Depression
"More than one third of all carers were found to be severely or extremely severely depressed or stressed" (Carers Australia 2007).
Caring and depression
Carers experience the highest rates of depression yet discovered of any group in Australia.
A special report carried out in 2007 titled The Wellbeing of Australians: Carer Health and Wellbeing used a measure known as the Australian Unity Wellbeing Index to determine rates of depression amongst carers. The study found that:
- Caring could be one of the leading causes of depression in Australia
- Caring does not get easier with time
- Wellbeing levels appear to stabilise after two years in a caring role, but do not generally increase while the caring role continues
- Caring compounds the effect of any other variable that may cause depression
- Wellbeing decreases as the number of hours spent caring increases
What is depression?
People experience depression differently. While some people may describe themselves colloquially as feeling "depressed" when they feel sad, hear bad news or when things are not going well, clinical depression is a serious illness. It can involve a range of symptoms, including:
- feeling extremely sad or tearful
- difficulty falling asleep or staying asleep, or difficulty waking up
- loss of interest and motivation
- feeling worthless or guilty
- loss of pleasure in activities
- anxiety
- anger or irritability
- feeling isolated
- changes in appetite or weight
- loss of sexual interest
- physical aches and pains
- impaired thinking or concentration
Depression can impact on the quality of the carer's relationship with the person being cared for. Feelings of isolation, guilt, sadness, anger and anxiety can increase the potential for relationship breakdown or loss of intimacy.
Could I be depressed?
If you think you may be depressed, the first step is to get an assessment from your doctor.
It is normal to feel sad, anxious or stressed in difficult times. However, if the sadness and negative feelings just don't go away, or you find that you are too easily upset or angered, this could be a warning sign for depression. Remember that depression does not always mean sadness - excessive anxiety, weight loss or difficulty sleeping could all be indications that you need to talk to someone.
Carers often don't attend to their own health issues, because they seem minor compared to those of the person they are caring for. But keeping a check on your own wellbeing is vital - who would look after your loved on if you became ill yourself? If you notice any warning signs of depression, it is important to see your doctor.
Why am I feeling depressed?
Caring for someone with cancer can be stressful and exhausting. On top of all of the emotions brought out the protracted illness of a loved one, such as grief, denial, anger and sadness, the daily demands placed on a carer can be overwhelming. You may spend your days preparing meals, cleaning, providing transport, dealing with health professionals, administering medication, listening, talking, keeping relatives and friends informed, working and ensuring your loved one gets all the help they need. You may feel that you can't possibly get everything done - or guilty that you haven't done enough. The significant and unrelenting burden on carers can trigger depression and may place strain on their relationships.
Unfortunately, depression is often seen as a sign of weakness. Comments such as "snap out of it" or "it's all in your head" are not helpful, and reflect a belief that mental health concerns are not real. Ignoring or denying your feelings will not make them go away.
Gender and depression
In Australia, women account for 54% of the caring population. While female carers experience depression at a higher rate than male carers, many do not seek treatment for depression because they are embarrassed or in denial about being depressed.
Male carers are even less likely to admit to depression than female carers, and doctors are less likely to diagnose depression in men. Men will more often 'self treat' their depression symptoms of anger, irritability or powerlessness with alcohol or long hours at work. Although male carers tend to be more willing than female carers to have outside help and assistance with home care duties, they tend to have fewer friends to confide in or positive activities outside the home. The assumption that depressive symptoms are a sign of weakness can make it especially difficult for men to seek help (Family Caregiver Alliance).
What can I do about depression?
If you are diagnosed with depression, your doctor will discuss a number of possible treatments with you. These treatments may include medication, but may also include therapy sessions with a psychologist or counsellor. The treatment (or combination of treatments) that you choose, in consultation with your doctor, will depend on the type of depression you are suffering from and its severity.
The National Institute of Mental Health (Family Caregiver Alliance) offers the following recommendations for dealing with depression:
- Set realistic goals in light of the depression and assume a reasonable amount of responsibility.
- Break large tasks into small ones, set some priorities, and do what you can as you can.
- Try to be with other people and to confide in someone; it is usually better than being alone and secretive.
- Participate in activities that may make you feel better, such as mild exercise, going to a movie or attending a social or community event.
- Expect your mood to improve gradually, not immediately. Feeling better takes time.
- It is advisable to postpone important decisions until the depression has lifted. Before deciding to make a significant decision, discuss it with others who know you well and have an objective view of your situation.
- People rarely "snap out of" a depression. But they can feel a little better day by day. Remember, positive thinking will replace the negative thinking that is part of the depression. The negative thinking will be reduced as your depression responds to treatment.
- Let your family and friends help you.
- Seek out and use respite care, as well as positive feedback from others, positive self-talk, and recreational activities, which are all linked to lower levels of depression.
- Look for classes and support groups available through carer support organisations - contact Carers NSW 1800 242 636 or http://www.carersnsw.asn.au to help you learn or practice effective problem solving and coping strategies needed for caring.
- For your health and the health of those around you, take time out to care for yourself.
- You can arrange to have much needed sleep. Have a respite worker come to be with the person you are caring for while you get sleep, take a nap or have a break for a few hours. Having a family member stay over on a regular basis may also be the answer. Contact the Commonwealth Carer Respite Centres on 1800 059 059 or Carers NSW 1800 242 636 for assistance.
