A 49-year-old female client tells me, “I wake up every day with images of the hospitals flashing in front of my eyes. I seem to sleep well but there is this pit in my stomach by the time I get up. I see myself in hospitals caring and being there for someone. Though I never know or see anyone in the hospital, I know it’s a loved one. I never resented the caregiving I ever had to do, yet I feel so guilty every time I have such dreams.”
She said the anxiety would linger when she got up. During the pandemic, she had spent significant time in the hospital, caring for her best friend and her partner, both of whom recovered and are extremely close to her. She couldn’t make sense of these dreams and the feelings that followed it.
Caregiving, when it’s long-term or filled with uncertainty, which it is most of the time, can have an impact on the emotional and mental well-being of the caregiver. Very often this impact is not immediate, it can show up or manifest much later, even when things have settled, as it did for my client. After 2020, I am seeing a lot of caregivers reaching out and reporting signs which include anticipatory anxiety, signs of hypervigilance, increased sense of fear, and, sometimes, even a full range of symptoms which point towards a trauma response. A consistent low mood, detachment from social interactions and lingering feelings of irritability, rage and even numbness is what clients report, without being fully cognizant of what’s accounting for these.
Anticipatory anxiety may show up either in dreams, night terrors, nightmares, or a lingering fear and anticipatory grief where they feel they would be left alone. At other times, fears about being the only one standing to take care of fragile family members.
In my practice, I see a lot of people, who have been caregivers, report physical symptoms in the form of chronic fatigue, body aches, gut issues, migraine, even an inability to feel fresh when they wake up. The reality is that our stress and trauma gets stored in our bodies; its showing up in these ways is the body’s way of asking for help.
At the same time, caregivers often underestimate their own concerns in relation to the family member who may be struggling with an ailment, so it takes a long time before they can reach out to a mental health professional. Not just that, society too often fails to recognise how caregiving can evoke a range of emotions and concerns, such as financial costs, impact on the caregiver’s career, a feeling of loneliness if there is absence of community support and a continuous pressure to take hard decisions, at the hospital and generally, for the person one is caring for.
At the same time, what makes this extremely hard is when caregivers make a choice to care and provide support to a loved one towards whom they have mixed emotions and with whom they share a complicated relationship. This can bring up traumatic memories, and, in turn, lead to frustration, impacting mood, even how they feel about themselves and life in general.
All these factors combined can often make the caregiver susceptible to stress, burnout, even trauma. If you are a caregiver and find yourself experiencing any of these feelings, it may be a good idea to reach out to a mental health professional. Sometimes the very act of reaching out is mixed with guilt and a feeling that one is not resilient enough. Yet, paying attention to what is emerging in you is a sign of strength.
If you can work on yourself and process all that caregiving brings up for you, it will allow you to take better care of yourself and your loved ones. Having a community and set of people one can speak to, be transparent with, and who can hold space for what we are feeling, makes the caregiving process a little easier.
Sonali Gupta is a Mumbai-based clinical psychologist. She is the author of the book Anxiety: Overcome It And Live Without Fear and has a YouTube channel, Mental Health With Sonali.