Caregivers across all professions—from therapists to nurses, spiritual directors to first responders—are often companions on the path, walking with those they care for, helping to hold space for healing. But what happens when the caregiver feels lost or weary on this shared journey? The truth is, burnout is not only inevitable in caregiving—it is essential. It is a natural part of the cycle, creating the necessary space for caregivers to reconnect with meaning and redefine their sense of purpose. 

Clarissa Pinkola Estés speaks powerfully about the cycles of life and death, both literal and metaphorical. As she writes, “Sometimes the one who is running from the Life/Death/Life nature insists on thinking of love as a boon only. Yet love in its fullest form is a series of deaths and rebirths. We let go of one phase, one aspect of love, and enter another. Passion dies and is brought back. Pain is chased away and surfaces another time. To love means to embrace and at the same time to withstand many endings, and many, many beginnings—all in the same relationship” (Estés, 1992, p. 243). 

Just as this is true of love in relationships, it is also true of our relationship with our life’s work. We must be willing to let go of certain phases of our work—allowing parts to die—so that something new and vibrant can be born. The caregiving journey is not linear; it involves many endings and beginnings, growth and loss, just as any other meaningful relationship in life does. This is why burnout, often seen as an ending, is actually an invitation to enter into a new beginning. 

Understanding Burnout: More Than Exhaustion 

You probably already know what causes burnout: from a combination of personal challenges, demanding work environments, and the emotional and mental load of supporting others. Burnout is more than just feeling exhausted—it’s the depletion of meaning. Christina Maslach and Michael Leiter, leading researchers on the subject, explain that people experiencing burnout lose not just energy but their psychological connection with their work. This loss of meaning can make caregivers feel detached, depressed, exhausted, and cynical (Maslach & Leiter, 1997). 

Read this twice: Burnout is normal, recurring, and necessary. 

Befriending Burnout: A Natural Part of Growth 

What if we could reframe burnout? Instead of seeing it as a failure, we could view it as a natural part of our professional lives—a shedding of old ways, making room for new perspectives. As Dr. Clarissa Pinkola Estés describes in the Life-Death-Life Cycle, everything goes through phases of birth, growth, decline, death, and rebirth (Estés, 1992). In caregiving, we’re often testing our ideals against the reality of the work. When these diverge, meaning can be lost. But this loss creates the space for renewal and new ideas to emerge. 

Whether we’re caring for a person or a project, burnout is inevitable. It’s part of the natural cycle between periods of steady meaning and purpose and the void of burnout, which gives rise to new meaning. In the space between, we can feel empty, lost, or unsure of how to move forward. It’s often the point where we question why we began or if we should continue. But this very void is where meaning has the chance to be reignited. 

My Personal Experience with Burnout 

Art has always been my refuge, a way to connect with something deeper and alive. As a child, creating wasn’t about producing—it was about tapping into a world rich with imagination and meaning. But by the time I neared the end of art school, I had lost that connection. The demands of turning out finished work left me feeling burned out and hollow, detached from the very source that had once nourished me. 

In my search for renewal, I discovered Carl Jung and his teachings on the imaginal world—the realm where symbols and images speak to us from the unconscious. It felt like a homecoming. Jung’s work helped me understand that the very images I explored as a child were alive, carrying wisdom I hadn’t fully realized. It was a turning point that not only restored my sense of purpose but inspired me to become a therapist. Now, I help others reconnect with their own inner worlds, guiding them through the same transformative process that helped me. Burnout, I’ve learned, isn’t an ending—it’s an invitation to begin again, with deeper clarity and meaning. 

What to Do About Burnout: Restoring Energy and Meaning 

We often tell our clients to rest, recharge, and take care of themselves, but how often do we practice what we preach? Self-care is important, yes, but equally important for recovering from burnout is the ability to restore meaning. Meaning is fluid, and over time, it will change—just as we change. 

For caregivers, embracing burnout as a necessary cycle in life allows us to reconnect with the deeper “why” behind the work. Meaning will decline and go away, only to re-emerge in new, healthier, and more vibrant forms. Burnout doesn’t mean you should quit. It means you are in the void, and something new is on its way. Don’t quit before the change happens. 

Imaginal Exercise: Discovering Your Inner Guide 

In Jungian depth psychology, the imaginal realm is where inner symbols, archetypes, and guiding forces reside. These inner images, often unconscious, can provide insight and guidance during moments of confusion, burnout, or change. One practical exercise that caregivers can use to reconnect with their inner wisdom is to invite an image to emerge and begin a dialogue with it. 

Here’s a simple way to try this practice: 

Additional Resources for Caregivers 

To further support you in managing burnout and reconnecting with your purpose, we recommend these helpful resources: 

Join Nattan Hollander’s Care for the Caregiver Workshops 

If you’re a caregiver experiencing burnout, feeling disconnected from your work, or in search of deeper meaning, Nattan Hollander offers workshops designed specifically for caregivers like you. These workshops use imaginal (Jungian) techniques to help participants access their inner guidance and find renewed purpose. Whether you prefer to work in a group setting or embark on a solo journey of self-discovery, Nattan’s workshops offer practical tools to help you navigate the void and rekindle your spark. 

Visit  HYPERLINK “http://www.nattanhollander.com/”www.nattanhollander.com to learn more and sign up for an upcoming workshop or explore the solo journey options. 

References 

Estés, C. P. (1992). Women who run with the wolves: Myths and stories of the wild woman archetype. Ballantine Books. 

Maslach, C., & Leiter, M. P. (1997). The truth about burnout: How organizations cause personal stress and what to do about it. Jossey-Bass. 

Dear GoodTherapy,

Ever since my dad died last year, I have had no one to talk to. And really, I had no one to talk to for the last three years of his life, ravaged as he was by Alzheimer’s.

