Sources for this article include NAMI.org , va.gov (U.S. Department of Veterans Affairs), adaa.org (the Anxiety and Depression Association of America) and caregiver.org. Other sources included the U.S. Department of Health and Human Services, “Identifying and Addressing Family Caregiver Anxiety” by Karen O Moss, PhD, RN, CNL; Colleen Kurzawa, MSN, RN, MFA; Barbara Daly, PhD, RN, FAAN; and Maryjo Prince-Paul, PhD, RN, FPCN. The article “Hidden from view” in Breathe magazine, issue 57, also provided insight.
Are caregivers vulnerable to anxiety?
More than one in five Americans today are caregivers, providing care and support to an adult or child with special needs. That is 21.3 percent of the population.
A study of family caregivers cited above found roughly 38 percent find their situation extremely stressful. Caregivers are a vulnerable population for psychological distress, including anxiety. In fact, the caregiver’s anxiety can even exceed the levels that their loved one’s experience. This study covered caregivers of people with cancer and dementia, but I’m sure the statistics for families dealing with mental illness are similar or even worse.
How anxious are you feeling? Are you managing too many responsibilities? Strain because you can’t control your own life? Fear for a loved one’s well-being? Deal with financial and healthcare coverage stressors? As a caregiver, you may spend many more hours a week providing care than in a regular job. Caregivers report employment problems, health issues, lack of sleep and little time to do the things they enjoy.
What is anxiety?
Anxiety is the most common form of mental illness in the U.S., affecting 14% of the population. That includes 18% of adults and 8% of children and teenagers. (These figures are from the National Institutes of Health.)
It is a common emotional response to a perceived threat, often accompanied by tension, worried thoughts and physical changes like high blood pressure and insomnia.
Severe and persistent anxiety typically has these aspects:
- Extreme fear and dread, even when there is nothing to provoke it
- Emotional distress that affects daily life
- A tendency to avoid situations that bring on anxiety
How is anxiety different for mental health caregivers?
As we see above, anxiety can be extreme fear without reason. Caregivers for people with mental illness have plenty of reasons to experience fear and ongoing grief, including:
- Fear of living life without the personality we loved.
- Grief over our loved one’s lost potential and possible future.
- Fear of being overwhelmed by the issues surrounding mental illness.
- Fear of future pain.
- Fear of losing your own identity and life.
- Grief over lost plans for retirement.
Once my primary care doctor said to me: “If you weren’t anxious, I’d be worried that you didn’t understand the situation you are in.”
While some caregivers probably do have generalized anxiety disorder, many caregivers are just plain anxious. The study I read was focused on caregivers for people with cancer and dementia, but many of the aspects are the same.
I once attended a retreat for mothers of children with severe mental illness led by Kay Warren. She said: “We receive wounds of many sorts. Some forms of pain and loss we just don’t get over. A soul wound damages the architecture of the soul. What is grief, if not love persevering? The “natural order of things” and the depth of the love impact the grief.”
What are the symptoms of anxiety?
Signs and symptoms of anxiety are similar to the symptoms of depression. They can co-exist. Among caregivers, the symptoms are:
Neurological: Trembling/shaking, restlessness, headaches, dizziness, apprehension, numbness, tingling, fatigue, poor concentration, nervousness.
Cardiac: Increased pulse rate, chest pain or discomfort, palpitations.
Digestive: Diarrhea, loss of appetite, nausea, dry mouth, indigestion.
Mood: Nervousness, irritability.
Musculoskeletal: Muscle tension.
Urinary: Frequency, urgency.
Do you have high functioning anxiety?
Daily anxiety can affect your health long before it affects your productivity. High functioning anxiety means that you suffer internally from anxiety without it affecting your productivity. People with high functioning anxiety may become more irritable, withdraw socially or self-medicate through alcohol use.
See if these questions reflect things happening to you:
- Do you worry every day?
- Are you a perfectionist?
- Do you suffer from sleep disturbances and muscle tension most of the time?
- Do you find that your mind is always “on the go,” preventing you from living in the present moment?
- Are you tired or mentally exhausted most of the time, even after a good night’s sleep?
- Do you sometimes forget what you were saying or doing?
How to manage your anxiety
Be sure that your doctor knows that you are a caregiver for a person with mental illness so they can test for and monitor anxiety. Many caregivers do not seek out help for anxiety because they are concentrating on their loved ones, giving themselves little or no care.
Remind yourself it’s normal to have fears and anxious thoughts in our situations.
Talk to others who understand. Sharing your fears to a support group helps us realize we are not alone. Therapy can help with marital problems, changed relationships or family issues as a result of the change.
Take care of your body. Caregivers should exercise, get enough sleep, eat healthy meals, take their own medications and get regular check-ups. Walking, biking, yoga, swimming and running can reduce anxiety.
Rest in God. God wants you to experience his compassion during this time. Jesus himself was overwhelmed and deeply shaken as he faced his coming suffering and death at Gethsemane. He said, in Mark 14, “My soul is overwhelmed with sorrow to the point of death.” He knows.
Increase your times of prayer, maintain regular church and small group attendance, and read uplifting materials. “Humble yourselves, therefore, under God’s mighty hand, that he may lift you up in due time. Cast all your anxiety on him because he cares for you.” (1 Peter 5:6-7)
So do not fear, for I am with you; do not be dismayed, for I am your God. I will strengthen you and help you; I will uphold you with my righteous right hand. (Isaiah 41:10)
Peace I leave with you; my peace I give you. I do not give to you as the world gives. Do not let your hearts be troubled and do not be afraid. (John 14:27)