How Can I Tell the Difference Between the Normal Stress of Caregiving and Depression?

15 answers | Last updated: Nov 08, 2016
A fellow caregiver asked...

How can I tell the difference between the normal stress of caregiving and depression?


Expert Answers

Dr. Leslie Kernisan is the author of a popular blog and podcast at BetterHealthWhileAging.net. She is also a clinical instructor in the University of California, San Francisco, Division of Geriatrics.

To screen for depression, doctors often ask the following two key questions:

  • During the past month, have you been bothered by feeling down, depressed, or hopeless?
  • During the past month, have you been bothered by feeling little interest or pleasure in doing things, especially activities you used to find pleasurable?

Answering "yes" to either is a red flag. Persistent sadness and anhedonia (the inability to enjoy anything) are strong signs of depression.

Eldercare can be very stressful, obviously. And stress can make a person feel pressured, sad, or worried -- in other words, have the blues. But having these emotions usually isn’t the same as being truly clinically depressed.

Unfortunately, chronic (long-term) stress is known to put people at higher risk of developing depression, and caregivers are known to be at particular risk for depression. So if you find yourself often bothered by feeling depressed, or if you're unable to enjoy activities you used to like, don’t just chalk it up to stress. Consult with your doctor.


Community Answers

Octoman answered...

I have all sorts of depressing thoughts every day I cannot face a meal I have no appetite I dont want a to make a journey I dont want to do the every day jobs,but I just take a mouth full of food and continue till the meal is all finished,just get in the car and start   the journey and it is soon over. I,just start the job and it is soon done.I always expect a disaster to happen (sort of panic attacks )I never lose these feeling.but have got used to ignoring them.  keep them on the surface do not let these feelings settle they will drag you down . I  have great highs.which are enjoyable A beautiful flower ,meeting happy people.everything or anything that lifts your spirts helps.  Once you fall into pit of despair it is hard to get out. I some times wake up feeling like a zombie I found if I go into doing everything in slow motion mode helpsyou to relax and recover .In fact I beleive all depression is about stress if you can relax you have the battle half won,the other half is reviving your soul or spirituality the love of life.You can be alive yet still dead without the ability to enjoy life.7 years ago I was told I had untreatable cancer ( After two years, I had not succumbed they changed their minds)  I went out and bought a small dog and two Zebra Finches,My  they do have lots of life,they are still going at it now.demanding attention,those about to die,surround yourself with life,it seemed to work for me.If you allow your self become a martyr you will die you must retain some selfishness or you lose your self..  


Axsmithprobate answered...

 I don't think there is a difference, frankly.  Get some support, get some help.  Go to an elder care support group or a senior center.  That's a great place to start.

Christine Axsmith, Esq.

www.Axsmith.net


Catdagger answered...

I've been feeling overwhelmed with taking care of my 92 year old mother and feeling not only depressed but resentful because she's constantly needing something and wants to go with me on weekends to an activity that I want to be with my friends.  I feel guilty at times, because my therapist keeps telling me she's not going to live that long.

I excuse myself when I remember to do so and try not to feel guilty because she had a good life and a long marriage to a good man.  I've never been married and have lived with my parents most of my life and took care of my father when my mother took a part-time job when he retired and he didn't want her to go to work.  I lost out on the best dating years taking care of my father, so I justify myself, saying, I'm not giving 100% to take care of the other parent, who always took care of her needs over everyone elses needs.


A fellow caregiver answered...

I recently asked my doctor the same question and was prepared to go on anti-depressants.  I was in the midst of deciding whether or not to bring my mother home from rehab or put her in a nursing home.  He said it was irrational to think about bringing her home and irrational thoughts are a symptom of depression however my depression was situational.  Perhaps anti-depressants would ease my pain but so might time so why risk the side effects of meds unless the symptoms persist..  Just hearing this from a trusted doctor who really knows me was enough to straighten out my thinking.  I decided that putting mom in a home was in her best interests as well as mine.  Although I'm not exactly jumping with joy, the depression has yielded to appropriate sadness.  I can sleep at night, the anxiety has lessened, I can function at work and I've been enjoying being with friends. 


Octoman answered...

Yes my Mother who was schizophrenic had to go in home she needed day and night supervision.she was happy in the home all family members could visit her ,problem solved. 


A fellow caregiver answered...