I don’t have any other family. I have no close friends, no husband or boyfriend, and no children. It’s just me and my constant companions: emptiness, loneliness, and my 8-year-old dog Roxie. When she goes, my life will truly be meaningless. Sometimes I hope she outlives me. If God had told me this would be my life, I would have stayed put.

[fat_widget_right]

I’m not kidding when I say I can go three or four days without saying a word to anyone. I write, but it’s just for me (except this letter). Writing is like talking to myself, so that’s something, I guess. And it keeps me from losing track of language altogether. Sometimes I feel like I’m starting to lose my mind the way Dad did.

So now that you know how pathetic my life is, go ahead and tell me there is “hope” if only I do this, that, and the other thing. I probably won’t believe you, but I wouldn’t be writing if I had given up completely. —In Solitary

Dear Solitary,

Your letter inspires my curiosity, not my advice. I’m not going to tell you to do anything because I believe you already know what to do—you’re just not ready. Perhaps you’re too mad or too sad. Both, maybe? What I will say is caring for your dad for three years took a lot out of you. You’re flattened, your energy seemingly used up.

It’s time for renewal. I think that’s why you wrote this letter. I don’t know what you do to care for yourself. I don’t know what you like to do, what you’d like to learn to do, or what you’d like to do differently, but you probably know the answers. Knowing what to do can be a lot easier than doing it, of course.

I’m not sure what you mean when you write, “If God had told me this would be my life, I would have stayed put.” Stayed put where? In a different house, job, city, state, state of existence? There are hints of hopelessness in your words, but there is always hope. Sometimes it helps when someone removed from your situation points it out. Speaking of hope, I hope you will consider working with a therapist for this reason. No good therapist is going to tell you what to do, but they will walk with you through the hardest parts until you see your own way forward.

Can you use your compassion and commitment for yourself, too? If not, why not?

Had you always lived with your father? Had you always lived the same way? You cared for your dad, Alzheimer’s and all, for three years. You know plenty about commitment and devotion to others. I wonder where and how you learned. Did someone once care for you that way? Can you use your compassion and commitment for yourself, too? If not, why not?

I have a lot of questions. Maybe too many. Do you ever question yourself? You write, so I’m guessing you do.

You are clearly lonely, but you know how to reach people if you want. You’ve put yourself in solitary confinement. I wonder what you’ve done to deserve this. Or what you think you’ve done.

Is it punishment or choice? Maybe you like having time alone, too. After all, you don’t have to take care of anybody except yourself and your dog.

You think your life is “pathetic”? I don’t think so. I think you’ve got plenty going for yourself. You just need to decide to use what you have.

Take care,

Lynn Somerstein, PhD, NCPsyA, C-IAYT

Hiker with backpack and long ponytail watching the sunset on top of a mountain and over the oceanBeing the parent of a child with a disability carries with it unique responsibilities, stressors, and rewards. It requires an extra dose of emotional resilience, perseverance, and resourcefulness. Powered by the same (or an even stronger) drive to nurture, protect, and empower their children as parents of kids perceived as normatively abled, parents of children with physical, intellectual, or developmental disabilities such as autism spectrum issues, spina bifida, or Down syndrome often face profound social and systemic prejudices. These “invisible” obstacles can be all the more agonizing when they are unacknowledged.

The Global Partnership for Education notes “children with disabilities remain the most excluded group [when it comes to educational opportunities], discriminated not only because of their disability but also because of lack of understanding and knowledge about its causes, implications, and stigma.” Even parents seeking to support their child with attention-deficit hyperactivity (ADHD) or physical conditions such as blindness or mobility issues can find themselves overwhelmed by the challenges of getting proper testing or access to a restroom or play space. When a child’s disability dovetails with preexisting societal or cultural prejudices related to gender, race, religious affiliation, or sexual identity, the challenges intensify, with an impact on parents that peers, colleagues, and others may not fully comprehend or appreciate.

[fat_widget_right]

As parents of children with disabilities proactively seek information and support and advocate for their children, they may discover frustrating limitations that reinforce a sense of isolation or exclusion and stoke emotions such as grief or anger. As a result of these and other factors, parents seeking support for their special needs children have special needs of their own when it comes to self-care.

Here are some key ways parents of children with disabilities can make self-care a priority:

1. Get support.

Parents of children with disabilities face added pressures and need to acknowledge their limitations and find ways to slow down, let go, and relax control, giving their nervous systems a much-needed rest.

2. Find time to do the things you love.

As the parent of a child with a disability, you likely expend tremendous energy trying to make sure your child has the privileges and opportunities available to other children. When your child’s disability is long-term or involves being vigilant about basic safety needs, the strain can take a toll on your well-being unless you are disciplined about your self-care.

Finding ways to recharge, relax, and experience pleasure in your life is essential. The more balanced, relaxed, and recharged you are, the more patient, caring, and proactive you can be as your child’s protector, nurturer, and advocate. Start with making a list of “Fun Things I Would Do If I Had Time.” You might include activities like going for a bike ride, going to dinner with a friend or partner, painting or journaling, watching a movie, getting a massage, taking a walk outdoors, or going to the gym.

3. Seek and take advantage of respite care services in your city or state.

Some parents of children with disabilities avoid taking advantage of respite care services for their children or feel pressured to “do it all on their own.” They may be anxious about their children not receiving proper or attuned care, or they may feel guilty about needing a break. In fact, allowing yourself and your child to be supported by trained caregivers can offer both of you a positive “time out” from each other, allowing you to hit the figurative reset button. It can help you replenish your emotional resources so you can be stronger and more resilient in your parenting.

4. Meditate.

Meditation can help you slow down, be in the present moment, and let go of trying to fix or control external circumstances, even if only for 5 to 10 minutes a day. There are multiple phone apps available with free or low-fee audio recordings of brief, guided meditations you can do between tasks, while you’re waiting in line at the store, or when you’re taking a bathroom break. These apps have reminders that encourage you to take a few moments out of your day and check in with yourself.

