Managing Depression for Caregivers

This information explains what depression is and how you can manage it.

About Depression

As a caregiver, you play an important role in your loved one’s life. In addition to helping them cope with their diagnosis, treatment, and physical health, you also assist them with their everyday tasks and the emotions they experience before, during, and after their cancer care. While caregiving can be a rewarding experience, it can also be a stressful and challenging as you’re balancing helping your loved one with your own responsibilities. You also do all this as you cope with your loved one’s illness. This is why it’s common for caregivers to sometimes feel sad, overwhelmed, or hopeless. While it’s normal to feel sad on some days, depression is when you feel sad most days for at least 2 weeks and this sadness gets in the way of your everyday life. Recognizing the causes and signs of depression can help you understand your feelings and work towards feeling better.

Causes of Depression in Caregivers

Depression in caregivers can be caused by many things, such as:

• Feeling overwhelmed by the many responsibilities of caregiving.
• Experiencing feelings of anxiety, anger, or exhaustion that you then feel guilty for having.
• Not having enough time for yourself.
• Feeling like you don’t have control over your own life.
• Not getting enough sleep.
• Concerns about your loved one’s health and well-being.
• Uncertainty about the future.
• No longer doing things that you once enjoyed.
• Your loved one’s emotions around their cancer diagnosis and treatment.
• Your own emotion’s about your loved one’s cancer diagnosis and treatment.
• Not having enough support from your family, friends, healthcare team, or other people in your life.

Signs of Depression in Caregivers

Depression can cause physical symptoms, emotional symptoms, or both. It’s important to recognize them and ask for help when you need to. Some examples include:

• Feeling sad, down, or hopeless.
• Not enjoying activities that you once liked.
• Feeling guilty, worthless, or helpless.
• Sleeping too little or too much.
• Feeling very tired or having little energy.
• Eating too little or too much.
• Feeling like nothing will make you feel better.
• Having thoughts or plans of suicide.
• Having thoughts or plans of hurting yourself.
• Feeling anxious.
• Having trouble focusing on tasks or activities.
• Having pain, nausea (a feeling like you’re going to throw up), headaches, or cramps.
• Feeling like everything is out of your control.

Some symptoms can be caused by medical issues or medication you’re taking. This is why it’s important to pay attention to how you’re feeling. If you experience any of these signs, talk with your healthcare provider. You can also contact any of the resources in the “Resources at MSK” section for help.

How to Manage Your Depression

Depression not only affects your mood but it can also affect your health and the care you provide to your loved one. Being a caregiver while making sure you have enough time to focus on your needs can be very hard. This is why it’s important to take care of yourself and ask for help when you need to. Here are some things you can do to help you feel better.

• Ask for help and accept it. Ask your friends and family members for help with the things you have to do. When people offer their help, accept it. Feeling guilty about accepting help is normal, but needing support isn’t a sign of weakness or failure. The less overwhelmed you feel, the better you’ll be able to take of your loved one and yourself.
• Check in with yourself. Ask yourself how you’re feeling and consider your own emotions. Some caregivers find it helpful to keep a journal. Others find it helpful to thoughts and feelings.
• Make time for yourself. Making time to do the things that you enjoy, such as going to the movies or a baseball game, will help you slowly feel better. It will also help you better manage your caregiving responsibilities.
• Do some light physical activity. Light physical activity can be going for a walk or a short bike ride. Physical activity can help improve your mood and relieve stress. Talk with your doctor before starting new exercises.
• Spend time with friends and family. It’s important to create a support system for yourself as a caregiver. Depression and your caregiving responsibilities can make this feel hard to do, but staying connected to people who can support and talk with you about your experience can help reduce stress and make you feel better.
• Get professional support. MSK has many support programs that can help you with depression. You can contact any of the resources in the “Resources at MSK” section for help.
  • MSK also has a counseling center specifically for caregivers called The Caregivers Clinic. The Caregivers Clinic provides support for people who are having trouble coping with the demands of being a caregiver. For more information, call 646-888-0200 or go to www.mskcc.org/cancer-care/doctor/allison-applebaum.
• Join a virtual program. You may also find it comforting to speak with other caregivers in one of our online educational or support groups for caregivers. Visit www.mskcc.org/vp or email virtualprograms@mskcc.org for more information.
• Join an in-person support group. MSK’s in-person support groups are led by cancer-focused social workers. To learn more, call the Department of Social Work at 212-639-7020 or email forcaregivers@mskcc.org.
• Connect with other caregivers. Through MSK’s Patient and Caregiver Support Program, you can speak with former patients and caregivers that went through a similar experience as you. They can speak with you in person, over the phone, or through email. For more information, call 212-639-5007 or email patient2patient@mskcc.org. You can also visit www.mskcc.org/experience/patient-support/counseling/support-groups-programs/patient-patient-support.
  • You can also connect with other caregivers through Connections, MSK’s online community for people affected by cancer. For more information about Connections, visit www.mskcc.org/experience/patient-support/counseling/support-groups-programs/connections.
• Make an appointment with the Integrative Medicine Service. They provide patients and caregivers with services such as massages, acupuncture, yoga classes, reflexology, meditation, music therapy, and nutritional consults. You’ll need to pay for these services out-of-pocket. For more information, call 646-608-8550 or go to www.mskcc.org/cancer-care/integrative-medicine.
• Try relaxation techniques. Relaxation techniques, such as deep breathing, meditation, and acupressure (putting pressure on parts of your body to help you relax), can help you with depression.
  • Listen to and follow along with the Integrative Medicine Service’s free meditations on www.mskcc.org/meditation.
  • You can also try acupressure to help relieve anxiety and stress. To learn how to do acupressure on yourself, read our resource Acupressure for Stress and Anxiety.
• Medication. If your depression gets in the way of your daily activities, medication may be helpful. Medications called antidepressants can help improve your mood and treat your depression. For more information, talk with your doctor or call 646-888-0200 to make an appointment with the Counseling Center.
• Find out if your workplace has an employee assistance program (EAP). EAPs can be different depending on where you work, but they often include counseling for financial problems, stress, anxiety, and depression.
• Use your resources. MSK offers many support options for caregivers. For more information about what MSK offers, visit www.mskcc.org/experience/caregivers-support/caregiver-services. Other organizations also offer educational and supportive resources. For more information about other support services and caregiving tips, read our resource A Guide for Caregivers.

