About 43 million Americans act as unpaid caregivers, the National Institutes of Health (NIH) reported in 2015. Women make up the majority of caregivers (about two-thirds). About three in five caregivers have a full-time job in addition to their caregiving responsibilities, reported the Office of Women’s Health (2012). It’s a recipe for stress and even depression for many who feel frustrated, angry, sad, and overwhelmed.

If you care for someone with dementia, the risks of depression are even greater. According to research by the National Institutes of Health, caregivers for dementia patients showed much higher levels of a potentially dangerous stress hormone and had associated health problems, including weaker immune response and slower wound healing. Some caregivers with depression may develop memory issues or trouble paying attention.

If you a loved one’s caregiver, here’s some information about depression and when it may be time to get help.

What are the symptoms of depression in caregiving adults?

According to the Alzheimer’s Association, symptoms of caregiver depression may include:

  • Feelings of hopelessness, guilt, or worthlessness
  • Becoming easily angered or frustrated
  • Changes in sleep habits (more or less than usual)
  • New physical symptoms (headaches, digestive problems, pain) that don’t respond to medical treatment
  • Trouble concentrating
  • Losing interest in activities you used to enjoy
  • Thoughts of dying, death, or even suicide
  • Appetite or weight changes

If you think you may have depression symptoms, the Alzheimer’s Association urges you to see your doctor right away. If depression is untreated, it can result in serious emotional and physical problems and affect your caregiving abilities.

How is caregiver depression treated?

Your doctor might recommended one or both of the following to treat your depression, reports the Alzheimer’s Association:

  • Counseling or talk therapywith a social worker, counselor, psychologist, or psychiatrist. Counseling lets you talk about your emotions and the challenges you face and helps you identify new ways to cope with your feelings and the difficulties involved in caregiving for an ill loved one.
  • Medication management. There are many anti-depressant medications available to help alleviate the symptoms of depression and balance the neurotransmitters in the brain. Consult your doctor about what medications may be appropriate for you.

Where can I turn for support to relieve caregiver depression?

Many caregivers may benefit from classes or programs to help them cope with stress, feel more in control, and improve their caregiving skills. The National Cancer Institute uses the COPE program, which stands for Creativity, Optimism, Planning, and Expert Information, to teach caregivers how to solve problems, make plans to address individual needs, and stay more connected and positive.

The National Institute on Aging reports that a 2015 study showed positive results for caregivers who got phone-based support. All the study participants cared for people with dementia. Those caregivers who received phone calls with encouragement, information, and other support had less depression and were better able to cope with difficult behaviors by the loved ones they were caring for, compared with the study participants who didn’t get these calls.

So, getting involved with a support group for others in similar caregiving situations may be a good first step. The National Cancer Institute suggests calling a family meeting, often with members of your loved one’s health care team, to identify caregiver needs and concerns and make a plan to address them. You might also contact the Eldercare Locator, which lists resources for help in your area. Their phone number is 1-800-677-1116 and their hours of operation are 9AM-8PM ET, Monday through Friday.

Ultimately, it may be important that, as a caregiver, you take the time you need to care for yourself, including medical and mental health care when you need it. Reach out for support when overwhelmed and visit your doctor if your caregiving stress is unmanageable or you suspect depression.

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