Everyone needs practice letting go of endlessly regenerating thoughts, beliefs, fear-based stories, and regrets in the interest of simply accepting life as it is right now. Parents of children with disabilities face added pressures and need to acknowledge their limitations and find ways to slow down, let go, and relax control, giving their nervous systems a much-needed rest.

In addition to experiencing high levels of chronic stress, anxiety, and depression, parents of children with disabilities are faced with the heartbreaking limitations that exist in a world where not all children are included, considered, and prioritized in the same ways. As you work to confront and overcome these limitations and to secure services, treatments, opportunities, and access for your child that will help them develop and thrive, it’s easy to ignore or minimize your needs. Far from being a self-indulgent luxury, your self-care is a critical necessity.

Reference:

  1. Children with disabilities. (2017). Retrieved from http://www.globalpartnership.org/focus-areas/children-with-disabilities
  2. Self-care for parents and caregivers of children with a disability. (2017). Retrieved from https://www.kidcentraltn.com/article/self-care-for-parents-and-caregivers-of-children-with-a-disability

Thoughtful young adult with hair in ponytail, scarf, hands in pockets, walks through park When you live with someone who is clinically depressed, there will be days when you’ve got it as tough as they do. Taking care of a loved one—whether it’s a child, partner, relative, or friend—can leave you just as debilitated, in pain, and wracked with frustration as they are. Having a hard time while your loved one is dealing with mental health issues can be like a guilty secret: it’s there, but no one wants to acknowledge it. Unfortunately, in many cases there aren’t a lot of resources available to caregivers. That might make you try to hide your discomfort, which only makes it worse.

For the person living with depression, life may be a constant fight. What looks from the outside like giving in often feels on the inside like consistent effort—when you’re depressed, it can take great exertion just to get out of bed, get dressed, and go to the grocery store. For the person who hopes to care for the sufferer, it’s hard to figure out how best to help. Your great ideas to motivate and distract your loved one might feel too difficult for them, and might even be seen as pushing too hard or having expectations they can’t possibly meet.

[fat_widget_right]

Many times, your day will be dictated by their mood, which may leave you feeling some of the same symptoms. If they wake up feeling bright, you can breathe a sigh of relief that your mood may be similarly light. If they come home from work in a funk, you may feel your night is ruined. Consumed by tracking their emotional temperature, they can feel like a tide that sweeps you away.

The hardest part is this: Because you aren’t the one who has the diagnosis, you aren’t supposed to be in pain. Not only are you given little attention or help, but you might call yourself selfish or petty when you feel your own symptoms. When that happens, it’s adding insult to injury—in addition to going through the difficulties of your situation, you’re mad at yourself for not being a superhero or a saint and rising above every challenge, every reaction.

You’re not alone. Many caregivers experience burnout. These are some of the symptoms:

Symptoms of Caregiver Exhaustion

Fear of the Future

One of the main worries when living with someone who is suffering is, “Will this ever end?” The person you knew in the past seems to be gone. The future plans you’ve made together are in jeopardy. Your role has changed. This is not what you signed up for, and you’re not sure you can handle it forever.

With depression, the good news is you can always count on some sort of change. If the condition had a sudden onset—illness, accident, trauma—then it’s possible that as the situation stabilizes, so will their mood. If your loved one has always experienced some degree of depression and it’s recently gotten worse, there is a high likelihood the right combination of medications, therapy, and coping skills will dial the intensity down.

You may never free your life completely of depression. But it tends to be a cyclical condition, with ups and downs, so it rarely stays the same. So, while there is no answer to the question, “How long will this last?” at least you can count on having better moments, and often stabilizing.

Desire for an Escape

No one wants to yearn to get away from the person they love, but when that person acts consistently negative or helpless, it’s a common reaction. And a natural one. Remember there’s a difference between feelings and facts. You can feel rebellious and fantasize about leaving, but act responsibly and stay put.

If you feel trapped, unable to leave or even to take some time off, then it’s important to find as much support as possible. If you have the resources, hiring caregivers or alternative healers can be not only helpful to kick-start your loved one’s recovery, but also to give you some rest. You need a team, whether that’s paid professionals or friends and relatives, to help both of you. Hire a masseuse, personal trainer, or life coach. Ask a friend to come play cards, read books aloud, or cook dinner. Your need to break away is normal and is a strong signal you’re experiencing what therapists call compassion fatigue.

Helplessness and a Thwarted Desire to “Fix” Your Loved One

Are you a researcher? If looking for answers makes you feel more productive, it can feel useful to check out all the different avenues to healing, such as EMDR (eye movement desensitization and reprocessing), TMS (transcranial magnetic stimulation), supplements, and electroshock. Many have provided relief to people who have tried other avenues without success.

If you’ve exhausted the possibilities, however, or have limited resources to keep trying new things, then you can easily sink into dejection. Here’s where acceptance comes in, and trying to avoid black-and-white, all-or-nothing thinking. Your loved one won’t always be like this. You might need to give yourself a breather from “fixing” before you can move on to new ideas. Or you might need to adopt a more tolerant point of view, a sense that if this is “the new normal,” perhaps there are ways to make it livable.

Anger and Guilt

The top two emotions experienced by caregivers are anger and guilt—two sides of the same coin. Anger is the more active of the reactions, and its target can be your loved one, the condition, yourself, God, or doctors. Everyone who is tired, anxious, and worn out will at some point feel anger.

And from the outside, it makes sense to resent your loved one. It is an unfortunate symptom of depression that it makes people feel helpless and hopeless, which means that from the outside, they may look like they aren’t trying. As a caregiver, knowing your wife isn’t doing any of the things prescribed to her—like exercise, medicine, or socializing—can appear to be a lack of effort, and can make you frustrated and powerless.

