When someone you love has a mental health crisis, or is diagnosed with a serious mental illness, it’s natural to want to help. But not everyone takes on the role of primary or secondary caregiver. If you have, though, first and foremost, I want to say thank you. The support and care you offer is lifesaving and you are a superhero, truly. You may not take care of me, personally, but I guarantee I have traits in common with the person you do support and care for. I also recognize that it’s far too easy for you to push your own needs to the side and focus entirely on helping your loved one. This can place immense strain on you, as a caregiver, and strain on the relationship. But, as someone who cares, the last thing you want is compassion fatigue. It’s very important for you to take care of yourself, even when caring for someone who is chronically ill.
This is me trying to smile through a rough time. I know this because… well, I remember taking the picture for one, but also because of the bags under my eyes and the way my “smile” looks more like a slight grimace and does not reach my eyes. This is what I look like when my nights are plagued with nightmares and ensuing insomnia.
I have a friend who, upon seeing a photo like this, will immediately reach out and listen to anything I have to say. I’m writing this blog post for that person; for the one in my life who has literally walked through every single step of my recovery with me. I’m also writing it for the handful of people who have been other sources of support. The people who have tag-teamed to come visit, to check in, to do everything in their power to help. I can’t imagine how exhausting taking care of me must be.
I struggled enough with self care as a professional caregiver, but at least I got to leave my clients at the end of the day and come home. There are people in my life who, in the last year, have gone so far above and beyond any reasonable expectation of anyone, even someone considered family.
To you, I know that you are not going anywhere, and I know that you will continue to show up and support me. And I am so far beyond thankful for that support. There are no words. I wish I could repay you for your unending support and care, but there’s no way. Nothing would be enough. At the very least, though, I can consolidate some solid information on self care for caregivers in a place I know you will see it. And that’s why I’m making this post.
The truth is, I have spent the majority of this past year having a hard time. I’ve had moments of full blown crisis and also persistent stretches of struggling and intense pain. I’ve had slip ups with unhealthy coping mechanisms. I’ve had moments of being so “stuck” in depression that I can’t admit that I’ve made any progress at all. I’ve had hypomanic episodes. I’ve been suicidal. I’ve been angry. I’ve been depressed. Honestly, I’ve been on a massive roller coaster. To the people strapped right in with me, holding on tight and going along for the ride, I’m begging you to please read this, and then apply it.
The last thing I want, as someone who loves you as much as you love me, is to be a source of pain for you. I’ve done some research on how you can take care of yourself (because I know you’ve been busy all year doing research on bipolar and PTSD and medication and warning signs and crisis management and probably have not gotten around to looking this stuff up for yourself). This list is a consolidation of information from the National Alliance on Mental Illness (NAMI) and the Family Caregiver Alliance. I will link both at the end of this post. That said, here are three ways you can take care of yourself while caring for loved ones with mental illnesses.
Understand and Recognize that Caring for Others Affects You
It’s OK to say it. Those of us with mental health diagnoses can be exhausting. Believe me, I know. I exhaust myself. I annoy myself. And you show up for me consistently and without question in those moments and in every moment. I can only imagine how exhausting and annoying I can be to you. (Even when you tell me repeatedly I am not.)
Let’s look at the documented effects of care-giving on human bodies. Feeling responsible for the well being of another person has some very tangible impacts on your body and mind. It can cause:
- lack of sleep
- nausea/upset stomach
- lowered energy
- poor eating habits
- poor exercise habits due to exhaustion and lack of time
That’s a hell of a list, isn’t it? Not everyone will experience all of this, but it’s important to check in with yourself around which of these effects may be present in your life. You are not betraying anyone by taking stock and being honest with yourself. Neither are you being selfish to consider your needs. Which is exactly what you have to do once you’ve identified the effects your role as care-taker is having on you.
Look, I can be stressful. Seriously stressful. Anyone with a mental illness can be. Think about it for a minute, if you’re spending your time talking your suicidal friend into getting help, reminding your loved one to take medications (or finding yourself needing to “gently convince” that loved one to take their meds and stick with their treatment plan), holding your sister while she has a massive panic attack for the fifth time in a day, or listening to someone process traumas, you’re doing something amazing and very important, but you’re also probably feeling pretty perpetually wiped out and tense.
Now that you’ve taken some time to consider what, specifically, is affecting you in your specific role as a caregiver, figure out which situations provoke the most stress.
It’s likely there are certain situational stressors that you need to consider. Is it difficult for you to be out in public with your loved one while they are symptomatic? Is it hard to be in social situations with your loved one, consistently worrying they may become symptomatic? What situations cause you the most stress? It’s important to know triggers so that you can either avoid these situations or be prepared with fortified coping skills prior to the event.
Take Time for Yourself
Hey caregiver. Yeah, you. I can hear you. Right now. “I can’t.” “There’s no time in my day.” “I’m fine.” To that, I give a skeptical, “Mmmhmmm.” When I tell you, “I’m fine”, you dig. You dig deep. I’m flipping the script in this one. I know it can seem hard, especially if you have more people to take care of in your life than just your mentally ill loved one.
