Topics Covered in This Post
- The stress of being a caregiver.
- What is secondary trauma?
- Are compassion fatigue and post-traumatic stress disorder (PTSD) the same?
- What can trigger PTSD in caregivers?
- How to recognize the symptoms of PTSD.
- How can caregivers prevent PTSD?
- Help for caregivers who have developed PTSD.
The Stress of Being a Caregiver
“The expectation that we can be immersed in suffering and loss daily and not be touched by it is as unrealistic as expecting to be able to walk through water without getting wet”.
Françoise Mathieu - The Compassion Fatigue Workbook
Many of us find ourselves in the role of caregiver not only because of love but also due to a sense of obligation. We may be the only one willing or able to take on this task. It is often a role that we end up in unexpectedly (e.g. a parent gets sick) rather than through a vocation such as wanting to be a nurse.
Caregiving can be the most rewarding thing we ever do, but it also likely to be a difficult undertaking. It is a huge responsibility, and it can mean putting our own life on hold for weeks, months, or even years. While acting as a caregiver, we may find ourself involved in medical care, emotional support, counselling, personal care, advocacy, and taking care of household chores. These are usually tasks for which we have no real training for, and this means learning as we go while often lacking support and encouragement.
Being a caregiver can be highly stressful. The demands involved in looking after for a loved one can be exhausting. It may involve caring for somebody who is confused or agitated. Unlike a professional carer, there may be no clock-off time and no holidays. On top of this, there is usually worry, sadness, and possibly despair.
Caregiving and Secondary Trauma
“Some caregivers experience secondary trauma from their loved one’s experiences and difficult medical interventions. The invasiveness of certain treatment protocols can be unavoidable traumatic to witness or experience. Furthermore, patients may regularly share descriptions of their emotional and physical pain, which may be disturbing for the caretaker”.
Trudy Gilbert-Eliot - Healing Secondary Trauma
In our role of caregiver we can be exposed to events that are traumatic. Being with a loved one who is in pain or experiencing intense emotions (such as fear) can lead to secondary trauma. This means that even though we are not personally experiencing the pain or fear, we are still affected by it. If the person we are caring for is dying, this can have a huge impact on our mental health.
When the Strain of Caregiving Becomes Too Much
The stress and emotional trauma involved in acting as a caregiver can become too much. It can leave us in a state of burnout or compassion fatigue. Burnout is where we have surpassed our personal inner resources for dealing with stress. We feel exhausted, and may also experience a sense of depersonalization (we just don’t feel ourselves) and a lack of effectiveness. Burnout means that we have not being getting enough rest and relaxation – it usually happens after weeks or months of pushing ourselves too hard.
Compassion fatigue is caused by secondary trauma (see above). It shares similar symptoms to burnout such as exhaustion, but it also involves a shift in the way we relate to people. Compassion fatigue means feeling emotionally drained with nothing left to give. It occurs because so much compassion has been directed towards those we are caring for that there has been none left for ourselves.
Are Compassion Fatigue and PTSD the Same Thing?
Compassion fatigue and PTSD differ in that the former occurs due to secondary trauma (https://vva.org/programs/ptsd/ptsd-compassion-fatigue/ ). The person with PTSD is impacted by the event directly while the person with compassion fatigue is impacted indirectly. The symptoms of these two conditions can be very similar. It is also possible that the stress of being a caregiver can lead to PTSD.
What Can Trigger PTSD in Caregivers?
PTSD can be triggered by any event that frightening or distressing (https://www.nhs.uk/mental-health/conditions/post-traumatic-stress-disorder-ptsd/causes/ )such as:
- Watching a loved one die.
- Observing a resuscitation attempt.
- Having to perform CPR on a loved one.
- Dealing with a loved one who is agitated/confused.
- Dealing with anger outbursts.
- The responsibility of looking after a loved one.
How to Recognize the Symptoms of PTSD
PTSD is a psychiatric disorder that is caused by emotional trauma. The person with this condition will continue to experiencer symptoms long after the triggering event. The symptoms of PTSD include:
- Intense memories of the past where it seems as if the event is happening now (this is usually referred to as flashbacks).
- Physiological responses to situations that trigger a memory of the trauma (e.g. increased pulse rate or sweating).
- Avoidance of people, places, and situations that might trigger a memory of the trauma.
- Intrusive thoughts – the mind keeps on going over what happened.
- Inability to stop thinking about the past.
- Repeatedly experiencing images or physical sensations associated with the traumatic event (e.g. a physical memory of performing CPR).
- Overactive startle response (e.g. a loud noise might trigger a sense of panic). This is also referred to as hyperarousal.
- Anger outbursts.
- Emotional numbness.
- The sense that life is unfulfilling and lacking meaning.
How Can Caregivers Protect Themselves From PTSD?
One of the reasons caregivers can be prone to PTSD is because they lack support. We may even experience a sense of shame when it comes to admitting that we are struggling to cope. There is this expectation that ‘love should be enough’ when it comes to fulfilling this role, so admitting to any difficulties can feel like a betrayal of this love.
Putting another’s needs before our own is undoubtedly a beautiful thing to do, but a lack of self-care can also mean that we burnout, develop compassion fatigue, and possibly even PTSD. Somebody needs to care for the carer, so getting support is a must – there is growing research that support this (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7459858/ ).
Other steps caregivers can take to prevent PTSD include:
- It is suggested that people with a strong sense of meaning and purpose in life (e.g. religious belief) find it easier to deal with the stresses of caregiving.
- Practices such as mindfulness can help caregivers better deal with emotional stress.
- Making sure that you have time for yourself.
- Practicing self-compassion.
- Talk regularly to other people about how you are feeling and what you are experiencing.
- Laughter can be a great anecdote for stress so make time for comedy shows etc.
- Spending time in nature can have a healing and recuperation effect – even if it is only for a few minutes.
- Be aware of your own limits and be mindful of any symptoms that could suggest a risk of burnout.
Help for Caregivers Who Have Developed PTSD
There are a number of evidence-based approaches that have been shown to be effective when it comes to treating PTSD such as:
- Acceptance and Commitment Therapy (ACT) – this involves learning to accept what has happened while also committing to action that will allow us to build a life based on what is important to us.
- Trauma therapy – this involves revisiting the trauma in a way that is safe and healing.
- Eye movement desensitization and reprocessing (EMDR) – is a process that help to alleviate the distress triggered by traumatic memories.
- Cognitive-behavioral therapy (CBT) - this focuses on the thoughts and beliefs that play a large role in PTSD.
- Mindfulness – is a way of detangling ourselves from intense emotions and intrusive thoughts.
- Dialectical behavioral therapy (DBT) – can be useful for learning to deal with emotions, intrusive thoughts, and it can also help us reconnect with others.
If you are a suffering from PTSD associated with caregiving, we would like you to consider joining us at 180 Sanctuary. Our internationally recognized program uses the best available approaches that help with recovery from emotional trauma. All this happens in a nurturing and supportive environment. Contact us right away to find out more.