Try to see your guilt as a misdirected signal of how much you care. And then do more self-care to nurture yourself through these difficult waves of feeling.

It’s common, though misplaced, to blame yourself for your loved one’s condition. You might tell yourself you didn’t do enough to head it off, or that you’re not sacrificing enough to cater to them. Each social event or night off becomes a land mine of remorse.

Most of all, you can feel guilty for all of the above reactions, especially anger, because you love the sufferer so much and want so much to help. Try to see your guilt as a misdirected signal of how much you care. And then do more self-care to nurture yourself through these difficult waves of feeling.

I hope it’s clear from reading this list that the sum of all of these feelings leads to exhaustion and burnout. But if that’s where you are, there are steps that may allow you to take back control in your life.

How to Look Out for Yourself

You Need Self-Care as Much as Your Partner

When they struggle, you struggle. Your pain is just as important. Taking good care of yourself helps them at the same time, in two ways. First, you’re increasing your strength, patience, and ability to look after them. And second, you’re modeling the very skills that your loved one needs to do more of. By setting a good example, you can motivate and inspire.

Set Boundaries

It’s okay to say no. Even if your loved one is unable to manage their life, that doesn’t make their life all your responsibility. Decide for yourself how you can best support them and allow the rest to remain undone. Maybe you have skills at finances or cooking and want to take over those tasks. Or maybe it’s clear where the most pressing needs are and you’re willing to take those on. But remember you cannot do everything—nor should you. It can be helpful to the depressed person for you to insist they shoulder some of the responsibility for their life. This can help focus and motivate them. So when it’s reasonable (not during a major breakdown), insist on some reciprocity.

Be Mindful and Practice Acceptance

Many people try to fight discomfort by either fretting over it (fight) or distracting from it (flight). Paradoxically, modern approaches teach instead that sitting with the negative feelings is the quickest way to master them. If anxiety is worry about the future and depression is sadness over the past, then usually the present moment is, if not perfect, at least more bearable. By taking some of the tenets of mindfulness—staying in the moment and noting your reactions without judging them—you can deal with difficult times with more patience and less pain.

Try Not to Buy into Distorted Thoughts

When we’re thinking negatively (stinkin’ thinkin’), our thoughts tend to fit into the same negative slots over and over. Experts call these cognitive distortions, and they include jumping to the worst possible conclusions, seeing the world in all-or-nothing extremes, and blaming. Being able to label those thoughts as inaccurate, or as symptoms of depression, helps us put less stock in these exaggerations and think in a more evenhanded way.

Get Help and Support for Yourself

When you’re starting to feel extra irritable, getting sick more often, and not seeing your friends for weeks, these are all signs you need more. More exercise, more rest, and most importantly, more people around you. If you don’t want to go the professional route, you might be surprised at how much your friends and family members are willing to help. And if you prefer to speak to someone impartial, there are therapists who can provide a safe space to vent your feelings. Finally, support groups for caregivers offer a space where everyone will understand and empathize with what you’re going through. Whatever you choose, know help is available—and it is not only acceptable, but often necessary, to reach out.

Mature woman and adult daughter sit close to each other with sad expressions on their faces. Younger woman is holding her mother's hand.Whether out of obligation or out of a caring heart, more than 65 million adults in the United States take care of an elderly, chronically ill, or disabled loved one. Most of these ailing adults want to continue living at home as they age and their health declines, rather than in an assisted living situation like a nursing home. Because resources are more abundant now for in-home care, “aging in place” has become more common.

If you’re a caregiver in this situation, chances are you’re prioritizing care of another person over your own needs. You might be losing sleep and feeling fatigued or distracted. It could be you find yourself losing your temper easily. There’s even a possibility you have lost friends or are facing new financial struggles because of your caregiver role. All of this might leave you experiencing overwhelm.

Is it possible to care too much?

[fat_widget_right]

The answer is yes. This “caring too much” can be described as “compassion fatigue.” Compassion fatigue, a stress condition marked by a gradual decline in compassion and empathy toward others, often affects people in professional health care positions. But it can also happen at home when a well-intentioned caregiver overexerts in helping a person with a chronic illness or disability.

Compassion fatigue is different than burnout. When a caregiver is experiencing burnout, they have all but lost the ability to empathize or give care to others. Compassion fatigue happens when we help others who are in stressful situations, and burnout originates from occupational stress and being overworked.

Signs and Symptoms of Compassion Fatigue

Caregivers tend to experience compassion fatigue rather than burnout, although in severe cases, caregivers can experience burnout too. Some signs of compassion fatigue include:

Because people in caregiver situations often feel compelled to continue this role, they could be at risk for compassion fatigue. Learning to recognize and manage the signs and symptoms above effectively is imperative if you want to continue caregiving for your loved one. If ignored, these emotions and symptoms can intensify, and can eventually lead to more serious mental and physical issues.

5 Tips for Fighting Off Compassion Fatigue

If you believe you are at risk for compassion fatigue, it is not too late to stop the progression. Here are five tips for self-healing:

  1. Get enough sleep: You will likely have more energy and sharper thinking when your body is well-rested. This might mean engaging home health care services or a sitter to be with your loved one through the night while you rest. It may help you recharge and feel ready to take on a new day.
  2. Eat nutritious food: When we’re in a hurry, we tend to eat whatever is easy, and those choices aren’t typically wholesome. Unhealthy food (including drugs and alcohol) can leave us feeling sluggish and bloated, making it a challenge to be active and effective. Meal planning for the week can be a helpful way to stick to a healthier diet. Skipping alcohol and choosing water will likely help cleanse and rejuvenate your body.
  3. Get moving: While it may seem selfish to take time out of caregiving to exercise, the fact is exercise can boost your immune system, increase the “feel-good” chemicals in your brain to fight off depression, and relieve physical stress. Sparing even 20 minutes a day can be beneficial both physically and mentally.
  4. Enlist the help of others: Solo caregiving is asking for trouble. It is nearly impossible to care for another person 24/7 without aid. Asking a family member or close friend to take your place for a few hours, or enlisting home health care may give you some respite time to care for yourself. Your support system is crucial to your survival!
  5. Practice boundary-setting: Know when caregiving is too much and when you need to ask for help. Even if your loved one prefers your care to someone else’s, be aware of your limits and say no when needed. Express your own needs and concerns with others.

