insult to injury—in addition to going through the difficulties of your situation, you’re mad at yourself for not being a superhero or a saint and rising above every challenge, every reaction.
You’re not alone. Many caregivers experience burnout. These are some of the symptoms:
Symptoms of Caregiver Exhaustion
Fear of the Future
One of the main worries when living with someone who is suffering is, “Will this ever end?” The person you knew in the past seems to be gone. The future plans you’ve made together are in jeopardy. Your role has changed. This is not what you signed up for, and you’re not sure you can handle it forever.
With depression, the good news is you can always count on some sort of change. If the condition had a sudden onset—illness, accident, trauma—then it’s possible that as the situation stabilizes, so will their mood. If your loved one has always experienced some degree of depression and it’s recently gotten worse, there is a high likelihood the right combination of medications, therapy, and coping skills will dial the intensity down.
You may never free your life completely of depression. But it tends to be a cyclical condition, with ups and downs, so it rarely stays the same. So, while there is no answer to the question, “How long will this last?” at least you can count on having better moments, and often stabilizing.
Desire for an Escape
No one wants to yearn to get away from the person they love, but when that person acts consistently negative or helpless, it’s a common reaction. And a natural one. Remember there’s a difference between feelings and facts. You can feel rebellious and fantasize about leaving, but act responsibly and stay put.
If you feel trapped, unable to leave or even to take some time off, then it’s important to find as much support as possible. If you have the resources, hiring caregivers or alternative healers can be not only helpful to kick-start your loved one’s recovery, but also to give you some rest. You need a team, whether that’s paid professionals or friends and relatives, to help both of you. Hire a masseuse, personal trainer, or life coach. Ask a friend to come play cards, read books aloud, or cook dinner. Your need to break away is normal and is a strong signal you’re experiencing what therapists call compassion fatigue.
Helplessness and a Thwarted Desire to “Fix” Your Loved One
Are you a researcher? If looking for answers makes you feel more productive, it can feel useful to check out all the different avenues to healing, such as EMDR (eye movement desensitization and reprocessing), TMS (transcranial magnetic stimulation), supplements, and electroshock. Many have provided relief to people who have tried other avenues without success.
If you’ve exhausted the possibilities, however, or have limited resources to keep trying new things, then you can easily sink into dejection. Here’s where acceptance comes in, and trying to avoid black-and-white, all-or-nothing thinking. Your loved one won’t always be like this. You might need to give yourself a breather from “fixing” before you can move on to new ideas. Or you might need to adopt a more tolerant point of view, a sense that if this is “the new normal,” perhaps there are ways to make it livable.
Anger and Guilt
The top two emotions experienced by caregivers are anger and guilt—two sides of the same coin. Anger is the more active of the reactions, and its target can be your loved one, the condition, yourself, God, or doctors. Everyone who is tired, anxious, and worn out will at some point feel anger.
And from the outside, it makes sense to resent your loved one. It is an unfortunate symptom of depression that it makes people feel helpless and hopeless, which means that from the outside, they may look like they aren’t trying. As a caregiver, knowing your wife isn’t doing any of the things prescribed to her—like exercise, medicine, or socializing—can appear to be a lack of effort, and can make you frustrated and powerless.
Try to see your guilt as a misdirected signal of how much you care. And then do more self-care to nurture yourself through these difficult waves of feeling.
It’s common, though misplaced, to blame yourself for your loved one’s condition. You might tell yourself you didn’t do enough to head it off, or that you’re not sacrificing enough to cater to them. Each social event or night off becomes a land mine of remorse.
Most of all, you can feel guilty for all of the above reactions, especially anger, because you love the sufferer so much and want so much to help. Try to see your guilt as a misdirected signal of how much you care. And then do more self-care to nurture yourself through these difficult waves of feeling.
I hope it’s clear from reading this list that the sum of all of these feelings leads to exhaustion and burnout. But if that’s where you are, there are steps that may allow you to take back control in your life.
How to Look Out for Yourself
You Need Self-Care as Much as Your Partner
When they struggle, you struggle. Your pain is just as important. Taking good care of yourself helps them at the same time, in two ways. First, you’re increasing your strength, patience, and ability to look after them. And second, you’re modeling the very skills that your loved one needs to do more of. By setting a good example, you can motivate and inspire.
It’s okay to say no. Even if your loved one is unable to manage their life, that doesn’t make their life all your responsibility. Decide for yourself how you can best support them and allow the rest to remain undone. Maybe you have skills at finances or cooking and want to take over those tasks. Or maybe it’s clear where the most pressing needs are and you’re willing to take those on. But remember you cannot do everything—nor should you. It can be helpful to the depressed person for you to insist they shoulder some of the responsibility for their life. This can help focus and motivate them. So when it’s reasonable (not during a major breakdown), insist on some reciprocity.
Be Mindful and Practice Acceptance
Many people try to fight discomfort by either fretting over it (fight) or distracting from it (flight). Paradoxically, modern approaches teach instead that sitting with the negative feelings is the quickest way to master them. If anxiety is worry about the future and depression is sadness over the past, then usually the present moment is, if not perfect, at least more bearable. By taking some of the tenets of mindfulness—staying in the moment and noting your reactions without judging them—you can deal with difficult times with more patience and less pain.
Try Not to Buy into Distorted Thoughts
When we’re thinking negatively (stinkin’ thinkin’), our thoughts tend to fit into the same negative slots over and over. Experts call these cognitive distortions, and they include jumping to the worst possible conclusions, seeing the world in all-or-nothing extremes, and blaming. Being able to label those thoughts as inaccurate, or as symptoms of depression, helps us put less stock in these exaggerations and think in a more evenhanded way.
Get Help and Support for Yourself
When you’re starting to feel extra irritable, getting sick more often, and not seeing your friends for weeks, these are all signs you need more. More exercise, more rest, and most importantly, more people around you. If you don’t want to go the professional route, you might be surprised at how much your friends and family members are willing to help. And if you prefer to speak to someone impartial, there are therapists who can provide a safe space to vent your feelings. Finally, support groups for caregivers offer a space where everyone will understand and empathize with what you’re going through. Whatever you choose, know help is available—and it is not only acceptable, but often necessary, to reach out.
© Copyright 2017 GoodTherapy.org. All rights reserved. Permission to publish granted by Vicki Botnick, MA, MS, LMFT, therapist in Tarzana, California
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