Caregiver burnout is real. And it sucks.

Caregiving is a gift. The ability to take care of someone you love, at home, with relative comfort and routine, can be a beautiful and rewarding experience. It can also be a living nightmare. Most of the time it’s both, by turns.

Caregiver burnout doesn’t just appear one day, though it can feel like that: one day you’re fine and the next day you’re not. In truth, it’s not that dramatic; instead, it creeps in over time, slowly and steadily, until one day you find yourself overwhelmed, exhausted, frayed. It can be easy to miss or ignore the signs of burnout at first because caregiving is a full-time job. Additionally, you might also have a regular job and a family and friends and you know, a life. Or you did, before you became a caregiver. Slowly those other parts of you become buried underneath the weight of being someone’s sole care provider. It’s no surprise then that one day burnout hits you like a ton of bricks, in the form of exhaustion, irritability, anxiety, guilt, a miasma of shitty feelings.

You aren’t alone and it’s not unfixable. There are, in fact, both big and small steps to take when you discover that you’re burnt out. Before we explore those though, I would be remiss if I didn’t note that there are big systemic problems here that can make accessing those solutions tricky. For instance, one solution is to hire private help. However, for many people, hiring someone to help out is simply not a choice. There are programs through the county and state that will subsidize the cost but they’re means-tested, which means you have to come in under a certain income and asset level to access those programs. The result is, a lot of people fall into the middle ground of not rich enough for private care and not poor enough for state assistance.

That being said, there are still options. Maybe you can’t afford 24 hour care but you can swing a few hours here and there so you can take a break (an old client once called this Granny sitting, a phrase I find delightful). Maybe you can call on some nearly grown grandkids or other family members to take the occasional overnight or midday shift so you can rest. Maybe you’re resistant to that idea, and for good reason. But I would encourage you not to dismiss the idea of asking for others to step up out of hand. Sometimes someone becomes so stuck in their role as a caregiver, they don’t hear the other people in their lives who are offering to help. Or they decide not to ask for fear of hearing no. But if you don’t ask, you definitely do not receive.

Beyond that, there are other, smaller remedies. Who were you before this? What brought you joy? This is important because you cannot pour from an empty cup. In order to be someone’s caregiver, you have to be in good working order yourself. Meaning it isn’t selfish to take a shower or eat a hot meal or exercise. It’s actually a necessity that you do things for yourself so that you don’t become a shell of a person who resents what started as a gift: caring for someone you love.

There’s more to say here, namely about what happens when you’re caring for someone you don’t love or even like that much. But that’s another story for another day. Today, if you’re a caregiver, I want you to consider what things you do to keep yourself healthy and sane. If you can’t think of anything, it may be time to take a real break and take stock, and yes, consider therapy. Caregiving should be a gift, not a prison sentence.

When your body betrays you

Last week, I wrote about grief. I was mostly referring to the grief we experience when someone we love dies. But there are losses throughout our life cycle that don’t necessarily have to do with death.

For the majority of my career, I’ve worked with people experiencing life-changing and often chronic illness. The prognosis doesn’t have to be terminal for the symptoms of being ill—of having a body that doesn’t do what it used to do—to be devastating and isolating. Your friends and family can’t understand what you are experiencing. It’s difficult to explain pain or fatigue or some other unquantifiable symptom to someone whose body is not sick. In a misguided attempt to help, these family members and friends may tell you that your situation isn’t as bad as it could be; that you just have to push yourself harder; that you need a second, third, fourth opinion.

Their hearts are in the right place. They’re hoping that the power of positive thinking will do the trick and cure you. But not everyone is helped by the relentless positive thinking memes that social media throws at us: believe you’ll get better and you will! Trust your body! Mind over matter! Et ceterra, et ceterra, until you start to doubt your own feelings. Among these feelings, of course, is the grief of what you have lost.

Because although you are still here, your body has betrayed you. Illness takes from us. Maybe you aren’t able to exercise anymore, or even get on the floor with your kids or grandkids. Maybe you can’t drive anymore. Or your brain fog is making it hard to concentrate at work or school or in social situations. Those are big losses to bear by yourself.

Therapy is not going to cure your illness. Further, your therapist will not be able to tell you how long you’ll be sick or if any of what you’ve lost will be returned to you. Your therapist can’t tell you that everything is going to be ok. What therapy can do is meet you where you are. You can grieve. Then you can start to rethink and rebuild your life. Then grieve some more and then rebuild some more… You can be hopeless and hopeful both at once. And you do not have to walk this path alone.