Sandwich Stress

by Audrey Miller on May 12, 2011

in Baby Boomers, Caregiving, Geriatric Care Management, In the Media

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By: Michelle Roberts
Esperanza Magazine Spring 2011

[excerpt from “Sandwich Stress]

Julie H. knows all too well how hard it can be to juggle the needs of older relatives and kids at home. She recalls one moment in particular when she was squeezed between competing needs:

“I was breastfeeding my baby, trying to chase my 2-year-old and getting called on the phone by the elder-care worker telling me her car was broken and that if I didn’t give her $500 right now, she wasn’t going to show up.”

Julie developed severe depression in her early 40s from the strain of caring for her two young children and her husband’s elderly grandparents. She recalls feeling like there wasn’t enough of her to go around.

The pressures of her dual role intersected with a “predisposition for depression,” explains the Dallas resident, now 51, adding: “The way I handled stress in my life created a perfect crucible for that disease to thrive.”

Stress for the so-called “sandwich generation” can be overwhelming and unrelenting. Adults caught between the generations above and below them may develop depression as a result of the constant demands they face.

Most of the research on caregiver depression relates to caring for the elderly or those with a chronic illness. According to a study published in the April 2005 Annals of Long-Term Care, about one in five caregivers of all ages reported having been told by a health professional in the past 12 months that they have depression, which is nearly twice the rate as in the general population.

Caring for children, meanwhile, can be a challenge on its own. Anyone who has found themselves padding the hallway for a 3 a.m. feeding, doing the day-care dash or carpooling to weekend soccer games knows how exhausting modern-day parenting can be. In fact, a 2005 study by Florida State University on parenting stress found that parents have significantly higher levels of depression than adults who do not have children.

Taking care of others does not in it- self cause depression, nor will everyone in that role experience the low feelings and physical symptoms that go with it. At issue is how each individual responds to stress, both on a physiological level and in lifestyle choices.

Problems often arise when caregivers sacrifice their own physical and emotional needs—a situation that may be particularly acute when the demands on them double. That’s why experts say it’s vital to take preventive measures.

“Depression in caregivers is a major problem, but it is not always recognized,” says Audrey Miller, executive director of Elder Caring Inc. in Toronto.“When we’re looking at the caregiver, we are always trying to assess, ‘Are they burning out? Are they getting enough resources?’ ”

For Julie, the draining demands had a cumulative effect. She was able to soldier on until the immediate challenges eased—her children started school around the time that her elderly relatives died—only to enter the worst phase of her depression.

“For the first time in my life I had about six hours a day with nothing to do,” she recalls of fall 2001. “I felt unmoored. Despite the extra time, I became less productive. I changed from someone with a ravenous appetite, to someone indifferent to food. Pounds dropped to an unhealthy level. My periods stopped. I couldn’t sleep. I had nightmares. I began to believe I was mentally incompetent.”

Julie turned to medication and talk therapy, and was hospitalized for a time. Although electroconvulsive therapy helped her out of the deep pit, she says, “it took me years to build myself back up.… I had no idea when I was taking care of everyone how run down and depleted I had gotten.” [end of excerpt]

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