No matter how you’re feeling, we’re here to support you and we have resources that can help. Depression is something that can be treated. If you ever find yourself thinking about suicide, get help as soon as you can. You can call the National Suicide Prevention Lifeline at 800-273-TALK (800-273-8255). You can also visit their website www.suicidepreventionlifeline.org to chat with a counselor online. You can contact the Lifeline 24 hours a day, 7 days a week.

Resources at MSK

If depression is affecting your life in any way, talk with your healthcare provider. You can also contact any of the resources in this section for help. We can help you find the right treatment for you.

Social Work
212-639-7020
www.mskcc.org/experience/patient-support/counseling/social-work-support
Our social workers provide emotional support and guidance to patients and their families, friends, and caregivers. Social work offers programs, including both in-person and online support groups. They can also help with practical issues such as transportation to and from medical appointments, temporary housing, and financial concerns. Social workers are available at every MSK location. To talk with a social worker, ask your doctor or nurse, or call 212-639-7020.

Counseling Center
646-888-0200
www.mskcc.org/experience/patient-support/counseling
Many people find that counseling helps them manage their emotions during caregiving. MSK’s counselors provide counseling for individuals, couples, families, caregivers, and groups. They can also prescribe medications to help with anxiety, depression, and other mental health problems. For more information, ask your doctor or nurse, or call 646-888-0200.

The Caregivers Clinic
The Caregivers Clinic provides support specifically for caregivers who are having trouble coping with the demands of being a caregiver. For more information, call 646-888-0200 or go to www.mskcc.org/cancer-care/doctor/allison-applebaum.

Location
MSK’s Counseling Center
641 Lexington Avenue (on 54^th St. between Lexington and 3^rd avenues)
7^th floor
New York, NY 10022

Spiritual Care
212-639-5982
www.mskcc.org/spiritual-religious-care
At MSK, chaplains (spiritual counselors) are available to listen, help support family members, pray, contact nearby clergy or faith groups, or simply to be a comforting companion and spiritual presence. Anyone can meet with a chaplain, no matter their religious affiliation.

MSK also has an interfaith chapel that’s open to everyone. For more information, ask your doctor or nurse or call 212-639-5982.

Hours
24 hours a day, 7 days a week

Interfaith Chapel Location
Memorial Hospital (near the main lobby)
1275 York Ave. (between 67^th and 68^th streets)
New York, NY 10065

Patient and Caregiver Support Program
212-639-5007
www.mskcc.org/experience/patient-support/counseling/support-groups-programs/patient-patient-support
You may find it comforting to speak with someone who has been through a similar experience. Through the Patient and Caregiver Support Program, you can speak with former patients and caregivers. They can speak with you in person, over the phone, or through email. For more information, call 212-639-5007 or email patient2patient@mskcc.org.

Integrative Medicine Program
646-608-8550
www.mskcc.org/integrativemedicine
Our Integrative Medicine Service offers many therapies to complement (go along with) traditional medical care. Some of the services offered include music therapy, mind and body therapies, dance and movement therapy, yoga, and touch therapy. Services are available to patients, their families and caregivers, and to the general public. For more information, or to make an appointment, call 646-608-8550.

Hours
Monday through Friday from 9 a.m. to 8 p.m.
Saturdays from 9 a.m. to 5 p.m.

Location
Bendheim Integrative Medicine Center
205 East 64^th St. (on 64^th Street between Second and 3^rd avenues)
New York, NY 10065

Patient and Caregiver Education
www.mskcc.org/pe
Visit the Patient and Caregiver Education website to search our virtual library. There, you can find written educational resources, videos, and online programs.

Virtual Programs
www.mskcc.org/vp
MSK’s Virtual Programs offer online education and support for patients and caregivers, even when you can’t come to MSK in person. Through live, interactive sessions, you can learn about your loved one’s diagnosis, what to expect during treatment, and how to prepare for the various stages of cancer care. Sessions are confidential, free, and led by expert clinical staff. If you’re interested in joining a Virtual Program, visit www.mskcc.org/vp for more information.