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Depression, suicidal thoughts plague some caregivers

by Carol Bradley Bursack, Editor-in-Chief

Most people begin caring for their mates or their elders with hearts full of love, compassion and support. However, few caregivers stop to realize how long this caregiving could go on. As months blend into years, caregivers can get more prone to burnout. Frustration over not being able to cure their loved ones and isolation from a social life can, for some caregivers, lead to depression. Some carers admit to suicidal thoughts. These people need help for themselves if they are to continue to be effective caregivers.

I recently received a phone call from a man who regularly reads my newspaper column. He was desperate for help because he felt guilty about the need to get his wife into a memory unit of some type. He talked for nearly an hour and then said to me, "Sometimes I just want to die."

Talk about a red flag! People can feel life is not worth living for any number of reasons. Sometimes, when we are clinically depressed, it's not for any particular reason, rather it's a chemical imbalance that affects our ability to feel joy. But often, something going on in a person's life is the trigger for their clinical depression.

Conventional wisdom says that if a person is feeling down for two weeks or more, he or she should see a doctor, as this could be a case of clinical depression. Frankly, if all caregivers who feel down for a couple of weeks straight went to their doctors, the clinics wouldn't have room for any other patients. That being said, caregivers need to watch for signs of real depression. Whether it's one day or two months, if thoughts of suicide are part of the depression, people need to immediately seek help.

Caring For Two Generations

The man who called me had an even tougher problem than most caregivers. His wife was suffering from early on-set Alzheimer's disease and was only in her late forties. They have a teenage daughter. The man said he couldn't be a good parent to their daughter, because his wife needed so much care. He was rightly worried about the effect that this unintended neglect was having on his daughter. He felt guilty putting his wife in a care center, but he felt guilty about keeping her home, because his wife's needs were affecting his ability to be a good parent.

The daughter didn't feel comfortable inviting friends to visit both because her friends were uncomfortable around her mother and because her mother was easily upset by people who were, to her, strangers. The father couldn't leave his wife long enough to go to a band concert or a ballgame to see his daughter perform. The daughter was trying hard to understand, but the girl felt she was losing both parents and was often distraught.

Therapy for the Caregiver Can Help

That this family needs therapy is an understatement. I told the gentleman who called me that the most important thing right now was for him to get himself to a doctor. I suggested in-home care for his wife while he went to his appointment. I felt the man's doctor would likely prescribe for this man an antidepressant and perhaps some sessions with a psychologist. At least I hoped that some psychological care would be suggested. I also gently suggested that his daughter may benefit from some counseling.

The main problem with this caregiver, as with most, is feelings of guilt. I'm not sure there's a caregiver alive who isn't guilt-ridden during much of the caring. It's hard to feel you are doing enough when the person you are caring for continues to go downhill. But this gentleman had to think of more than his own guilt. He had to consider his daughter.

I suggested to him that getting his wife into a memory unit would keep her safer than she would be at home, living with two people who are emotionally frayed. I told him that he needs to think of his daughter and her future. And I told him what I tell people often--that one way I made decisions when the needs of my children and my elders conflicted was to think of what my parents would have wanted me to do, if they could still think rationally.

What Would Your Care Receiver Have Wanted You to Do?

I have no doubt my parents would have said, "You need to be a good mother. Take care of us, but not at the expense of your children."

I believe this man's wife would, if she could, say to him, "Our daughter needs you. Don't sacrifice her to my care. If you die she will lose both of us. Come and see me and take care of me, but don't die, and don't feed our daughter's resentment toward me by neglecting her. Get help and find a balance."

I don't know what the gentleman decided to do, but he felt better having talked it out. I think about him often, and hope he got help for all three of them. Caregivers need many kinds of support as they travel the long road of their loved one's decline. Often, that help comes from professionals.