Caregiver Burnout and Mental Health: Signs, Symptoms, and How to Find Support

For most people, life has periods of giving and receiving care. Individuals in a caregiving role—whether to small children, aging family members, or friends in need—may find that this begins to take a toll. Longer periods of care, especially for individuals who are not likely to improve, can become very taxing and wear down mental health, leading to compassion fatigue and caregiver burnout.

The National Alliance for Caregiving indicates around sixty-three million people in the United States provide care to a family member or loved one. Of those people, around 29% are "sandwich generation" caregivers—people who are providing care to adults and children simultaneously, such as a woman caring for young children and her aging parents. This can create added pressure from either end of the spectrum and make balancing the needs of self and others even more difficult. Furthermore, data suggests this number is continuing to grow year over year as our country ages and the caregiving needs of older adults continue to expand.

How Does Caregiving Affect Mental Health?

Caregiving, while a very important role, is also a responsibility that can come with significant stress and challenges. In an ideal environment with high family support and a strong positive relationship, the daily requirements can still be exhausting. This is no one's fault, but simply the reality of the situation. But few of us live in ideal situations, and when there are additional interpersonal stresses, medical concerns, financial issues, or practical limitations, those factors can magnify the difficulties experienced. Caregivers often experience heightened distress and should be mindful of their own physical and mental health.

What Is Caregiver Burnout?

Caregiver burnout happens when the caregiver becomes overwhelmed, exhausted, or stressed to the point that it has a negative impact on their wellbeing. It may also become harder for the caregiver to be as attentive and caring as they would like to the person receiving care, sometimes leading to feelings of guilt and shame.

Signs and Symptoms of Caregiver Burnout

Common signs and symptoms of caregiver burnout include:

• Fatigue
• Depression
• Irritability
• Anxiety
• Insomnia
• Social withdrawal
• Concentration problems

Left unaddressed, the stress of caregiving can lead to more serious mental health issues that impact not only the caregiving relationship, but other facets of life. For example, a tired caregiver may stop spending time with friends, engaging in hobbies, or practicing healthy self-care. Any mistake or frustration can turn into a reason to berate themselves for failing to meet impossible expectations. It may make the caregiver feel like they are a bad family member or friend—as if they should have no negative feelings about the circumstance they are in. 

Toxic positivity—the pressure to stay upbeat and 'look on the bright side' no matter how difficult things get—can make this worse. When a caregiver hears (or tells themselves) things like 'At least you still have your mom' or 'Everything happens for a reason,' or even just 'You got this!', their real feelings of exhaustion and grief get dismissed rather than addressed, which can lead to further negative emotions, harsh thoughts, and self-destructive patterns. 

Caregiving, Grief, and Anticipatory Loss

Many family caregivers are providing care to someone in declining health. This means grief is often a part of the picture. It can be very difficult to watch a beloved family member lose the ability to care for themselves. This may also bring about anticipatory grief because their loved one may continue to decline in health.

When dementia or other cognitive changes are part of the picture as well, this can dramatically change the relationship between the caregiver and their family member. The person receiving care may not act like themselves, may forget who the caregiver is, or may react with anger, anxiety, or fear that feels unpredictable. Not only is the caregiver then wrestling with their own sense of grief and loss, but the loss of independence can lead to greater friction between the caregiver and their family member.

Many have heard the story of someone who had to take the keys away from their mother because she could no longer drive safely, only to have it turn into a family argument. Often, people outside the home do not have all the information, and this can add more interpersonal stress. In the end, the caregiver may experience a stuck feeling—caught in the middle, wondering if they are making the right decision, and wondering if they are up for the task.

Why Caregiver Support Matters

Taken together, it is easy to see why caregiving is a public health crisis. Many people who love their family deeply and sincerely find themselves in a difficult spot trying to navigate many different needs, emotions, and circumstances. It can become overwhelming.

Research into caregiver mental health has repeatedly demonstrated that support for caregivers is critical not only for their own wellbeing, but for the wellbeing of the people they are caring for. Caregivers may feel they cannot take time for their own physical or mental health needs, but it is crucial that they do.

How to Cope with Caregiver Burnout

The most common recommendations for caregivers dealing with burnout are:

1. Know the resources
2. Take personal time
3. Find support

Know the Resources Available to Caregivers

Resources vary by state and locality, but may include home health, respite care, financial programs, and other options. Often connecting with the state's department for aging, such as Alabama's Department of Senior Services, can help identify local area resources and support groups.

Take Personal Time

Taking time for oneself is a key element, but one that can be much easier said than done. It is easy for a caregiver to lose themselves in the act of caring for a loved one. They may decline social invitations because they feel they must be available for their family. Getting to the gym or spending time on a hobby may not seem to fit into the schedule any longer. Taking a trip or time away? Impossible, because who will look after their family member then? However, creatively approaching these situations and finding ways the caregiver can stay connected to the things they enjoy is important.

Find Mental Health Support for Caregivers

Connecting with support can be a vital part of putting these pieces together. Mental health support can provide tools to manage heightened emotions, correct negative self-talk, dismantle unrealistic expectations, build healthy habits, and find ways to carve out time for positive activities. By using evidence-based approaches, symptoms of anxiety, depression, insomnia, and other mental health needs can be addressed. Treatment may incorporate elements such as mindfulness, cognitive-behavioral approaches, acceptance-based interventions, conflict resolution skills, relaxation training, and many other elements based on personal needs and treatment goals.

Therapy for Caregivers in Birmingham, Alabama and Nationwide

No matter what, it is important to recognize that you are not alone in the caregiving journey, nor do you have to carry it all on your own. Upward Behavioral Health is located in Birmingham, Alabama, and provides services to clients nationwide. If you see the signs of caregiver burnout in yourself, please contact us for a free 15-minute phone consultation so that Upward Behavioral Health can help you take care of you.