Dr Aadil Jan Shah, Dr Ovais Wadoo and Dr Javed Latoo, Psychiatrists
Carer’s play a vital role in supporting family members who are sick, infirm or disabled. There is no doubt that the families of those with mental disorders are affected by the condition of their near ones. The demands of caring can bring significant levels of stress for the carer and can affect their overall quality of life including work, socializing and relationships. Research into the impact of care giving shows that one-third to one-half of carer’s suffer significant psychological distress and experience higher rates of mental ill health than the general population.
The association between feelings of burden and the overall caregiver role is very well known. Caregivers provide assistance with activities of daily living, providing emotional support to the patient, dealing with incontinence, feeding and mobility. Due to high burden and responsibilities, caregivers experience poorer self-reported health, engage in fewer health promotion actions than non-caregivers, and experience lower life satisfaction.
There is evidence that depressive symptoms are twice as common among caregivers as noncaregivers. Family caregivers who have significantly depressed mood may be adversely affected in their ability to perform desirable health maintenance behaviour or self-care behaviours in response to symptoms. Women have higher rates of depression than men in the care giving role. Carers can also end up neglecting their own physical health leading to various issues and poor quality of life. Caregiving is also associated with decline in social support, increased isolation and withdrawal.
The impact of caring for different mental disorders and associated risk factors:
Schizophrenia with associated risk factors like; high disability, very severe symptoms, poor support from professionals, poor support from social networks, less practical social support and violence can lead to guilt, loss, helplessness, fear, vulnerability, cumulative feelings of defeat, anxiety, resentment, and anger among caregivers.
Dementia with associated risk factors like decline in cognitive and functional status, behavioural disturbances and dependency on assistance can lead to anger, grief, loneliness and resentment in caregivers.
Mood disorders with associated risk factors like symptoms, changes in family roles, cyclic nature of bipolar disorder, moderate or severe distress can lead to significant distress, marked difficulties in maintaining social and leisure activities, decrease in total family income and considerable strains in marital relationships.
It is therefore very important that carers make sure they are looking after themselves well to do their role better and help reducing any physical or psychological distress. Also, the efforts to identify and treat caregiver psychological distress will need to be multidisciplinary, consider the cultural context of the patient and caregiver, and focus on multiple risk factors simultaneously.
Signs and symptoms of caregiver’s psychological distress can be following:
•Anxiety, low mood, irritability
•Feeling tired and exhausted
•Overreacting to minor problems
•New or worsening health problems
• Problems concentrating
•Feeling increasingly resentful
•Drinking, smoking, or taking drugs to cope
•Cutting back on leisure activities or not socialising well
Coping styles and Interventions to reduce psychological distress in carers are:
Below is the list of websites for different organisations who can provide advice, support, guidance and interventions for carers suffering from any psychological distress or other stresses related to their role.
Please check author names highlighted with each article.
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