What is stress?

While caregiving can be rewarding, it can also make you feel like you carry the world your shoulders. Those pressures can become harder to handle if your loved one’s condition gets worse, or if you must juggle several other responsibilities. Many caregivers are part of the “sandwich generation,” that is, they are “sandwiched” between taking care of their children and taking care of an aging parent. Others care for a child or an adult with special needs, which can be hard on the caregiver both emotionally and physically. On top of everything, caregivers often have to hold down jobs.

The strains of caregiving are called “stress”. It shows up in many ways. You might feel overwhelmed. Worries distract you. You get tired or irritated easily. You may feel guilty about not being a better caregiver, parent, or worker. You become frustrated or resentful because you have little help. It is natural to feel stress, especially if demands on your time seem never to let up.

When does stress turn into depression?

Many caregivers can manage their stress. However, when dark emotions seem never to leave, you may have an illness called depression. This is not just “the blues.” This is a very common mood disorder, and is NOT a result of any weakness or failure on your part. It is very important, though, to talk to your doctor if you suffer many of the symptoms below almost all day, every day for two weeks or longer.

• Feeling sad, empty or hopeless
• You cannot have fun or enjoy activities that you used to like
• Overeating or not eating at all
• Being unable to sleep or sleeping too much
• Feeling jittery OR feeling like you have no energy
• Unable to focus or make decisions
• Suffering from pains (stomach aches, headaches, back aches) that seem to have no cause
• Thinking that you are worthless
• Wishing you were never born, or thinking life is not worth living

What can I do to feel like my old self again?

Depression is treatable! But you have to take action. First talk to your doctor. During your visit, she might do any or all of the following:

• Take your medical history. Depression can run in families. It is also a result of extreme stress. He will also talk to you about any other prescription drugs, or over-the-counter medicines (like cold medicines or sleep aids) you are taking. Some drugs should not be taken with each other.
• Discuss how you have been feeling in order to diagnose whether or not you have depression, to judge how severe it is, and to work with you to decide on a treatment plan you can follow.
• Run lab tests. Depression can be a result of other diseases, such as problems with an important gland called your thyroid. It is also a side effect of certain drugs, including alcohol.
• Prescribe medications such as antidepressants. Prescription drugs for depression may take up to 8 weeks to work, so you need to have faith and take them every day as your doctor directs. Ask your doctor what side effects the drug may cause. (They usually go away as your body gets used to the drug, but some side effects, like feeling worse than before, are reasons to change the drug). Schedule a follow-up visit within the next month or two. If you still have many symptoms, your doctor and you may decide to switch your medication, or add another. When you feel healthy again, do NOT stop taking your medication. Speak with your doctor about any changes you want to make involving prescription drugs. If you stop your medicine, the depression can come back.
• Tell you to talk about your challenges with a counselor or psychologist. Besides offering compassion, your counselor might suggest ways for you to find help. He or she can guide you to shift your thinking so you can feel proud of all the good you do, and remind you that worry and guilt are useless and even harmful. Finally, these professionals can teach you ways to relax, like breathing deeply or meditating (calming your mind).
• Suggest that you connect with others. It is important to spend time with friends and with people who are going through caregiving challenges, too. You can locate a caregivers support group by finding your local Area Agency on Aging http://www.n4a.org , consulting the National Alliance for Caregiving site http://www.caregiving.org/ , through the NJ Department of Health, Division of Mental Health Services state.nj.us/humanservices/clients/mental/ , or by visiting the site, Today’s Caregiver at www.caregiver.com.
• Tell you to take good care of YOURSELF! If you spend all your energy on others, you will not have any left for yourself. Exercising for a half hour a day and following a healthy diet are basics for a healthy body and mind. (See our articles on exercise and healthy eating).

As you can see, there are many things you can do to recover from depression, but you must take the responsibility to reach out for support when you recognize your blue mood has lasted more than two weeks. If your sadness, exhaustion, or any symptoms make it hard to function, these are signs you must get help, soon. Do not put it off.

Sometimes I feel so down that I want to hurt myself. I do not want to talk to friends or family about this because they will either worry or think I am crazy. These feelings often come at night when my doctor is not available. Who can I go to when I feel desperate?

If you are thinking of hurting yourself, it is a medical emergency. If you cannot visit your doctor immediately, go to an emergency room. Call 911. Those who care about you and love you will suffer the most if you end your life. Remember, it is the depression talking – not you.

If you are reluctant to visit an emergency room, but you feel an urgent need to escape or feel that life is not worth living, call the 24-hour National Suicide Prevention Lifeline at 1-800-273-TALK (1-800-273-8255). Trained counselors are there to listen to you and advise you.

Sometimes, it helps to simply talk to someone when you are very sad or afraid, but not thinking of hurting yourself. In times like this, you can call a “warmline” -- a call center with peers who are trained supportive mental health workers and specialize in active listening. They may also suggest helpful resources or activities. The Mental Health Association in New Jersey manages a Peer Recovery WarmLine. It has been recognized nationally for many positive things, including making callers feel like they have control over their situation. Call the WarmLine at 877-292-5588. It is available from 10:00 am to 10:00 pm, Monday through Friday, and on Saturday from 5:00pm to 10:00 pm.

If your loved one is in the MLTSS program and you are his or her caregiver, tell your MLTSS Care Manager about your feelings, or about your diagnosis of depression. Ask if there is anything she can do to help you with caregiving. There may even be an MLTSS service, like respite care, which would assist you.