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Depression & Caregiving

Every other Wednesday there is a Twitter chat around caregiving. Each time a different topic is discussed and those in the caregiving community — both family caregivers and caregiving professionals — weigh in. Here are highlights from the July 13 chat that focused on Depression & Caregiving:

Question 1: What do you think leads to depression during caregiving?

@SeniorCounselor: Feeling isolated, lost of control over your situation, built up resentment that you feel you can’t expressed

@Seniors4Living: A feeling of helplessness, vulnerability, and discouragement about the caregiving situation.

@alzfdn: Grief must be a big cause of depression. <— Absolutely. This is a big one.

@JordanEM: Response to stress, added responsibility, decreased self care, grief, change in lifestyle

@rightathomeUS: 1) observing the declining conditions of loved ones 2) fatigue 3) worry 4) despair

@CareGiverGuy: Felt depression moments mostly at night when isolation kicked in & the Ground Hog repetition continued…

@SeniorCounselor: Trying to meet so many demands that we place on ourselves & others place on us makes us feel “not good enough”

@SandwichINK : Having to STOP driving ¬†ūüôā

@KatyMcKenna: Knowing up front that your caregiving is probably not going to end with recovery.

@KathyKastner: Causes of caregiver depression: Exhaustion, isolation, guilt, pressure, un-met personal needs

@alzfdn: Isolation and lack of socialization must be major causes of depression as well.

¬†Question 1a: Do you think it’s possible to NOT experience depression during caregiving?

@SandwichINK: Can go both ways – the senior parents get depressed coz they have to stop/ caregivers depressed coz of extra errands

@GracefulAging: I think you must begin with a look at physical/medication reasons. Begin with a good Dr. exam for an objective cause.

@rightathomeUS: Hard to experience depression with everything going on, especially if a family rather than professional caregiver.

@CaringTransCorp: Feeling hopeless to change situation of person you R taking care of & fear of when/if will worsen

@KatyMcKenna: It’s possible not to become depressed, but I think the longer the caregiving goes on, the more likely the depression.

@SeniorCounselor: Most caregivers know they are on a different journey than the care recipient; end-of-life care is a challenging time

@CaringTransCorp: Need to communicate with others & other caregivers, take time to themselves without feeling guilty about needing a break

Question 2: What are the symptoms of depression? How do we know if we are suffering from depression? 

@CaringTransCorp: Mood swings, sleep all day, eating disorder, isolation, hard to concentrate.

@SeniorCounselor: Symptoms include: Loss of interest in activities, fatigue, change in sleep patterns, eating habits, isolation

@KathyKastner: I think hard if depressed, to self-identify. Also still stigma about being depressed imho

@Seniors4Living: I think that is so common among caregivers. Good point as to how the denial relates to protecting emotions.

@alzfdn:  Other symptoms of depression: depressed mood, downcast appearance, frequent crying

@KatyMcKenna: For me, symptoms were crying, withdrawing from friends, loss of other interests, loss of hope for better future.

@RachelleNorman: Symptoms of depression: loss of appetite/energy, increased pain/stomach upset/headaches, feelings of hopelessness

@SandwichINK: More depression symptoms – easily frustrated and angry,

@JordanEM: Think many of the symptoms are masked by the demands of caregiving – similar results.

@SilveradoSenior: Depression symptoms… self isolation, lack of motivation, self neglect despite caring for the health of a loved one.

Question 3: What’s your personal story about depression?¬†

@SandwichINK: My tuffest-senior dad dealing w/dementia symptoms/sundowning due to meds. Spent many nites awake-praying LOTS

@Seniors4Living: When I was grieving the death of my grandfather, I fell into depression. Lost my motivation to work/do anything new.

@KathyKastner: My story of depression (http://tinyurl.com/29drcc9)

@MKing09: I’m a lifetime caregiver: 2 bros w/CP, 3 children profoundly mentally impaired. I have chronic depression now.

Question 4: Why is treating depression in family caregivers so important? 

@SeniorCounselor: Depression can also lead to physical ailments and complaints–the body is sometimes be impacted by what is going on mentally

@KathyKastner: Far reaching repercussions if not treated

@SandwichINK: Untreated depression in caregivers impacts person they’re caring for-comes back on caregiver. No one wins.

@SeniorCounselor: Depression impacts not just the person who is suffering but entire family systems

@MJHS01: You never know who may be experiencing a similar situation. Talk to people. Nothing like HUMAN resources. <-LOVE!

@SeniorCounselor: The elder is often impacted by the mood of the caregiver. If caregiver is depressed, it can lead to negative impacts

 @alzfdn: The old oxygen mask scenario. You need to take care of yourself to provide care.

@SilveradoSenior: ¬†It is very important to treat depression because it will eventually affect the caregiver’s health. & lead to abuse.

