Mental Health Caregivers

According to the National Alliance on Mental Illness, “At least 8.4 million Americans provide care to an adult with an emotional or mental illness” and spend an average of 32 unpaid hours per week doing so. While mental illness often is invisible, the stress for caregivers is real. Studies show that parents of children with psychiatric disorders are more likely to experience anxiety, depression, fatigue, insomnia and marital problems. In addition to giving emotional and social support, loved ones of individuals with mental health conditions often help with accessing services; arranging, providing transportation to and/or paying for treatment; and monitoring symptoms.

While family members who provide care to loved ones represent all ages, genders, races/ethnicities and socioeconomic statuses (SES), nearly 40 percent identify as Black, Indigenous, or People of Color (BIPOC). Although BIPOC caregivers frequently receive more support from family and friends than their white counterparts, they also experience unique challenges. On average, BIPOC caregivers have a lower SES; Black and Hispanic caregivers often feel ignored by medical professionals during crucial discussions; and Asian-American caregivers utilize professional support services at a lower rate, possibly because they are of limited cultural relevancy. For many BIPOC families, caregiving is a cultural expectation, typically based on birth order and gender. In comparison, white caregivers tend to cite feelings of personal responsibility as their motivation.

Taking care of loved ones often disrupts the professional lives of caregivers and many have to adjust their work schedules, eventually quitting or retiring early. The emotional burden of caregiving is extensive and individuals who care for a close relative are at a greater risk of declining health than those who watch distant relatives or unrelated persons. In addition to meeting their own needs by eating healthily, exercising as often as possible (Physical activity helps to counteract depression, fatigue and insomnia.) and focusing on quality sleep, caregivers should grant themselves permission to rest and regularly do things that they enjoy. Consider spending time with people who have no connection to the individual for whom you are serving as a caregiver; stay connected to others; and establish a time each week for socializing, even if that is simply having a cup of coffee with a friend. Doing so will minimize caregiver burnout.

Mental health conditions are a combination of brain chemistry, genetics and predisposition so thinking “What could I have done differently?” is unproductive and unnecessary. It is important, however, that you do not work harder than your loved one does at his or her healing process. Allow yourself to grieve what you have lost as a result of your caretaking responsibilities, realize you are doing the best you can, and do not feel guilty about asking for aid. Friends and loved ones may want to help but not know how. Try specific requests, like “Can you drive him/her to therapy?”, “Will you watch him/her next week so that I can get a haircut?” or “If I give you a list, can you pick up some groceries for me?”, and then accept assistance when it is offered.

Stay informed and obtain the knowledge and skills you need to be effective. Learn about your loved one’s diagnosis and if he/she is in therapy, talk to his/her mental health provider about better ways to handle his/her anger, anxiety attacks or outbursts, etc. Try not to take the individual’s behavior personal and realize that mental health issues often cause people to say and do hurtful things. In the moment remind yourself that “My love is deeper than my loved one’s pain.” Hospitals and other organizations offer classes on caregiving and may cover information specifically about the condition your loved one has. Joining an online or in-person support group can reduce any sense of isolation you may feel and provide ways to cope as members share similar experiences. For example, the Caregiver Action Network has a Caregiver Help Desk, along with a forum for individuals who have “Loved Ones with Mental Health Issues.”

Try listening to your loved one with your full attention to better understand and respond to his or her needs. (Sometimes a caregiver can focus on his/her own goals and miss what a relative is really trying to say.) Accept him or her (and yourself) without judgment. Caregiving can be exhausting and embracing all of your emotions, both positive and negative, will increase your ability to respond with patience instead of anger or frustration. Thinking about your loved one’s feelings and viewpoint also will lead to greater compassion. Write down his or her good qualities, even if you have not seen them lately, and try smiling when he or she enters the room. Start a journal and record one positive thing that happens every day. (If that involves the person you are caring for, share that with him or her.)

It is important to be “good enough” rather than to aim for perfection. Making choices that take the entire family into consideration and preserve a caretaker’s own mental health ultimately is the best thing for the individual who requires care.