Caregiver Stress and Compassion Fatigue

Caring for someone with a mental health problem like bipolar disorder or ADHD can be overwhelming. Learn how to deal with caregiver burnout.

As the parent of a child (or children) with high needs, the lives of all involved are complicated. It's very easy to become hyper-focused, over-involved, and unable to separate "self" from "situation." This is very common, normal, and at the same time, dangerous.

The very things required to function within the daily life of caring for a child or other family member with exceptional needs can lead to feeling overwhelmed and frustrated. If unchecked, these feelings build; leaving one vulnerable to getting stressed over things that were once not stressful. This can be further complicated if the caregiver has a diagnosis of, or tendencies towards depression, anxiety, bipolar disorder or other similar mood disorders.

Compassion fatigue

Have you heard of compassion fatigue; sometimes called secondary victimization or traumatic stress, vicarious traumatization? It's a form of burnout, a deep physical, emotional and spiritual exhaustion accompanied by acute emotional pain. Compassion-fatigued caregivers continue to give themselves fully to the person they are caring for, finding it difficult to maintain a healthy balance of empathy and objectivity. The cost of this can be quite high in terms of functionality, family, work, community and most of all, self.

You probably already realize that living with an unstable child (with behavior problems) subjects all family members to daily trauma at times. Numerous symptoms indicate that a caregiver is experiencing reactions to traumatic stress. In fact, the very qualities that make one an excellent caregiver - empathy, identification, safety, trust, intimacy and power - are the very qualities that can cause one to face burnout.

Learning to recognize the symptoms within oneself that indicate heightened stress is imperative to addressing, relieving and avoiding it. Stress unchecked will lead to caregiver burnout.

Those who have experienced compassion fatigue describe it as being sucked into a vortex that pulls them slowly downward. They have no idea how to stop the downward spiral, so they do what they've always done: They work harder and continue to give to others until they're completely tapped out.

Symptoms of burnout

• Abusing drugs, alcohol or food
• Anger
• Blaming
• Chronic lateness
• Depression
• Diminished sense of personal accomplishment
• Exhaustion (physical or emotional)
• Frequent headaches
• Gastrointestinal complaints
• High self-expectations
• Hopelessness
• Hypertension
• Inability to maintain balance of empathy and objectivity
• Increased irritability
• Less ability to feel joy
• Low self-esteem
• Sleep disturbances
• Workaholism

To those who are in the throes of compassion fatigue, time, or more precisely the lack of it, is the enemy. To compensate, many caregivers try to do several things at once (e.g., eat lunch while returning telephone calls). And to make more time, they tend to eliminate the very things that would help revitalize them: regular exercise, interests outside of caregiving, relaxed meals, time with family and friends, prayer and meditation.

Treating caregiver stress and burnout

To recharge your batteries you must first learn to recognize when you're wearing down and then get into the habit of doing something every day that will replenish you. That's not as easy as it sounds. Old habits are oddly comfortable even when they're bad for us, and real lifestyle changes take time (some experts say six months), energy and desire.

The first line of action is to prioritize situations so you have some measure of control.

Ask yourself:

• What do I have control over?
• Who is in charge here?
• What do I really need to change?
• What do I see as necessary that really is not?
• Will the world stop spinning if I do not do ____?

Have your own self-care plan

The lifestyle changes you choose to make will depend on your unique circumstances, but three things can speed your recovery.

1. Spend plenty of quiet time alone. Learning mindfulness meditation is an excellent way to ground yourself in the moment and keep your thoughts from pulling you in different directions. The ability to reconnect with a spiritual source will also help you achieve inner balance and can produce an almost miraculous turnaround, even when your world seems its blackest.
2. Recharge your batteries daily. Something as simple as committing to eat better and stopping all other activities while eating can have an exponential benefit on both your psyche and your physical body. A regular exercise regimen can reduce stress, help you achieve outer balance and re-energize you for time with family and friends.
3. Hold one focused, connected and meaningful conversation each day. This will jump start even the most depleted batteries. Time with family and close friends feeds the soul like nothing else and sadly seems to be the first thing to go when time is scarce.

Here are some other ideas for relieving stress, compassion fatigue and caregiver burnout

• Plan time to be alone. (even 5 minutes can be a life saver)
• Develop a personal relaxation method.
• Claim a place that belongs to you alone for personal time.
• Dress comfortably in clothes you like.
• Take a bubble bath.
• Hire a sitter for an hour/evening.
• Make and keep a regular date with significant other or friend.
• Go for a drive, roll down the windows and crank up the radio.
• Reduce all sensory input. (dim lights, turn off TV's, radios and phones, put on comfy clothes)
• Read a book.
• Light some candles.
• Order dinner delivered.
• Get a massage.
• Take time to be sexual.
• Plan and get enough sleep.
• Eliminate unnecessary activities in life.
• Eat regular and healthful meals.
• Dance, walk, run, swim, play sports, sing or some other physical activity that is enjoyable.
• Try something fun and new.
• Write or call a friend.
• Give yourself affirmations/praise...you are worth it!
• Find things that make you laugh and enjoy them.
• Prayer or meditation.
• Let something go for a day. The world does not stop spinning if the beds are left unmade.
• When energy is flagging, a B Complex supplement is very helpful.

The idea is to take care of your "self" to avoid negative outcomes. What works for one person in avoiding or relieving stress differs from the next. It could take some experimentation or willingness to try something new to discover what really helps. Once found, practice often. If, after trying several things on a regular basis and not finding significant relief, consider that you may be suffering from depression and/or anxiety and consult with a mental health professional.

Sources:

• Can you care too much? Hippocrates. April 1994:32-33.
• American Academy of Family Physicians, April 2000.