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When loved ones are experiencing long-term health issues, we naturally feel compelled to devote every moment we can to see them through this difficult period. The stress of dealing with their care, however, either in person or long distance, can lead to problems the caregiver doesn’t even recognize.

That’s why the concierge family practice doctors at MD 2.0 in Jupiter, Florida, would like to take a look at the stress often encountered by caregivers and offer some suggestions on how to alleviate the resulting health issues.

Types of caregiver stress

As a 2009 study by the National Institutes for Health (NIH) reported, “The associations between physical and psychological health and being an informal caregiver are well established. Caregiving has all the features of a chronic stress experience: It creates physical and psychological strain over extended periods of time, is accompanied by high levels of unpredictability and uncontrollability, has the capacity to create secondary stress in . . . work and family relationships, and frequently requires high levels of vigilance.

In other words, these are precisely the circumstances encountered by soldiers in battle, and can similarly result in the symptoms of post-traumatic stress disorder (PTSD). Caring for an ill loved one over a long period of time is so stressful, in fact, that it is used as a model for studying the health effects of other types of stress, the NIH added.

The impact of caregiving on those who are providing it depends in large part on the length and type of care required as well as the stress of dealing with finances, paperwork, and any associated family tensions that might arise. Someone who has a fairly manageable long-term illness, for example, might create less stress in their caregiver than someone in the advanced stages of Alzheimer’s disease, who requires constant monitoring.

Symptoms of PTSD in caregivers

Caregiver stress can manifest both while providing care, and also after the crisis has passed or the loved one has died. Those caring for ill loved ones can experience significant psychological impact and even physical illness.

Symptoms can include:

• flashbacks
• numbness
• anxiety
• guilt
• depression
• dread
• irritability
• apathy

In addition, according to the NIH, while engaged in caregiving, “researchers have found evidence of impaired health behaviors, such as neglecting their own health care . . . and eating a poor-quality diet.”

Not all bad news

The NIH researchers, however, found that among caregivers studied, approximately a third not only didn’t suffer ill effects but seemed to thrive in the role. Those study subjects “report that caregiving makes them feel good about themselves and as if they are needed, gives meaning to their lives, enables them to learn new skills, and strengthens their relationships with others.”

The degree of stress encountered with caregiving seems to depend on several factors:

• the disability and cognitive impairment of the person being cared for;
• the breadth and depth of social support available to the caregiver;
• the duration and amount of care necessary;
• the age and financial situation of the caregiver;
• whether the caregiver has had a traumatic incident in their past (which could trigger latent PTSD symptoms); and,
• the caregiver’s perception of how much the patient is suffering.

“We recently found,” the NIH reported, “that two types of patient suffering—emotional and existential distress—were significantly associated with caregiver depression and use of antidepressant medication.” And even if you’re not involved in daily care, long-distance monitoring and decision-making and associated travel, as well as financial stresses, can also play a role in triggering these types of negative reactions.

Don’t assume you’re “fine”

It’s often difficult to recognize signs of stress in yourself when you’re in the throes of managing daily care for a loved one. You may think your difficulty sleeping or panicky feelings every time the phone rings are just normal reactions to your overbooked schedule and the additional responsibilities you’ve taken on. But they may be much more than that.

The most important thing is to not try to do it all yourself. Reach out to family and friends for material as well as emotional support. There are numerous organizations available to help caregivers, including the National Alliance for Caregiving, the Family Caregiver Alliance, VA Caregiver Support for those providing care to veterans, and the National Center for PTSD, which also offers mobile apps for caregivers experiencing PTSD. Your local Area Agency on Aging (every state has them) can provide help with senior patients and caregiver assistance. In addition, if your workplace offers an Employee Assistance Program, it can provide additional avenues for assistance and counseling.

Be sure to talk to us if you’re in a long-term caregiving role, especially if you’re experiencing any of the symptoms listed above. We can show you how to alleviate some of the physical and mental challenges you face in this difficult situation.