United States Department of Veterans Affairs
 Resources & Education for Stroke Caregivers' Understanding & Empowerment

RESCUE Lifepreserver Fact Sheet Masthead Logo

RESCUE HOME  |   RESCUE Fact Sheet Library


An older woman is holding her head like she is sad and depressed

UNDERSTANDING HOW CARING FOR A LOVED ONE AFFECTS YOU

Caregiver Stress & Depression

Taking care of someone else can be stressful. Caregivers often sacrifice their own well-being to provide care for their loved ones. The stress of caregiving can cause headaches and chronic neck and back pain. It can affect thoughts and feelings, leading to depression. Caregiving stress can cause serious health problems.



Small image of a life saver

What Do You Need to Know?

Small image of a life saver

What Treatments Should You Discuss with Your Healthcare Team?

Small image of a life saver

Do You Feel Stressed?

Small image of a life saver

How Can You Take Better Care of Yourself?

Small image of a life saver

Why Is It Important to Get Help?

Small image of a life saver

Helpful Tips

Small image of a life saver

Depression and Caregiving

Small image of a life saver

Remember

Small image of a life saver

How Do You Know if You Are Depressed?

Small image of a life saver

More Resources



What Do You Need to Know?

You may have feelings of anger, guilt and sadness. You may worry that you are not doing the right things. You may feel lonely and resent your new role. These are feelings that most caregivers have from time to time. Pay attention to how caregiving is affecting you. Talk to your healthcare team about your negative feelings.



Do You Feel Stressed?

Answer the questions on the Zarit scale to find out your stress level. A score of 8 or above shows a high level of stress. Talk to your healthcare team about ways to reduce stress.

Zarit Scale
Never

(0)
Rarely

(1)
Sometimes

(2)
Quite
Frequently
(3)
Nearly
Always
(4)
1) Do you feel that because of the time you spend with the stroke survivor that you don't have enough time for yourself?          
2) Do you feel stressed between caring for the stroke survivor and trying to meet other responsibilities (work/family)?          
3) Do you feel strained when you are around the stroke survivor?          
4) Do you feel uncertain about what to do about the stroke survivor?          
Total Score:          

Adapted from: Radloff, LS. (1977). The CES-D scale: A self-report depression scale for research in the general population. Applied Psychological Measurement, 1;385-401.



Why Is It Important to Get Help?

The stress of caregiving may be overwhelming and affect the care you give. Taking care of yourself will make you a better caregiver. Get help from your healthcare team. Proper treatments help most people.



Depression and Caregiving

Female caregiver has her head in her hand like she is depressed

Caregivers suffer from depression twice as often as non-caregivers. Depression is not a sign of personal weakness. Depression cannot be wished away.




How Do You Know if You Are Depressed?

The signs and symptoms of depression vary from person to person. Without treatment, symptoms of depression can last for weeks, months or years. Here is a list of the signs and symptoms of depression. If you have any of these signs for more than two weeks, talk to your healthcare team.

  • Sadness or an “empty” mood
  • Feeling guilty, worthless or helpless
  • Problems concentrating, remembering or making decisions
  • Change in eating habits and/or weight changes
  • Feeling hopeless
  • Lack of energy or feeling tired and “slowed down”
  • Problems with sleep, such as trouble getting to sleep, staying asleep or sleeping too much
  • Easily angered or irritable
  • Wanting to be alone or spending much time alone
  • Loss of interest or pleasure in hobbies and activities, including sex, that were once enjoyed
RED FLAG: Suicidal Thoughts
Red flag with the word "RESCUE" in white lettering

If you have thoughts of killing yourself, get help right away!

Call 9-1-1 or your healthcare provider. This is a serious problem.  



What Treatments Should You Discuss with Your Healthcare Team?

Ignoring the stress of caregiving is the number one cause of “caregiver burn-out”. Be honest with yourself about what you are feeling. Do not pretend that everything is okay. Proper treatment helps most people with depression. Ask your healthcare team about the best treatment for you.

  • Medicines, such as anti-depressants are almost always helpful.  
  • Psychotherapy (talk therapy) is used along with medicines. Talk therapy gives you a safe place to talk about your feelings.
  • Support groups provide a place to share your feelings with other caregivers.
  • Other caregivers understand what you are going through. They can help you find solutions to your problems.


How Can You Take Better Care of Yourself?

Group of four people playing cards and laughing with one another

Taking care of yourself will make you a better caregiver.

Put taking care of yourself at the top of your list – Have regular medical check-ups. Eat right and exercise.

Ask for help – Take on only what you can manage. Don’t try to do everything by yourself. Be prepared with a mental list of ways other people can help.

Find time for yourself – You need breaks from caregiving. Do things you enjoy. Go for walks or visit your friends. Take yoga or relaxation classes. Get a massage. Treat yourself to special outings on a regular basis.

