Taking care of an ailing spouse is no easy matter, and the stress many Americans experience as a caretaker is extreme.
Yet University of Buffalo researchers noted that helping behaviors, which are at the core of caregiving, typically relieve stress. Indeed, the caretaking role is paradoxical as the draining demands of caregiving appear to conflict with the uplifting effects of helping.
Resolving that paradox was part of the aim of a new study by Dr. Michael Poulin, an associate professor in psychology and an expert in empathy, human generosity and stress. Poulin and his co-authors found that the strress of caregiving is eased when it is seen to make a difference and is appreciated by the spouse.
The findings of the study, led by Drs. Joan Monin, Yale School of Public Health, Stephanie Brown, Stony Brook University, Kenneth Langa, University of Michigan, and Poulin, appear in the American Psychological Association’s journal Health Psychology.
Poulin said more than 30 years of research shows that being a caregiver is among the most stressful, emotionally burdensome and physically demanding roles a person can take on. Spouses who are caregivers show decreased immune function, increased signs of physiological stress and are at greater risk for physical and mental illness.
Yet other studies, including much of Poulin’s own research, suggest that the act of providing help to somebody is typically stress-relieving and is associated with better emotional and physical well-being.
“The problem is that when you’re a caregiver, not all of your time is spent helping,” says Poulin. “Sometimes all you can do is witness the person’s state while being passively on duty.”
But previous research also confirmed that the act of helping in this context was associated with improving the caretakers’ well-being, a finding that was true even when general caregiving was broken downs into tasks, like feeding or bathing.
“This is what we wanted to get at,” says Poulin. “We knew that something about being helpful is good in these circumstances. But why? Is it just being active? Is doing something better than doing nothing? Or is it that doing something to improve another person’s well-being is what matters?”
The research team conducted two studies with spouses caring for partners with chronic pain.
In the first study, 73 participants reported caregiving activity and their accompanying emotions in three-hour intervals. This allowed the researchers to look at the amount of help given and how much that help pleased the spouse and subsequently affected the caregiver.
The second study involved 43 caregivers who completed a diary at the end of the day that detailed the help they provided and the appreciation they received.
The findings suggest that spouses caring for a partner feel happier and report fewer physical symptoms when they believe their help is appreciated.
“Spending time attempting to provide help can be beneficial for a caregiver’s mental and physical well-being, but only during those times when the caregiver sees that their help has made a difference and that difference is noticed and recognized by their partner,” he said.
“Importantly, this study adds to a growing body of evidence showing that it is important to target emotional communication between spouses in daily support interactions to improve psychological well-being in the context of chronic conditions and disability,” the authors write.
Source: University of Buffalo
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A new Dutch study finds that the maternal use of antidepressants during pregnancy appears to increase the risk of the child developing a mental health issue. Risk increased for conditions such as autism, depression, anxiety, and attention deficit hyperactivity disorder (ADHD).
However, investigators are uncertain as to the role of hereditary as part of the elevated risk. Moreover, untreated severe depression during pregnancy can lead to negative outcomes for both the mother and child.
Experts acknowledge that the use of antidepressants among pregnant women has been on the rise for many years. Currently, between two and eight percent of pregnant women are on antidepressants.
In the new study, researchers from the National Centre for Register-based Research at Aarhus BSS show that there is an increased risk involved in using antidepressants during pregnancy.
The researchers, headed by Xiaoqin Liu, have applied register-based research to the study of 905,383 children born between 1998 and 2012 with the aim of exploring the possible adverse effects of the mother’s use of antidepressants during her pregnancy.
They found that out of the 905,383 children in total, 32,400 developed a psychiatric disorder later in life. Some of these children were born to mothers who were on antidepressants during their pregnancy, while other children had not been exposed to medication.
“When we look at children born to mothers who discontinued and continued antidepressant treatment during pregnancy, we can see an increased risk of developing a psychiatric disorder if the mothers continued antidepressant treatment while pregnant,” says Xiaoqin Liu.
Liu is the lead author of the article, which appears in the BMJ-British Medical Journal.
Researchers divided the children into four groups depending on the mother’s use of antidepressants before and during pregnancy.
The children in group one had not been exposed to antidepressants in the womb. In group two, the mothers had been taking antidepressants up until the pregnancy, but not during. In group three, the mothers were using antidepressants both before and during the pregnancy. Group four consisted of children, whose mothers were new users of antidepressants and had started taking the medication during the pregnancy.