@ShelleyWebbRN:  Treating depression in family caregivers is important for both health of caregiver & care recipient. 40% die before caree.

Question 5: What are the treatments for depression? What worked for you? 

@CaringTransCorp: Reaching out to the people I was really close with – baby steps at first then it became easier to just talk with people

@alzfdn: Counseling and continued support are some of the best interventions.

@SilveradoSenior:  It is sometimes difficult for the caregiver to feel like they are doing enough, sometimes just telling them will help.

@rightathomeUS: Informal treatment is a change of scenery. Getting away from caregiving and the stress it can bring.

@KatyMcKenna: Mom said to me, about 9 years in to caregiving, “You’d better get it together, or you won’t make it much longer!”

@SilveradoSenior:  Sometime just a hug can go a long way, or flowers & a card.

@HarryKaufer: I know it sounds simple, but take a walk every day. Studies even show it helps depression.

@KathyKastner: ¬†Tried counseling, exercise, St John’s Wort, a break) what worked: low dose anti depressants. Have to justify alll the time

@SeniorInfo4u: I use Cymbalta at night for anxiety and Wellbutrin in the morning.

@MJHS01: Also a great idea to ask your physician for info regarding support groups etc.

@CareCommunities: Healthy diet … fresh fruits & vegetables!!

Question 6: ¬†What about medications to treat depression? What’s been your experience?

@MKing09:  I take Amitriptylin at night and Lexapro daily. I sent my daughter to her sister, but still have a disabled son at home.

@ShelleyWebbRN: ¬†I just think it’s better to stay away from depression medications until you’ve exhausted other options.

@CareCommunities:  I agree, medications should be seen as the last solution

@SeniorCounselor: Medications can work. Talk with a doctor but most effective treatment is when counseling is involved too!

@ShelleyWebbRN: I’m saying that as a caregiver, not as a nurse. ūüôā Certainly meds are required for severe cases with doc recommendation.

@KatyMcKenna: I was prescribed meds once many years ago, and found them of no help to me, so I discontinued.

@SeniorInfo4u: I love meds. Fought against them for years. Since taking them, my life has been much better.

@MJHS01: If you don’t have a listening ear, pick up a pen and paper and write. Get your feelings out by any means necessary.

Question 7: What can we do to help family caregivers suffering from depression?

@ShelleyWebbRN: I think the availability of phone or internet coaching/counseling is a wonderful way to help family caregivers.

@caregiving: We can validate the feelings of guilt, anger, resentment, that it’s natural to feel this way. We can show understanding.

@CaringTransCorp: Offering support to those who are in need, offering our time for help w/patient or just to grab a bite to eat and talk

@caregiving: I also think we can encourage family caregivers to share what’s on their heart–that we will listen w/o judgment.

@RachelleNorman: As a friend, offer caregivers time for respite. Communicate your concern for their health.

@rightathomeUS: Careful to not let siblings residing in same town of loved ones to bear lion’s share of caregiving. Be supportive!

@GracefulAging: Don’t steal the ownership of their feelings by saying things like “I know how you feel.”

@KatyMcKenna: Perhaps the kindest question you can ask caregiver is, “But how are YOU doing?” They’ll be shocked you asked.

@SeniorCounselor: Making sure the caregiver has time to themselves, get out of the house, associate w/ppl other than care recipient

@SilveradoSenior:  Give the caregiver a Spa Day or a little vacation with a card that says you do so much. I just wanted to give something too

@SeniorInfo4u: More churches should start no cost adult day care centers, so caregivers can get some respite.

@SeniorCounselor: Offering to babysit, run errands–anything to get something off the caregiver’s “plate” can support them

@CareGiverGuy: We need to continue & increase the funding of Adult Care Centers, support GiftCare programs for caregivers

@TMMCare: If caregivers won’t take a day off, go through part of their day with them.

Question 8: What suggestions can you offer a family caregiver who may be depressed?

@ShelleyWebbRN: Family caregivers need to take breaks!

@caregiving: I think they just make a decision based on what’s in front of them, rather than what’s waaaay in front.

@rightathomeUS: Never feel reluctant to ask for help from community and family resources available. Avoid over exertion of caregiver duties.

GracefulAging: Weed their garden; take out their trash; bring them a new magazine. Perform an unexpected kind act.

@CaringTransCorp: Give them the gift of some time off and challenge them to do something they want to do for themselves whatever it may be!

@Seniors4Living: Do something that makes you happy, even for just 10 minutes a day. For me, going through the car wash makes me smile.

@SeniorCounselor: Share your concerns with them and have a conversation coming from a caring and non-judgmental place

@KathyKastner: Creative activities to do together (art, music, storytelling)

Editor’s note: The next #ElderCareChat will be on July 27 @ 1 pm ET. And be sure to visit out Caregivers Resource Center to find information for all stages of caring for your loved one.