Who is a caregiver?
Caregivers are those people who act as support for someone with a mental illness, be it a spouse, parent, sibling, friend, work colleague or relative. Being a caregiver is important because you not only provide love, care and support in the most difficult moments of a loved one's life, you also give feedback, act as a reality check, motivate and encourage, and ultimately, offer a window to a world of hope and normality.
How do I care for a person with depression?
During a depressive episode, the person you are caring for may withdraw from social activities, and keep to himself/herself a lot of the time. He/she may also become more emotional, reacting to situations, comments, and even movies, with more intensity than you would expect. You may notice the person experiencing the following symptoms:
- a consistently low mood;
- significantly decreased levels of energy and motivation;
- a lack of interest in previously enjoyable activities (including sex);
- disturbed sleep; and
- loss of appetite.
Being a caregiver for someone with depression frequently means being exposed to a grim world of hopelessness, unhappiness and negativity. Often, you may feel exhausted, 'dragged down' and helpless. It is al common to start feeling angry and traumatized when the loved one attempts suicide, or does not appear to be getting better.
You may be unsure of what to say because just about everything you say seems to be interpreted negatively. Your suggestions and advice may be rejected repeatedly, leaving you confused and unsure about what the person wants. It is likely you will feel that your support is unwanted, even though they may not be able to cope without you. The most you can do at these times is to be as understanding and as patient as possible.
The practical help you give under these circumstances is most important. You can make sure that your friend or family member is safe and being looked after. You can encourage them to eat, drink, and maintain personal hygiene, but if they are seriously neglecting personal care, you should seek professional help. Professional help should also be obtained immediately if there is any talk of self-harm or suicide.
Why am I feeling guilty?
It is common to start feeling guilty when the person you are supporting is not improving. Often, the caregiver agonizes over past mistakes and events, wondering what should, or shouldn't, have been done. Parents are particularly prone to these feelings and might think that "if only we had been better parents" their son or daughter would not have developed this mental illness. A caregiver, however, is not responsible for improvement or recovery. The reality is that although environmental factors can certainly have an impact, there are significant genetic and biological factors that make people prone to developing particular mental illnesses. Just as Type II diabetes can run in families, so too can mental illnesses.
Guilt can be a corrosive agent that saps at energy and motivation, ultimately destroying the relationship between you and the one you are supporting. It is important to be honest with yourself regarding the issue of guilt. If you are feeling guilty, make sure you talk it through with a trusted friend or doctor. There is little to feel guilty about because most causes for mental illness are outside a caregiver's control. You can, however, offer important and much needed support to the person you are caring for, and help them on the road to recovery.
Do I keep secrets?
Issues of confidentiality can often arise when dealing with someone with a mental illness. You may be placed in an ethical dilemma when the person shares 'secret' information about suicide, or about harming others. This process can put enormous emotional strain on you as you decide between maintaining confidentiality and looking after your friend or loved one's best interests.
Though each case is different, the rule of thumb is that any information you receive that suggests that the person is at risk of harming himself/herself, or somebody else, must be passed on to a doctor, community nurse or other health professional. In this situation, it is imperative to get the person to see a health professional as soon as possible.
Although he or she may be angry or feel betrayed, there is a clear duty of care that overrides any suicide pacts or plans. Simply be careful not to enter into any promises you cannot or should not keep. Be supportive and compassionate, but firm about where 'confidentiality' ends.
Important things to remember
Mental illnesses are genuine disorders.A person with a mental illness is not 'pretending' or 'weak' or 'selfish'. It is important to realize that he/she is struggling with a condition that has a number of possible causes.
- Realize that you can only do so much. You cannot talk a person out of a mental illness and you cannot cure his/her condition by yourself. Although you have a very important role to play, the healing process will need to involve other people, including health professionals.
- Be careful of being the 'rescuer'. In the short term, this can seem like a solution, but in the long run, no single person can rescue another individual. Trying to take on that degree of responsibility can result in burnout and 'compassion fatigue'.
- Remember, recovery is a gradual process. Even with the right medication and professional support, recovery from a mental illness can be a slow and gradual process. It takes time and patience.
- Suicidal talk is serious. If a person is suicidal, you must not be the only one to take on the burden of this knowledge. Anyone with suicidal ideas or plans must see a professional. This may be a GP, mental health professional, or the emergency department at your local hospital.
- "I would like to help you."
- "I cannot imagine what you are going through, but I am ready to listen."
- "I care about you and I would suggest you talk things over with your doctor."
- "I would like to be a caregiver for you, however, you need to tell me how I could best fulfill this role."
- "I cannot keep your suicide plan to myself. I would like to arrange for us to go and see a doctor together."
Do not say…
- "You need to pull your self together and snap out of it."
- "Let me tell you about my problems, which I am sure will make you feel better."
- "Taking medication is a sign of weakness in your personality."
These comments are unsupportive and unhelpful and may be dangerous.
How can I help the children if a parent has depression?
If you are caring for someone who is a parent, it is important to consider how the children may be affected. Try and minimize disruption to the children's daily routine. This may mean planning meals they are used to, making sure they have their shower or bath every day, and encouraging them to go to bed at the regular time each night. You may also need to arrange other practical issues, such as childcare, and transport to and from school.
It is natural for children to feel confused and anxious when their parent is ill and someone else is caring for them. It helps if you can respond to any distressed behavior in a calm and understanding manner. You may need to explain to the children why their parent's behavior has changed and why they seem sick, answering any questions factually and in a manner appropriate to their level of understanding.
Older children may need to be reassured that they are not to blame for their parent's illness. It may also help to encourage them to take part in the care of the parent, showing them what to do to assist.
How do I look after myself?
Supporting a person with a mental illness can be tiring work. In order to provide the best support, it is essential that you look after yourself.
- Create a support team for yourself. Visit friends or people you can talk with and who can lift your mood.
- Take time for yourself, e.g. meet a friend or watch a movie.
- Exercise regularly because this will help you manage stress.
- If you are feeling stressed and low, minimize your use of alcohol or other drugs, as this can decrease your ability to cope with stress.
- Follow through on your own activities and plans. The role of caregiver is important, but you must look after your own life. You may otherwise risk burnout and end up being unable to help yourself, or anyone else.