The result of the study showed an increased number of children with psychiatric disorders in the group in which the mothers had been using antidepressants during their pregnancy.
Approximately twice as many children were diagnosed with a psychiatric disorder in group four (14.5 percent) than in group one (eight percent). In groups two and three respectively, 11.5 percent and 13.6 percent were diagnosed with a psychiatric disorder at age 16 years.
Despite the apparent medication link, researchers are quick to note that psychiatric disorders are hereditary.
Therefore, the investigators took into account that heritability also plays a part in determining who will be diagnosed with a psychiatric disorder, and that it is not just a question of being exposed to antidepressants in the womb.
“We chose to conduct the study on the assumption that psychiatric disorders are highly heritable. For this reason, we wanted to show that is too narrow if you only look at autism, which is what many previous studies have done.
If heritability plays a part, other psychiatric disorders such as depression, anxiety, ADHD-like symptoms would also appear in the data,” says Trine Munk-Olsen, who is also one of the researchers behind the study.
Indeed, the study also shows that the increase covers not only autism but also other psychiatric disorders such as depression, anxiety, and ADHD.
Thus it becomes clear that the mother’s underlying psychiatric disorder matters in relation to the child’s mental health later in life. At the same time, it cannot be ruled out that the use of antidepressants further increases the risk of psychiatric diseases in the child.
“Our research shows that medication seems to increase the risk, but that heritability also plays a part,” says Trine Munk-Olsen, who also points out that it might be the mothers who suffer from the most severe forms of depression who need to take medication during their pregnancy.
The findings are murky. Indeed, the researchers hope the study can increase the focus on the fact that the research results are not just black and white.
This could help doctors advise women on the use of antidepressants both before and after their pregnancy. Some women might be able to discontinue treatment with the medication while pregnant.
However, the researchers also acknowledge that some women need medication and stress that the consequences of an untreated depression are severe and can lead to serious consequences to both mother and child.
The most important message is that we ensure and safeguard the mental well-being of the pregnant women, and for some women, this involves the use of antidepressants.
“These women should not feel guilty about taking antidepressants. Even though there is an increased risk of the child developing a psychiatric disorder later in life, our research shows that we cannot blame medication alone. Heritability also plays a part,” says Trine Munk-Olsen.
Source: Aarhus University
i live with depression. sometimes it’s major, sometimes it’s minor and sometimes i can’t tell if i have it at all. but i’ve been clinically diagnosed for over 13 years so i have gotten to know it pretty well. depression presents itself differently in each person. for me, depression feels like a deep, heavy sadness. like a thickÂ fog that slowly rolls in and envelops every part of me. it’s so hard to see my way out and it blocks my vision of a positive future or even a tolerable present. through many years of treatmentÂ i have worked hard to understand how i feel when depression comes back and how i can take the best care of myself when i feel sick. a few weeks ago i wrote about getting to know my anxiety. today i am going to talk about getting to know my depression. here are some of my own red flags and what i do to help myself when they come up.
don’t panic. when i feel that first tinge of sadness or when i feel more tired that usual, alarm bells start to go off in my head. NOOOOOOOOOOOOOOOOOOOOOOOO. NOT DEPRESSIONNNNNN!!!!!! for me, depression has been nothing short of devastating. it’s hard not to freak out when i feel it coming on. when i remember how sick i was, the thought of a relapse is absolutely terrifying – especially ifÂ i have been having a really good, upbeat streak. i feel my thoughts start to race ahead to the worst case scenario and a panicked feeling grows in my chest. this is a critical moment for me. this is a moment when i do have a choice. i have to stop and take a very deep breath. and then ten more. i talk to myself – sometimes out loud – and tap into my own strength and past experience. the conversation goes something like this: it’s ok to be scared of getting depressed again. it’s natural to feel anxious. you are a survivor. remember how much you have learned. whatever happens next, know that you can handle it.
know my red flags. i have found it necessaryÂ to understand what my thoughts and behaviors are like when i start to spiral downwards. this helps me catch myself before i hit the bottom. Â my first red flag is catastrophic thinking. nobody understands me. everyone else has it easier than me. i will never get over this. Â who cares. it doesn’t matter how hard i try. i’ll never be good enough.Â once i start thinking or saying things like this, i know that my depression is flaring up. another clue is if my energy is low for several days and i find it hard to complete daily tasks, like cleaning, showering or cooking dinner. when i noticeÂ these warning signs, i try to pause and reflect on what might be triggering the thoughts or behaviors. i talk to someone, like my family or my therapist.Â while it’s tempting to ignore red flags, i have found that it’s super important to acknowledge and explore them. for me, avoiding or denyingÂ them only makes depression worse further on down the line.