You need time in your day where you are not a “caregiver” of any form. Not for your loved one with mental illness, not for your other family members, not for coworkers, not for other friends. There are a lot of good suggestions on how to do this. Let your lunch break be your lunch break. Don’t text people to check in and make sure things are getting done, or to make sure that your loved one is OK. Think of the things that you enjoyed doing before becoming engrossed in the caregiver role and work them back into your schedule, slowly but surely. If you liked to knit, give yourself ten minutes at the end of the night to knit and only to knit. If you liked to exercise, get in a fifteen minute cardio workout somewhere in your day. If you like to zone out to Food Network, don’t feel obligated to also listen to your loved one and talk them through a rough time. Set standing, monthly plans with friends and loved ones who do not require you to be or do anything caregiver-like. According to my research on this topic, it’s easier to plan your busy life around if these are scheduled in advance, but spontaneous ones are fine, too!
When you are doing these things, resist the urge to worry. Try to be present, instead of preoccupied with what might be happening in the mind of someone else. You are not being selfish for taking time to recharge. In fact, you are setting yourself up to be a more effective caregiver. We all know the airplane mask metaphor, and we all know it’s true (no matter how much we try to deny it).
Take Care of Your Own Health
If you’re going to insist on taking care of my health (or someone else’s), make sure you’re tending to your own as well. It’s essential if you want to be effective as a caregiver. Truly. How can you do this? Remember how I said that I was going to flip the script on you? I wasn’t joking. Because many of the same things you try to remind me to do to improve my mental health are the same things you need to do to care for yourself. Take your own advice!
Tend to your physical health by:
- Eating well – don’t put off your nutritional intake to care for others. Don’t skip meals out of obligation. Try to avoid stress eating unhealthy, processed food every night for comfort.
- Exercise – it increases endorphin levels, decreases the physical symptoms of stress, and can serve as some of that very important “you” time.
- Avoid alcohol and other drugs – I know you’re stressed. And I know all too well that mood altering substances can feel like stress relief. But these things won’t actually help the situation. Caregivers are at an increased risk of developing problematic substance habits, just like those of us with mental illness. It’s important to be aware of this.
- Get enough sleep – Oh yes, sleep. It needs to be a priority. Unwind before bed. Set up a bed time ritual. Practice good sleep hygiene.
- Practice relaxation techniques – I don’t care if it’s yoga, meditation, guided breathing, progressive muscle relaxation. Find 10 – 15 minutes a day to work this in. Relaxation and mindfulness are powerful tools. Use them.
In addition to your physical health, protect your mental wellness also.
- First and foremost, avoid feeling guilt. There are going to be times you do feel annoyed, overwhelmed, and maybe even resentful of your role as caregiver. In those moments, you may well immediately start some negative self-talk. You may think “If I was a good person, I wouldn’t feel this way.” This is not true. You are a good person, you are simply human. These feelings are natural. Notice them, accept them without judgement, and validate them. What you are doing is hard. It is physically and mentally draining. You are working your ass off to support someone who, especially when symptomatic, is not able to do much to support herself or himself. Cut yourself some slack. Seriously.
- Second, notice the positives in your day. It can be hard to find positives when your loved one is in crisis, or even having a hard time. Often, when someone having a hard time, it can cause anxiety that a full blown crisis is just around the corner. You’ve got a lot going through your mind every single day. When you’re “in it” with someone with a severe mental illness, when you’re along for that same roller coaster ride, you can find it hard to see the positives, too. Just like those of us living with our illnesses. NAMI suggests keeping a journal and writing down a few good things about your day, every day. This might seem silly, but it really can help shift your mood and ease your tension.
- Third, and perhaps most important, find support. NAMI has in-person support groups in most states, but if you can’t make it to one of those, that’s OK. You can ask others for help, too. Are there others who could help you by being secondary caregivers? Can you ask someone to tag team with you occasionally? Can you reach out to other friends of yours and build your own support system? You don’t have to go into details at all if you’re not comfortable doing so – but you can ask friends to help you with making dinners, help you organize paperwork, or clean your house. Even just asking friends to make those standing, self-care plans with you, like nights out to dinner, a trip to the movies, a hike, or whatever you like to do can be an immense source of support and strength.
“You are not weak because you need support. You are not a failure for being overwhelmed. You are not pathetic for needing some help.” These are things you tell me almost every day. And guess what? They are true for you, too.
That’s my list. I know it’s not much, but I hope it’s something. Thank you so much for all you do.
Here is the link to the Family Caregiver Alliance and here is NAMI, I hope you’ll spend some time digging around these sites and researching further ways and resources to care for you, just like you spend time researching ways to care me, or for your loved one living with mental illness.
As always, I’d love to hear your thoughts! Did you find this article helpful? Drop your thoughts in the comment section below, Tweet me @paradichotomy, or jump over to Facebook! Speaking of Facebook, Monday, January 1st at 8 PM marks the one year anniversary to the hour of me checking myself into the psych ward (accompanied by my strongest support and caregiver). I’ll be doing a livestream at that time, reflecting on the year, the blog, and what “stigma” and “advocacy” mean to me. I hope you’ll tune in and join the conversation!
Thanks for reading, all! Happy New Year!