If you are on the downward spiral of compassion fatigue, seek the support of a licensed therapist and start caring for yourself, too. As American author and teacher in American Theravada Buddhism Jack Kornfield wrote, “If your compassion does not include yourself, it is incomplete.”

References:

  1. Signs of caregiver burnout and how to prevent it. (n.d.). Retrieved from https://www.vitas.com/resources/caregiving/signs-of-caregiver-burnout
  2. What is compassion fatigue? (2013). Retrieved from http://www.compassionfatigue.org/pages/compassionfatigue.html

Close-up photo of booted feet walking through leavesWhen you are the spouse or partner of a person experiencing depression, you may feel stuck between wanting to help and realizing depression is a force larger than your love at times. You may be on edge, hypervigilant, worried, and feel hopeless when you cannot fix it for them.

First things first. If your loved one is in a depressive state lasting longer than two weeks characterized by sleep disturbances, lack of interest in once-enjoyed activities, weight gain or loss, sad feelings, fatigue, irritability, suicidal thoughts, and/or social isolation, you should get professional help immediately. You can start with your family doctor, who may refer you to a mental health professional. Depression is not something to “wait and see” on, and it’s not something just anyone can identify or diagnose. Keep in mind, also, it is common for a depressed person to not want anyone (especially a loved one) to worry, so they will often put on a good front and minimize their true feelings.

[fat_widget_depression_right]

When your spouse or partner is hurting, it is natural to want to solve it for them—to search for actions you can do to remove depression and replace it with happiness. While this is a valiant and tender-hearted gesture, it is also ill-fated. Depression doesn’t simply go away because you’ve loved more. Clinical depression can be a chemical imbalance, a residual effect of past trauma, a situational outcome, or a genetic predisposition, making treatment difficult in the best of circumstances.

So what does it feel like to watch your spouse or partner go through depression? Well, it’s depressing. It creates a situation that may feel out of control, hopeless, and heavy. You may become a watcher—watching what the depressed person says, what they look like, how they acted, and what didn’t happen. You may become a detective trying to identify something that will create change and bring lightness. “If only …” may become your new motto, “Why don’t you try …” your new daily suggestion.

As a partner and (at least to some extent) caretaker, you will need to keep yourself healthy. That may mean seeking your own individual therapy, seeing friends, doing activities you enjoy, exercising, eating healthy, and setting clear emotional boundaries about what you can change and what you must accept.

You may become consumed with fighting this depression and then, without realizing it and without meaning to, you may get angry—angry your loved one isn’t getting better, angry your life stinks, angry you can’t change this. You know it isn’t your loved one’s fault and they didn’t ask for depression, but you may get impatient anyway, wanting change to happen more quickly than they may be able to move. You may experience a grieving of sorts—for the loss of the life with your loved one that you once knew.

As a partner and (at least to some extent) caretaker, you will need to keep yourself healthy. That may mean seeking your own individual therapy, seeing friends, doing activities you enjoy, exercising, eating healthy, and setting clear emotional boundaries about what you can change and what you must accept.

It is not unloving to learn to maintain a distance from the depression; it may, in fact, be the only thing that keeps you healthy and available. Observing your loved one suffering while you live fully can be difficult to comprehend. You will no doubt ask yourself if you should be laughing, eating out, or seeing a movie. However, who will take care of you if you don’t? Finding lighter, more upbeat activities can create space that allows for some happy times for you. This space can fuel you when times are heavy and tough. As with all things, “this too shall pass” can be a mantra to absorb and hold true.

In time and with treatment, your spouse or partner can be happy again, and you can feel less worried and vigilant.

Rear view of person sitting on low wall under cloudy sky hugging knees and looking out over riverI remember the first time I saw all the medication bottles in Mark’s cabinet. We hadn’t been together long, and I was curious to learn more about the medication he was taking. I asked him about them and he said they were for seizures. I didn’t quite understand what he meant by this, but he said “it” was under control, so I didn’t give it much more thought. I thought it was great he was willing to share such sensitive and personal information, considering it was early in our relationship.

Mark began to have seizures in his late 20s that did not respond to medication. Even though they are of the complex partial kind (e.g.,“smaller seizures”), when I witnessed one for the first time, it scared me. He wasn’t able to speak while it was happening, and he made strange sounds in addition to awkward movements with his hands.

Little did I know at that time the impact it would have on our lives. When epilepsy is under control, you don’t think about it. But when it is out of control, causing six or eight seizures a day, you can’t help but think about all the time.

[fat_widget_right]

The Impact of Epilepsy on Our Lives

Gradually, the seizures got worse until it impacted his work, home, and personal life. At work, supervisors did not understand his behavior and, at one point, asked him to take a leave of absence. He missed opportunities for advancement due to his employer knowing he struggled so much with seizures, and because of this his focus was impacted. At one point, I even contacted an attorney who said nothing could be done unless Mark was fired for having seizures.

Mark could no longer drive, meaning I had to do it. This impacted me so profoundly that I became resentful, both with our relationship and with epilepsy. To me, it was the thief that took away my normally laid-back and smiling husband and took away parts of our relationship. He began to withdraw more and played video games for hours at a time, struggled to talk about “it” and his feelings, and lost the ability to focus on our relationship and look forward to our wedding and life after.

