Caring Currents

Just Stressed or Depressed? How to Tell the Difference

Last updated: Feb 19, 2009

El Grito de Munch (Version Yosi)
Image by Y0si used under the creative commons attribution license.

If you feel cranky, blue, blah or like you're sinking under the weight of a caregiving situation, how can you tell if you're just understandably stressed out -- or truly depressed?

Living a stressful life is no picnic. But being stressed is different from having clinical depression. Depression is a mental health disorder of both body and mind that can have a variety of triggers -- chronic stress being a big one.  Depression can be life-altering, even life-threatening – and make it much harder to effectively take care of another person, as shown in two new studies on Parkinson disease caregivers and those caring for people with frontotemporal dementia and Alzheimer's disease.

Caregivers have much higher rates of depression than non-caregivers.

Stress can be self-treated, but for depression, you'll want help.

Use the following 7 questions to help you gauge if stress is sliding you into the danger zone of depression.

1. How long have you been in caregiving mode?

Studies show that the more years someone is an active caregiver, the greater the risk for depression.

2. Have your eating habits or weight changed to a noticeable degree?

Self-care can suffer when you're stressed out. ( Please pass the comfort food! ) But big shifts like gaining or losing a lot of weight or developing digestion problems more likely flag depression.

3. Do you complain about sleep?

Some caregiving situations are more sleep-friendly than others --- say, those involving an Alzheimer's wanderer or someone who gets up to go to the bathroom every night needing assistance. That's stressful. But chronic sleep disturbances linked to depression include the inability to sleep even when you have the opportunity, insomnia over several months, or just wanting to sleep all the time even though you get 7 or 8 hours a night.

4. How often do you snap out of it?

Sandwich-gen caregivers especially may feel crazy in the "witching hours" of mornings and coming home from work --but function pretty normally from 9 to 5. That's stress. Living a life pocked with stress, though, you should still be able to remember the last time you felt happy, or derive pleasure from those fleeting moments when your Mom cracks a joke or your sick and taciturn Dad has a nice day and says thanks. If you seldom feel "up," that's more than an ordinary type of "down."

5. Are you sick yourself?

Stress can feel buzzy, panicky, frustrated, short-of-breath, or exhausted. Stress can also leave you vulnerable to every cold and flu bug that comes around, because it raises cortisol levels and crashes immunity. Depression can manifest as long-term health issues that dont' "go away," like migraines, backaches, constant fatigue, and indigestion.

6. What would your friends say about you?

Most caregivers complain they don't have enough time. Everybody gets that. Wanting nevertheless to see friends and go out -- despite the craziness and stress that may make such times hard to organize – is a good sign. Having no desire to be social can be a sign of depression.

7. When you look to the future, how do you feel?

It's understandable to be apprehensive or even grieve a little about the prospects for an  aging relative. But if you feel hopeless about your own future, or can't shake a sense of helplessness, inertia, or pessimism – that's another story.

What to do next

  • Review the symptoms of depression .
  • Take off your Superperson cape and mention what you're feeling to your doctor if you're worried.
  • Be open to options. For depression, a combo of antidepressant medication and talk therapy has been shown most effective.
  • Be proactive. You've heard it before but I can't help saying it again: You have to come first, even when at first you think that's impossible. Where there's a will, there's a way.