remember that depression is an illness with symptoms. for a long time, i didn’t think of depression as an illness. it felt more like a personal defect that i needed to try to get over. looking back, i can see that this perspective made the symptoms of my depression feel even more overwhelming. i didn’t view my feelings or experiences as symptoms of an illness. sadness, guilt and isolation loomed large and my panicked reactionÂ magnified their effects. through a lot of reading and conversation, i have come to accept that depression is, in fact, an illness. and for me, one that needs to be treated with both medication and therapy. shifting my perspective has helped me to react with less fear when my symptoms present themselves. they make more sense within the context of depression as a legitimate medical condition. i still feel sad, afraid and lonely, but i am able to recognize those feelings as connected to my illness and as symptoms that i can respond to with self care.
accept that i am in a finite period of depression. one of the hardest features of depression is that it makes you think it will never end. which is what makes the onset so scary. a difficult piece of my work in therapy has been accepting that i have a mental illness and building my ability to tolerate it when it flares up. as much as i wish it would, depression won’t just disappear. and somehow, as counter-intuitive as it seems, allowing myself to feel the depression and accept its presence alleviates some of my suffering. for me, the symptoms don’t last forever.Â i have made it through depression before and, as gut-wrenching as it was, i can do it again. i tell myself that it is ok to feel sad, or angry, or frustrated. this is a perfect opportunity to…
practice self care. for a long time, i ignored and denied my symptoms. if i felt sad, i hid it. i can’t tell you how many times i cried in my car or in the bathroom stall so nobody else would know. i almost never told othersÂ about my depression. if i felt exhausted, i pushed myself harder and if i felt inadequate, i took on even more responsibility. i had a lot of negative coping skills – like drinking, smoking, shopping and over-working. and then one day i crashed. and burned. it took me two years to recover. which is why, today, nothing is more important to me than self care. i had to start from the bottom and rebuild my life in a healthier, more authentic way.
i could write all day on self care so i’ll try to keep it short (for now). for me, self care means being honest about my diagnosis. i don’t lie anymore about having depression or about my dad’s suicide. i honor who i am and what i live with. self care means saying no to others when i am feeling overloaded. it means making time to relax, to exercise, to create and to connect with others. self care is using all my senses to soothe and recharge myself – body, mind and spirit. and i practice coping skills every day, not just when i am at my worst. this is what makes them more effective when i do have an episode of depression – they work because i have been practicing.
know when to ask for help. depression is serious. and for some people, like my dad, depression is fatal. suicidal thoughts are a common symptom of depression. and i know that if and when i have them, they are not to be ignored. if i ever have the thought that i would be better off dead, i know that this is the most serious of red flags. Â i tell someone i trust immediately and i reach out for more professional support. i believe that i deserve helpÂ in treating my depression and i recognize that i can’t do it on my own. in the past i used a personal safety plan that outlined specific steps i would take in the event of suicidal thoughts – this was a very helpful tool. other red flags that indicate i need to step up my professional help are frequent crying, prolonged withdrawal from family or friends, and lack of desire to go to work. i always keep the national suicide prevention lifeline’s number programmed into my cell phone, so that i have someone to call at any minute of the day or night. while suicidal thoughts don’t mean that suicide is inevitable, it’s so very important to act immediately when they come up.
and finally, i remember that i am not depression. i am not my diagnosis or my mental illness. i am not depression – i have depression. when i am feeling especially blue, this is something i say to myself every day. depression impacts our thinking and makes it difficult to appreciate the whole picture of who we are. remembering that i am not depression puts some of the power back into my hands. i am reminded that i have so much strength, ability and compassion to use in support of myself when depression strikes. while i can’t control my symptoms and while nothing is more difficult for me than experiencing depression, it’s critical for me to remember that i deserve to, and will, feel better. i have become an expert in my own experience. developing awareness, acceptance, self care and support have shifted the way that i cope with depression.
to quote one of my favorite internet memes – i have survived 100% of my worst days. so far i’m doing great.
(check out the full version of the above comic strip at upworthy.com)
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