Although caregiving is not necessarily a cause of depression nor a guarantee that you will become depressed, it is not at all unusual for caregivers to become mild or moderately depressed. The fatigue, exhaustion, and demands associated with caregiving can leave even the most resilient person feeling sad.
It should come as no surprise that people who are caring for someone with dementia are twice as likely to develop depression than those caring for someone without dementia. Caregivers of dementia patients are more likely to devote more time and energy to caregiving, experience problems with their jobs, and have less time to devote to things they enjoy and other family members. They’re also more likely to experience more family conflicts.
Some people are more prone to depression than others. Women, for instance, who make up the majority of Alzheimer’s care¬givers, are more likely to develop depression than men. But men are less likely to admit they have depression. Men are also more likely to engage in negative behaviors to cope with depression, such as drinking alcohol and overworking. Men may be more likely to seek outside help, but typically have fewer friends to confide in.
Caregivers who frequently suffer from insomnia are also more vulnerable to depression. The constancy of caregiving for some¬one with Alzheimer’s can make a good night’s rest difficult to achieve. Over time, die sleep deprivation can bring on depression.
The sadness that accompanies caregiving is so intense that some¬times, even after the loved one is placed in a nursing home or dies, the caregiver may continue to experience symptoms of depression.
Loneliness
It’s not unusual to feel isolated in your struggle to come to terms with Alzheimer’s. The disease can cut you off from a once active social life as the demands of caregiving slowly begin to eat away at your free time and energy levels. Not surprisingly, studies have found that loneliness is a strong predictor for depression.
Anger and Frustration
Over time, as your loved one begins to lose more and more inde¬pendence, you may begin to experience feelings of anger and frustration. Your fury may be directed at your loved one, but it may also be turned toward others, including yourself. Anger is also typical because you have no control over your situation.
Changes in Your Routine
As your loved one’s cognitive abilities begin their slow decline, you will gradually begin to take on more and more duties. Some of those responsibilities may be new to you and may add to your frustration. And if the person who has Alzheimer’s is your spouse, your workload could increase considerably, especially if your loved one was someone who did a lot around the house. Some of the practical changes that you may experience in the early stages of the disease include:
• Handling money matters. Even in the early stages of Alzheimer’s, the person who is afflicted may no longer be able to handle tasks involving money, like paying bills, bal¬ancing a checkbook, or even making a cash payment in a store. For someone unaccustomed to handling the house¬hold finances, managing money may be a difficult and un¬familiar task.
• Adjusting to lost wages. Another money matter involves the probable loss of family income, especially if the person who has Alzheimer’s and the caregiver are both still in the work force. When the person who has the disease is forced to stop working, the household income may be signifi-candy diminished. If the caregiver is forced to cut back on her work hours, then the economic burden becomes even greater. The stress that comes with the loss of income adds another layer of hardship to a situation already taxed by the presence of a difficult illness.
• Doing more chores. When Alzheimer’s strikes, there is always an adjustment in the division of labor, especially if the disease affects your spouse or someone you live with. For instance, if your wife was the one who did all the cooking and cleaning, you may need to start assuming more household duties. While she may still be able to cook in the early stages of the disease, she may gradually become a hazard in the kitchen. Or if your husband was the resident lawn keeper and gardener, you may need to start mowing the lawn and tending the garden. Assuming new and unfamiliar chores puts yet another burden on the caregiver.
• Taking the wheel. Sooner or later, the person who has Alzheimer’s has to give up driving. For the caregiver, that means you will need to do all the driving, which typically means also doing all the errands and grocery shopping. It’s a good idea now to start getting in the habit of trying to do all your shopping in one trip, or finding ways to reduce the numbers of outings you need to make.