Laugh and have fun – Joke with your loved one. Laugh out loud. Read a funny book. Watch a funny movie or a comedy on TV.



Helpful Tips

Accept your feelings – Feelings of anger and sadness are normal from time to time. Be patient with yourself.

Remember that caregiving has rewards – About half of all caregivers report positive feelings about caregiving. Caregiving often leads to stronger relationships with loved ones. Many stroke survivors do not show their true feelings. But, know that your loved one needs and appreciates your care.

Don’t take things personally – Your loved one may say or do hurtful things. Remember that these behaviors are due to their illness.

Practice getting rid of negative thoughts – Replace negative thoughts with positive thinking or memories. Practice this every day. Focus on the things you can do. Relax about those things that you cannot. Forget and forgive your mistakes. We all make them.

Get information – Learn about strokes. Learn about resources and ways to provide good care. This will help you plan for the future.



Remember

  • Take care of your health. You will be a better caregiver.
  • Ask for help. Prepare a list of ways others can help.
  • Depression cannot be wished away. It is not a sign of weakness.
  • Proper treatment helps most people with stress and depression. Talk with your healthcare team.


More Resources

The following resources are related to this fact sheet only. View a full list of the resources from all RESCUE fact sheets.

American Medical Association
Web:  www.ama-assn.org*
Phone: 1-800-621-8335

The American Medical Association has a “Caregiver Self-Assessment Questionnaire.*” This tool allows caregivers to look at their own behavior and health risks.

Also available in Spanish.*


Photo collage of images representing computers and the Internet

Family Caregiver Alliance
Web:   caregiver.org*
Phone: 1-800-445-8106

The Family Caregiver Alliance provides information, education and services for caregivers. Some information is also available in Spanish.

The Family Caregiver Alliance has a fact sheet on “Taking Care of You: Self-Care for Family Caregivers.


Familydoctor.org
Web: familydoctor.org*

Familydoctor.org has information on ways to deal with stress*. Some information also available in Spanish.


Logo for My HealtheVet

My HealtheVet
Web: www.myhealth.va.gov

My HealtheVet (MHV) provides trusted information on stroke and other health conditions. It also provides resources for stroke caregivers and tools to track your loved one's health.

Take a depression screening test for symptoms of depression.

Visit the My HealtheVet Caregiver Assistance Center for more information on caregiving.


NYU Langone Medical Center/NYU School of Medicine, Department of Psychiatry
Web:   psych.med.nyu.edu*
Phone: 1-212-263-6216

NYU Langone Medical Center/NYU School of Medicine, Department of Psychiatry has information on depression and an on-line depression screening test*.



*Link Disclaimer: Links to information and Web sites outside of the Department of Veterans Affairs do not indicate an endorsement of products or services offered by the sites. In addition, these sites may have privacy and security policies that are inconsistent with those of VA.

Download a free version of Adobe Reader* to view PDF files.



References: U.S. Department of Health & Human Services. (2008). Caregiver Stress. Retrieved November 3, 2008, from Office on Women’s Health at http://www.womenshealth.gov*; Familydoctor.org. (2008). Is it normal to have so many feelings about being a caregiver? Retrieved November 6, 2008, from: http://familydoctor.org/online/famdocen/home/common/cancer/caregivers/719.html#ArticleParsysMiddleColumn0005*; 4Therapy.Com Network. (2008). What can I do about caregiver stress? Retrieved November 12, 2008, from: http://www.4therapy.com/consumer/conditions/item.php?uniqueid=5645&categoryid=261*; Family Caregiver Alliance. (2008). Retrieved June 26, 2008, from: http://www.caregiver.org/caregiver/jsp/content/pdfs/op_2003_caregiver_depression.pdf*; National Institute of Mental Health. (2008). Retrieved October 10, 2008, from: http://www.nimh.nih.gov*; Dreslin, J. (n.d.). Stroke Awareness for Everyone; Stroke Caregivers Handbook. Retrieved on June 26, 2008, from: http://www.strokesafe.org/Handbook.html*; Bedard, M, Molloy, D.W., Squire, L, Dubois, S. Lever, J.A., O’Donnell, M. The Zarit Burden Interview: A New Short Version and Screening Version. The Gerontologist, 2001. 41(5): p.652-657; Franklin, D.J. (2008). What is a Depressive Disorder? Retrieved June 26, 2008, from Psychology Information Online: http://www.psychologyinfo.com/depression/description.html*


Alternate lifepreserver logo for the RESCUE Project
Logo for the Rehabilitation Outcomes Research Center - White head on a blue background with a blue brain containing 5 white and one red star

These materials were created for the project:

Web-Based Informational Materials for Caregivers of Veterans Post-Stroke

Project Number SDP 06-327 funded by VA HSR&D Quality Enhancement Research Initiative (QUERI); Supported by the
Stroke QUERI

Visit the Stroke QUERI Website