Ask the Expert: Caregiver Depression

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Featuring Alireza Atri, MD, PhD

Question: I am caring for my mother who has Alzheimer's, and I feel like I’m losing her more each day. I'm having trouble coping with my own sadness. Could I be depressed or are these feelings just temporary? 

Answer: It is common for those caring for a loved one with Alzheimer’s disease to experience and work through the grief process. This includes the physical, mental, social, and emotional symptoms of sadness, anger, withdrawal, guilt and depression. While these feelings and symptoms can be mild, temporary and pass within months, for many caregivers they can persist and become amplified.

Sadness, yearning, anxiety, concern, frustration, guilt, and even withdrawal from social activities, hobbies and usual interests are common among caregivers. In addition, fatigue, poor concentration, physical aches and pains, headaches, and changes in eating or sleeping habits can also be attributed to a person’s role as caregiver. However, when these symptoms persist over an extended period of time and become amplified to include hopelessness, inability to experience joy or to impact one’s ability to function in daily life, it is a warning sign that clinical depression may be setting in. Clinical depression is not due to weakness in character or mental toughness, it is a medical condition that affects brain chemicals and circuits, and disrupts one’s ability process perceptions, thoughts, feelings, and emotions in a normal or positive manner. 

Suicidal thoughts, which are not part of the normal grief process, excessive difficulty sleeping, being unable to fully relax; feeling constant anxiety and negative thoughts; and extreme loss of appetite that affects one’s health are causes for concern that warrant an evaluation by a health care provider for clinical anxiety and depression.

The dementia specialist caring for your loved one can be a great resource for information about counseling services and support groups for caregivers, spouses, children and friends. Support groups offer a safe place to share and discuss feelings, fears and frustrations about the toll of dementia on a loved one and those who love and care for her/him. It can also be a place to find out that you are not alone in your feelings and experiences, and to discover a community of connection and support. Caregivers who suffer from more extreme symptoms of depression may benefit from one-on-one care from a mental health professional, which might include psychotherapy and/or temporary prescription of low doses of medications that help the brain regulate chemicals that affect mood and anxiety. 

Research shows that more than 50 percent of caregivers develop depression or another medical illness as a result of their caregiver responsibilities. Caregiver depression poses a substantial risk to the health and well-being of both the caregiver and her/his loved ones. While caring for a loved one with dementia is a noble endeavor, it is important that caregivers recognize the risks and take steps to preserve and protect their own health and well-being. Studies consistently show that individuals with dementia do much better in the long run when their caregivers take care of themselves – this includes providing selfcare (exercising, eating and sleeping well), managing stress, and taking necessary time to rest and renew. That’s why I always provide a prescription for selfcare to caregivers. 

Caregiving is not a sprint – it is more like a marathon – and it is in the best interest of everyone to avoid unnecessary suffering, prolonged depression and burnout. I can relay from personal experience as a past caregiver, that the caregiving journey is not an easy one. However, it is not one that must be traveled alone. The journey can be manageable, rewarding and meaningful, if one recognizes potential pitfalls, and seeks and accepts help, including recognizing and treating depression – it is the best and right thing to do for all. 

Alireza Atri, MD, PhD, is Director of the Banner Sun Health Research Institute. He previously cared for his father who suffered from dementia for 10 years. His office can be reached at (623) 832-6500.

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