It can be difficult to tell the difference.  If you recover and feel basically good when you are not caregiving than it's probably burn out rather than depression. Giving too much of ourselves in caregiving doesn't help anyone most especially the caregiver.  Resentment starts and then you can't really care with an open heart.  Everyone loses.

Taking care of yourself and your needs is essential.  If you are caring for yourself and tending to your needs you will be happier and a better caretaker. No matter how much you want to be a good caregiver you just can't do it all, all the time. You do what you can within reason and this can stop the burnout.

If you're feeling depressed all the time it may be  that you are giving too much of yourself and therefore, depleting yourself and/or you really are depressed.


Spockula answered...

I have a husband w/ Schizophrenia/ETOH dep., too. Also, I work in a locked Psych. facility. I have had "caregiver" burn-out/Depression sx's. for yrs. I recently, had to make a difficult decision. I had to ask my husband to move out, & find his own place to live due to relapse on booze/ciggs along w/ other on-going issues. I still worry, but, it HAD to be done. I'm still his primary support system, but, it's helping him become more independent, & take some ownership of his issues. It's hard, but, I've been able to have more contact w/ my own family/friends alone. A lot of stress has been lifted. Of course, sadness too. It's hard. I was labeled a co-dependent. I had to do this.


A fellow caregiver answered...

Spockula, Yes it HAD to be done, you to keep your sanity and your husband sounds like he is retreating to psychosis via ETOH method. It is extremely difficult to keep a marriage going when there is severe and persistent mental illness. The double wammy is you deal with MI during the day at work, to come home and face it again?? That was the least "co-dependent things to do." I wouldn't get hung up on the terminology, its the thoughts, behaviors, and feelings that need to be attended to. I'm glad to hear the stress lifted.


Spockula answered...

Thanks, anonymous. Yes, I ended up moving in right next door! We're under one roof, but, with his/her sides. We have our own space, yet, still nearby. It's weird, but, works for us. Yes, he 'self-medicates' w/ Etoh/cigs....only, it's slowly killing him. Yup, a double-wammy for sure. It's different, yet, the same. Being on both sides of it helps at work, for sure. I'm sad for him, & feel the system has failed in many ways. But, he's a grown man. I'll be there for him, but, had to get some space. I'll always worry, & help him out. Just had to accept it. He's doing better w/ cigs. I just had to take a few steps away.


Smnanc answered...

Think about it, your parents are in assisted living and you only see them once, maybe twice a week! Imagine if you were taking care of them, by yourself, all the time! Many of us are - feeding, doctor appointments, prescriptions, distributing meds, handling insurance and financial matters, cleaning out and selling the house, laundry...... and, perhaps like me, maintaining a job at the same time! This has been my life, so really, it could be much more difficult. Count your blessings!


Spockula answered...

@smnanc: Yes, it's easy to become bitter, & upset w/ others. Some of us are much stronger, & can cope w/ more....usually, because we HAVE to! But, let's try to be supportive to ALL who are on here. Obviously, they find this site for a reason. Life is tough. But, yes, we should ALL count our blessings! I always remind myself: things could ALWAYS be worse, & there's ALWAYS someone out there w/ more problems than I!


Hab-aid diva answered...

Everybody responds differently to challenging situations and grieves on their own timetable.


Povdds answered...

IMHO Depression, as currently (and imperfectly) defined, involves a medical diagnosis and can be addressed medically (with varying degrees of success).

I've been a caregiver for two sets of beloved aging parents and found considerable overlap between depression and stress. It also seems both are normal,given the situation, and sometimes both can even be useful indicators.

Stress, however, involves more of a "temporary" situation while depression is an emotional state that just seems to go on without any hope.

If there is any "what can I actually do about it?" advice I can give, it would be to skillfully cultivate mental states like gratitude (for self and others), kindness (to self and others), etc. to avoid being dragged down into the depths of despair and depression. When I was depressed, it was far tougher to manage the stress, and avoiding depression was a way to be nice to yourself and others. There are many resources to help you do this, but please don't wait too long if you see signs of depression. Depression makes the stress much worse, and your people need you.


A fellow caregiver answered...

stress and depression go hand in hand. My work is in home eldercare. I the one who comes in and gives people of aging parents a break. I am also a single mother of three childern one with down syndrome. I know stress. I also know that the person who is there all the time and can't go home like me has added stress and needs a break from it all. I guess what I want to say is don't add to the stress by feeling guilty. Take a day out and relax even if it's only an hour get away and think about nothing but you. You will feel differenly when you get home.