It became hard for me to cope. I had few friends and felt no one understood. How could they? No one I knew what I was going through. I didn’t want to go out much with him to social events, as I feared the embarrassing attention a seizure might attract. I hate to say that, but it’s how I felt at the time.

Once we moved out of state, Mark got better medication and his seizures have since been controlled.

Looking back, there is a lot I would have done differently. I waited too long to get Mark support from a therapist for his physical condition and for his emotional well-being, and waited too long to get couples counseling to help us manage the challenging realities of life with epilepsy, for both partners.

Recommendations for Caregivers for People with Epilepsy

I recommend caregivers seek support from as many friends, family, and neighbors as possible and reach out frequently. I wasn’t as willing to reach out to the few friends I had as I should have been, even though I felt isolated and alone.

I also think it’s helpful for caregivers to find some respite through social outings. Going out to dinner, a movie, or bowling can help you feel connected and replenish your emotional reserves.

Pursue local resources that may be available to you as well. For us, a support group for people with epilepsy and their loved ones would have made a world of difference. With the internet at our fingertips, resources including message boards and local support groups are much easier to find and participate in.

The Importance of Self-Care

I recommend caregivers take time for self-care: good eating habits, consistent exercise, plenty of restful sleep. I have learned that the more stressful the experience, the more self-care is needed to maintain good mental health. Find ways to relax through deep breathing, meditation, massage, and stretching. It can also be helpful to find a creative outlet through art, writing, or crafts.

Both people with epilepsy and those who support them can feel overwhelmed, hopeless, and helpless at times.

As a caregiver, it can be easy to allow resentment, guilt, or compassion fatigue to set in, but remind yourself that epilepsy impacts the whole family. It’s no one’s fault, and it’s no one individual’s problem. Like your loved one, you need to be cared for and supported through this difficult journey. The more you take care of yourself and get support, the better the caregiver you are able to be.

Lastly, maintaining a sense of humor through the experience is important. Epilepsy can take over your world like an unwelcome visitor and seemingly become the center of everything. Find what tickles your funny bone and come back to it as needed. Laughing reduces your stress response, relieves tension, improves your mood, and can make it easier to deal with difficult situations (Mayo Clinic Staff, 2016).

In closing, remember to keep the faith. Both people with epilepsy and those who support them can feel overwhelmed, hopeless, and helpless at times. Keep looking for support until you find it—from medical practitioners, from friends, from your community. Remember to support each other as well, because you’re in it together.

Reference:

Mayo Clinic Staff. (2016). Stress relief from laughter? It’s no joke. Retrieved from http://www.mayoclinic.org/healthy-lifestyle/stress-management/in-depth/stress-relief/art-20044456

Walking in park

Compassion fatigue can be a serious occupational hazard for those in any kind of helping profession, with a majority of those in the field reporting experiencing at least some degree of it in their lives. This is no surprise, as it is typically those with the most empathy who are the most at risk.

Compassion fatigue is characterized by physical and emotional exhaustion and a profound decrease in the ability to empathize. It is a form of secondary traumatic stress, as the stress occurs as a result of helping or wanting to help those who are in need. It is often referred to as “the cost of caring” for others who are in physical or emotional pain. If left untreated, compassion fatigue not only can affect mental and physical health, but it can also have serious legal and ethical implications when providing therapeutic services to people.

While it is not uncommon to hear compassion fatigue referred to as burnout, the conditions are not the same. Compassion fatigue is more treatable than burnout, but it can be less predictable and may come on suddenly or without much warning, whereas burnout usually develops over time.

Because it can arise so abruptly, it can be important for therapists and others in the helping professions to protect themselves from this condition. Here are 11 ways to prevent compassion fatigue from happening to you:

1. Get Educated

If you know you are at risk for compassion fatigue, taking the time to learn the signs and symptoms can be a helpful means of prevention.

The most common signs and symptoms of compassion fatigue include:

[fat_widget_right]Knowing the signs and symptoms and continuing to check in with yourself can help you better prevent and manage compassion fatigue if it arises. Many people find that ranking their level of compassion fatigue on a scale of 1-10 is an effective strategy. For example, a rank of 6 might mean you are declining social invitations due to feeling drained and a 7 might be difficulty sleeping due to excessive worry about someone else’s well-being.

Cultivating a high level of self-awareness and understanding of how your 6 differs from your 7 can help you gage where you are so you can implement necessary strategies to avoid the red zone that would likely be a 9 or 10.

It is not only the work itself that poses a risk, but the person’s life conditions as well. For example, someone who is not only taking care of people at work, but also caring for a child or adult family member at home may be even more susceptible to compassion fatigue. If you are currently experiencing increased life stressors at home as well as in the workplace, prevention strategies against compassion fatigue may be important.

If you think you may be experiencing compassion fatigue, you can take a compassion fatigue self-assessment developed by the Compassion Fatigue Awareness Project here.

2. Practice Self-Care

Practicing self-care can be a critical method of protecting yourself against compassion fatigue. It is not uncommon for those who are constantly concerned with the needs of others to wind up neglecting their own.

Those who practice good self-care are significantly less vulnerable to stress and compassion fatigue than those who fail to do so. A good self-care regimen will look different for each person, but it should generally include:

Making time for these self-care activities leaves less room for overworking, which can lead to compassion fatigue, said Nicole Urdang, MS, NCC, DHM, a holistic psychotherapist based in New York.

“Overworking is often at the heart of compassion fatigue and its first cousin: vicarious trauma,” Urdang said. “Taking the very best care of yourself includes setting limits.”

3. Set Emotional Boundaries

It can be especially important for therapists, social workers, nurses, and caregivers alike to set firm emotional boundaries to protect themselves. Empathy and compassion are generally at the forefront of a human services career.

