June 17, 20215:53 PM ET
The
pandemic has taken a massive toll on people's
mental health. But a new report by the U.S. Centers for Disease
Control and Prevention confirms what many of us are seeing and feeling in our
own lives: The impact has been particularly devastating
for parents and unpaid caregivers of adults.
Two-thirds
of survey respondents who identified as unpaid caregivers said
they experienced mental health challenges during the pandemic, such as symptoms
of anxiety or depression, or suicidal thoughts.
Only
one-third of people with no caregiving responsibilities reported the same
symptoms.
Of the
more than 10,000 survey respondents, more than 40% identified as being unpaid
caregivers.
"What
is striking here is just how widespread unpaid caregiving responsibilities are
in the population and how much of a burden and a toll these
responsibilities" are having, says Shantha Rajaratnam,
a co-author of the study and a psychologist at the Turner Institute of Brain and Mental
Health at Monash University in Australia.
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The
study also found that people who care for both children under 18 and adults —
many of them part of the sandwich generation — are faring the worst, with 85%
of this group experiencing adverse mental health symptoms.
"It's
an extremely important study," says psychologist Dolores Gallagher-Thompson,
professor emeritus at Stanford University who has researched family caregivers
and their challenges.
The
study is the first to document the problems caregivers have experienced during
COVID-19, she notes, and underscores "the importance of paying attention
to caregiver issues, caregiver mental health" and the need for education
and resources to better support them.
The contrast between
caregivers and others is stark
The
study, part of ongoing research by The COVID-19 Outbreak Public
Evaluation (COPE) Initiative, is based on surveys conducted in
December 2020 and February-March 2021.
More
than half of those who identified as caregivers said they had experienced
symptoms of anxiety or depression, or of disorders like PTSD related to the
stress and trauma of COVID-19.
A
significant number of caregivers said they had contemplated suicide. Nearly 40% reported having passive suicidal
thoughts, meaning "wishing that they had gone to bed and didn't wake
up," says study co-author Mark Czeisler, a graduate
student at Monash University and a research trainee at Brigham and Women's
Hospital in Boston.
And
more than 30% had seriously considered taking their own life — about five times
the number of noncaregivers, the study found.
Across
the board, mental health impacts have been more severe for people who care for
both children and adults. Half of this group said it had seriously considered
suicide in the past month.
The pandemic worsened
the challenges caregivers face
Even
before the pandemic, being an unpaid caregiver was stressful and associated
with a higher risk of mental
health issues, says Gallagher-Thompson. The COVID-19 pandemic has
made things even harder.
For
instance, the pandemic has taken away many formal and informal sources of
support for caregivers.
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That
was the case for Dr. Nicole Christian-Brathwaite. She's a Boston-based child
psychiatrist and lives with her husband, her mother, her husband's father and
two sons, who are 4 and 6.
Before
the pandemic, her father-in-law, who has dementia, went to a day program for
seniors with cognitive decline. Her mother, a survivor of breast and lung
cancers, went to physical therapy twice a week, doctor appointments and met
with friends.
When
the pandemic hit, they lost those services and social support — at the same
time Christian-Brathwaite and her husband began working from home while taking
care of their sons and parents.
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Life at
home became much more complicated. Her sons developed behavioral problems with
the transitions and stresses of the pandemic. Her mother struggled with chronic
pain, and was hospitalized during the pandemic. And there were days when her
father-in-law was confused, disoriented or aggressive.
"Many
days I was walking around on edge waiting for something to happen because our
entire setup was so very fragile and vulnerable," says
Christian-Brathwaite. "It's been exhausting."
And her
mental health has suffered. "I certainly was dealing with insomnia,"
she says. "I was short tempered. I was more irritable. I didn't have the
same tolerance for things."
More support needed to
help caregivers cope
The new
study highlights the extent to which unpaid caregivers have struggled during
the pandemic, says Gallagher-Thompson.
"There
are some serious issues here that shouldn't be ignored," she says.
And yet
caregivers are often ignored by the health system, which is set up to focus
only on patients.
"Family
members are rarely asked, 'How does this affect you? What is difficult? How can
we help you? How can we support you in being able to carry out your role, your
tasks, your responsibilities?'" Gallagher-Thompson says.
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As the
new study shows, support can make a big difference — respondents who could rely
on others for help with caregiving had a lower incidence of mental health
symptoms.
So it's
important to educate and support caregivers. For example, physicians can start
by screening their patients' caregivers for mental health symptoms and provide
more resources to those who need it, says Gallagher-Thompson.
Christian-Brathwaite
hopes the new study will help physicians recognize that family caregivers are
just as important to consider while treating patients.
"We
really need to take a step back and look at the village that's around them
because our patients can't be successful without having the support from
family," she says.
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