Self Caring

Caregiver Meltdown

Last updated: Jun 09, 2010

Caregivers may do some saint-like things, but we're no saints. We snap. We give and give and give and then, in an all too-human moment -- usually a moment fed by too little sleep and too many competing priorities for too long a duration -- we lose it. Maybe we yell at the person in our care. Some of us throw things. (I have been known to slam the dishwasher door and break what's inside.) We rail at the system, the circumstances, the fates that put us in this role. We slump down and say, "I can't do this anymore."

It's not pretty.

But it's pretty universal.

And what happens next is important.

Only in a semi-perfect world does money suddenly materialize for wonderful alternate care or do siblings or other relatives swoop in to relieve your burden. It happens, but not often enough. More often, caregivers are left to feel their way out of their dark place on their own (or with minimal assistance). "˜Losing it,' for many of them, becomes -- eventually -- not a sign of weakness or failure, but instead a force of good.

I often hear caregivers (looking back) say that their "caregiver meltdown" was:

A wake-up call to draw sharper limits. I've written about my sister-in-law, who wound up in the hospital and then pow-wowed with her husband to figure out what she could reasonably manage in caring for three older relatives, and what she couldn't do herself.

The kick needed to rally the troops. If you're holding it together, others might be more liable to hang back. Your saying, "I quit," might be what it takes to finally get other family members to get off their hineys and contribute.

A reminder to quit obsessing. No more berating yourself when you lose your temper. No more second-guessing your decisions. The buck starts here.

A wake-up call to lower your expectations. It's nearly impossible to take care of another person's total physical/emotional/social needs, even though you want him or her to be happy and may feel it's your duty.

A red flag to get checked out for depression. Nobody wants to be "another middle-aged woman on antidepressants." But increased irritability and/or a sense of hopelessness are symptoms of depression, especially when paired with two or more weeks of a change in eating (loss of appetite or overeating); disordered sleep; a loss of interest in activities, and pervasive sadness. It's just a sorry fact of caregiving: Stress worsens the biological set-up for depression.

Permission to grieve as you go. One woman told me that while her mom was in an extended rehab following a stroke, she couldn't afford the luxury of a meltdown; she had too much to do every day. I get that. But the crisis mode went on so long for her that she began having daily snappings. She wishes she had just been less super-strong -- at least out of her mom's sight -- and let herself cry, scream at the gods, and "grieve it out of my system a little." In crisis mode, you do have to just keep going and going. But if your crisis mode is sliding from weeks to months, your psyche simply can't withstand it.

My friend Tracy Gaudet, director of Duke Integrative Medicine, likes to say that "You can pay now, or you can pay later -- with interest." What she means: Take care of yourself in increments, or you'll need to do it later big time.

Have you ever had a meltdown? Was it all bad, or a force of good?