If left untreated, compassion fatigue not only can affect mental and physical health, but it can also have serious legal and ethical implications when providing therapeutic services to people.The challenge is to remain compassionate, empathetic, and supportive of others without becoming overly involved and taking on another’s pain. Setting emotional boundaries helps maintain a connection while still remembering and honoring the fact that you are a separate person with your own needs.

If people in a human services career are exposed to too much trauma, they may begin to feel overwhelmed, and people may feel that overwhelm in different ways, Urdang said.

“It might manifest as insomnia, overeating, skipping meals, addictive behavior, isolating oneself, depression, anxiety, or anger. We might find ourselves fighting with partners or children, having no patience, feeling exhausted, noticing a lowered libido, unmotivated, and, paradoxically, being less interested in what our clients have to say,” she said. “Believe it or not, these are all helpful, as they quickly alert us to our depleted state. If we are paying attention and are committed to radical self-care, we can act on this awareness by rebalancing our life. If that is not possible, simply taking short breaks throughout the day to close your eyes, focus on your breath, or put your hands on your heart and send yourself some compassion can all make a big difference.”

4. Engage in Outside Hobbies

Maintaining a solid work-life balance can help protect you from compassion fatigue. When all your time is spent working or thinking about work, it can be easy to burn out. Studies have shown work-life balance is becoming more important to workers, and making time for leisure activities and personal hobbies outside of work can help lower stress levels and improve overall life satisfaction.

5. Cultivate Healthy Friendships Outside of Work

While it is great to have strong relationships with your co-workers, it is equally important to cultivate and maintain healthy relationships outside of work. It can sometimes be difficult for co-workers to avoid talking about work even outside the workplace. Connecting with friends who are not aware of the ins and outs of your work situation can provide much needed emotional and professional relief.

6. Keep a Journal

Journaling is an excellent way to process and release emotions that may arise from your line of work. Taking the time to cultivate self-awareness and connect with your personal thoughts and feelings can help prevent suppression of emotions, which can lead to compassion fatigue over time.

7. Boost Your Resiliency

Resilience is our ability to bounce back from stress. While some people seem to naturally be more resilient than others, resilience is a skill that can be learned and cultivated.

“Resilience can be thought of as the ability to adapt to and become stronger through adversity,” said Marjie L. Roddick, MA, LMHC. “It can be a protective factor against compassion fatigue, so those with higher resiliency are better able to prevent compassion fatigue. Resilience is something that can be learned, and enhancing or boosting it can reduce the effects of compassion fatigue as new coping methods are learned.”

8. Use Positive Coping Strategies

While it may be tempting to wash away the stress and emotional burdens of your job with alcohol or drugs, this can actually work in the reverse and compound stress in the long run. Consider making a list of positive coping strategies to use in times of stress. This might include deep breathing, meditation, taking a walk, talking with a friend, watching a funny movie, or relaxing in a hot bath.

9. Identify Workplace Strategies

Workplace strategies are often an important part of compassion fatigue prevention. If your employer does not currently have any in place, consider suggesting their implementation.

Some workplace strategies that have been proven to be beneficial are:

10. Seek Personal Therapy

If you find yourself feeling emotionally vulnerable, significantly stressed, or overwhelmed, consider seeing a therapist who can help you process your feelings and implement strategies to help you combat compassion fatigue and maintain a healthy work-life balance.

References:

  1. Badger, K. (2008). Preventing compassion fatigue: Caring for ourselves while caring for others. Phoenix Society’s Burn Support News. Retrieved from http://www.phoenix-society.org/resources/entry/preventing-compassion-fatigue
  2. Brooks, C. (2013, March 5). Career success means work-life balance, study finds. Retrieved from http://www.huffingtonpost.com/2013/03/05/career-success-means-work-life-balance_n_2812707.html
  3. Boyle, D. A. (2011, January). Countering compassion fatigue: A requisite nursing agenda. The Online Journal of Issues in Nursing, 16, (1). Retrieved from http://www.nursingworld.org/MainMenuCategories/ANAMarketplace/ANAPeriodicals/OJIN/TableofContents/Vol-16-2011/No1-Jan-2011/Countering-Compassion-Fatigue.html
  4. Mathieu, F. (2007). Running on empty: Compassion fatigue in health professionals. Rehab & Community Care Medicine. Retrieved from: http://www.compassionfatigue.org/pages/RunningOnEmpty.pdf

Senior in nursing home visits with family memberPutting a family member in a nursing home may be one of the toughest decisions families have to make, and unfortunately, the decision for many doesn’t tend to feel “good.” Many hope for a long life of independence, and becoming immobile, senile, or dependent on others is a thought people simply like to avoid. As a psychotherapist who works in a nursing home, I often encounter family members racked with guilt, which has led me to analyze the experience.

Help Them Through the Adaptation Phase

Many of the nursing home residents I speak with openly express their discomfort at being in a nursing home, and some manifest symptoms of depression as a result. In my experience, it is typical for a new resident to struggle with this new environment. After a (sometimes long) transition period, many will begin to adjust. According to an article published in Nursing Research and Practice, this is called the “adaptation phase,” with the typical period of adjustment being cited as three to six months (2013).

[fat_widget_right]During the adaptation phase, a new resident may be struggling to respond to new rules and expectations of the nursing home staff, as well as learning to live with a new group of people. The adjustment period can be really tough, and unfortunately, some seniors may never fully adjust to a nursing home environment.

Help Them Avoid a ‘Loss of Control’

There are a number of ways family members, friends, therapists, and staff can help improve the quality of life of nursing home residents. I am focusing on family members in this article, but if you are looking at this problem from a different perspective, please utilize this advice to help a nursing home resident you care about.

