TMS THERAPY
FDA-cleared, non-medication depression treatment
When to Get Help for Caregiver Burnout and Depression
Theodora Blanchfield
Medically reviewed on 11/11/2020 by
Dr. Darlene Ifill-Taylor
Charlotte Regional Medical Director
Most people would drop anything to help out a loved one in need, but acting as a long-term caregiver can come at a cost they may not predict. Burnout is a very real concern for many caregivers and can eventually lead to depression. Caregiver burnout and depression can affect all areas of your life, including your ability to care for your loved one. According to one recent AARP study, 47.9 million caregivers provided an average of roughly 24 hours of care each week in 2019. Of those caregivers, 70 percent reported high emotional stress, 55 percent reported feeling alone, and 36 percent reported financial strain. It's not surprising that you would feel overwhelmed, nor is it your fault.
While caring for a family member is a labor of love—it's still labor, and emotionally taxing labor at that. If someone asked you to take on a 24/7 job—that you have to pay to do, on top of everything else in your life, you'd call them crazy. Yet, that's what being a caregiver entails, so it is natural if you are feeling burnt out. Caregivers may not have been given a choice or received training, and it is work that can feel intensely underappreciated at times. Ultimately, finding the time or emotional resources for self-care can become a challenge. So, as a caregiver, what should you do if you find yourself experiencing burnout or depression?
Recognizing Caregiver Burnout and Depression
Caregiver burnout is a common phenomenon. In fact, the American Medical Association has an assessment tool that specifically measures caregivers' physical and mental health. You may be experiencing caregiver burnout if you're often feeling overwhelmed or exhausted, you're becoming easily irritable, or you're losing interest in activities you used to enjoy. These symptoms can overlap with those of depression. For example, if you're experiencing depression, you might have diminished interest in hobbies, struggle with insomnia, or feel overwhelming guilt or worthlessness.
There are some key differences, though. With burnout, you may feel like all of your energy has been depleted because you've already given so much, whereas with depression, you may feel like you can no longer experience joy. Burnout is a response to a stressor; depression is a mood disorder.
One key factor that differentiates burnout from depression is that burnout usually stems from an ongoing, unresolvable, easily identified issue; depression is a bit more general, and it may be more difficult to pinpoint the cause. Left untreated, however, burnout can lead to depression. And if you have a history of depression, a stressful situation like caregiving may be more likely to exacerbate depression or cause a depressive episode.
If you're feeling burned out, caring for your loved one can be challenging. You might even feel frustrated with yourself and think you shouldn't feel this way. But these feelings are natural, and you are far from alone. In a recent study, up to 80 percent of caregivers reported feeling symptoms of stress. Plus, caregiving is often for the long haul. In the AARP study, the average length of caregiving was 4.5 years, with 30 percent of caregivers providing care for at least five years. If you are in a long-term caregiving situation, it may feel difficult to make the time to care for yourself, but your health is still paramount and worth protecting.
Seeking Treatment
Whether what you're experiencing is depression or caregiver burnout, if you believe that caregiving is impacting your mental health, it's time to get help. It's not just for you—it's for the benefit of your loved one, too. You can't be an effective caregiver if you're not also caring for yourself.
Seeking treatment is a sign of strength. It shows that you care enough about yourself and your loved one to take action, and it's one of the best ways you can care for both of you. Your first line of treatment will likely be talk therapy or medication. But don't be discouraged if the first medication you try isn't the right one for you—only about 1 in 3 people find the one for them on the first try.
But if you've tried one or more medications and you're still not feeling relief, you have plenty of other options. You may want to look into Transcranial Magnetic Stimulation (TMS), for instance. TMS therapy is a depression treatment that uses mild magnetic pulses to gently stimulate the brain and regulate mood.
Caregiver depression is common, but that doesn't mean you need to resign yourself to feeling low. There are plenty of treatment avenues to consider so you can feel better faster. Be sure to reach out to your doctor if you're experiencing signs of caregiver burnout or caregiver depression. But above all, remember that your health matters just as much as your loved one's.
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Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. 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Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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