Many nursing home residents I’ve spoken with express feelings of a “loss of control” when they don’t have any say in the facility where they end up living. With that said, one of the first ways to help a senior make the transition to a nursing home is to give the person a chance to evaluate options and make decisions regarding the new residence. Finances may be a huge barrier when looking for care, but giving a family member the right to shop around and choose a residence can help foster a sense of independence and control from the beginning of the transition (2013).

A window can make a big difference in a person’s living space within a nursing home. An article in the Journal of Aging Research says that a window view doesn’t even need to overlook plush greenery to be beneficial. It can simply offer something to look at, such as pedestrians, wildlife, or any landscape (2015). If the resident’s individual room does not offer a window, access to a private space with a window and a view may offer similar benefits. Adding plants to the resident’s room can also create a more personal environment and take away from the medical feel of the room.

Personal items from the resident’s previous home can also create a sense of familiarity and mastery over the experience. This may include pictures, furniture, or comfort items such as blankets. Allowing the resident to personally pick out items to bring to the nursing home can also contribute to the sense of control that can be so important to a healthy adjustment to nursing home living.

Help Them Stay Social

Initially, it can be intimidating to join the other residents in activities, but engaging in social activities and continuing ones enjoyed before the transition can positively affect a resident’s sense of happiness. If you’re a family member, go over the schedule of activities with your loved one and help pick out some that appeal to him or her.

Life in a nursing home is different, but it’s not the end. A person can continue to feel loved and cared for, and offer their love and care in return.One of the best ways to help your family members ease into a nursing home is simply to listen to them. Often, seniors at the nursing home I work in tell me they don’t tell their children or family members about their feelings of depression because they don’t want to burden them. Others say they attempt to tell their family members, but their feelings are dismissed. Many new nursing home residents will experience depressive symptoms and feelings of hopelessness as part of the adjustment phase. Allow your family member to talk about this experience so he or she doesn’t feel further isolated. This may evoke your own guilt or a desire to fix the situation, but remind yourself that your loved one has limited people to talk to, especially about emotions. Your ability to sit and listen will help demonstrate that you care and are available for support.

Lastly, and perhaps most important, provide a sense of hope for your family members. Consider what might increase comfort in the home and offer some options. Listen to their struggles without defending them. Offer them your time and company, share pictures of the family, bring food from home, and remember to tell them how important they are to you. Life in a nursing home is different, but it’s not the end. A person can continue to feel loved and cared for, and offer their love and care in return.

References:

  1. Degenholtz, H.B., Resnick, A.L., Bulger, N., & Chia, L. (2014). Improving quality of life in nursing homes: The structured resident interview approach. Journal of Aging Research, 2014, doi: http://dx.doi.org/10.1155/2014/892679
  2. Riedl, M., Mantovan, F., & Them, C. (2013). Being a nursing home resident: A challenge to one’s identity. Nursing Research and Practice, doi: http://dx.doi.org/10.1155/2013/932381
  3. Van Hoof J., Verhagen, M.M., Wouters, E.J.M., Marston, H.R., Rijnaard, M.D., & Janssen, B.M. (2015). Picture your nursing home: Exploring the sense of home of older residents through photography. Journal of Aging Research, doi: http://dx.doi.org/10.1155/2015/312931

GoodTherapy | How to Help an Aging Parent with DepressionAs the human lifespan grows, many people are now living well into their eighties and nineties. That’s wonderful news, but it comes with new challenges. One of them is the challenge of addressing mental health issues in our aging parents.

Depression is frequent among older adults. The rate of depression in persons over age 65 varies depending on the person’s overall health and living situation, but it can be as high as about 27% (Cswe.org, 2015).

What Causes Aging-Related Depression?

Several factors can contribute to depression in older adults, including:

For many aging adults, the world can seem like an increasingly confusing place. There are always new technologies and new ways of doing things. Feeling unsure of themselves, older adults may become stubborn and cling to the things they know and are more comfortable with. Keep in mind that for many in this generation, psychotherapy and mental health treatment may not be seen in a positive light, having been stigmatized throughout their lives. Thus, suggesting therapy may seem extreme or even insulting to an aging person, even if he or she would clearly benefit.

How to Support a Depressed Parent

  1. Respect his or her need for independence, and don’t try to take control.
  2. Offer love and support; just letting him or her know you care and are available is enough. For many people (young and older), admitting that they are depressed is difficult.
  3. Delicately suggest one or two visits with a therapist who is experienced in geriatric issues, then leave it up to your parent whether to continue.
  4. Talk about a friend or someone you know who experienced a time of depression and then recovered. Gently suggest that perhaps it is similarly possible for your parent to improve his or her mood and sense of happiness.
  5. Learn active listening and empathy skills and become a good listener, without judgment or advice.

Is Medication a Good Option?

Sometimes, medication can be a good option for older persons, and sometimes it can make things worse by affecting cognitive function. It’s important to get a thorough evaluation by a qualified mental health professional who is trained in a variety of treatment approaches.

Watching an aging parent give up and not take good care of himself or herself can be heartbreaking and frustrating. It’s natural to want to insist that your parent get help, but being overly pushy can make things worse. A gentle approach that respects your parent as a competent adult is often the best bet.

Reference:

Gellis, Z. D., & McCracken, S. G. (2015). Mental Health and Older Adults – Chapter 3: Depressive Disorders in Older Adults. Council on Social Work Education. Retrieved from http://www.cswe.org/File.aspx?id=23509

Important Notice

GoodTherapy is not intended to be a substitute for professional advice, diagnosis, medical treatment, or therapy. Always seek the advice of your physician or qualified mental health provider with any questions you may have regarding any mental health symptom or medical condition. Never disregard professional psychological or medical advice nor delay in seeking professional advice or treatment because of something you have read on GoodTherapy.