When the subject of bipolar disorder comes up, the focus is typically on the patient and their burden. After all, we’re the ones who experience the mood swings of mania and depression as well as the after-effects and consequences of any behavior. It’s also important to acknowledge the people who care for those of us with mental illness. Often these are informal caregivers such as friends and family members. Not only do they live with the day-to-day effects of our moods, they can also experience anxiety, stress and depression on their own due to the difficulties associated with caregiving. New research suggests that the amount of psychological distress experienced by informal caregivers can be predicted by their satisfaction with support along with adaptive or maladaptive coping mechanisms.
Not enough appreciation is given to informal caregivers of people with mental illness. It is not a career that they are paid for. In some cases people are somewhat forced by feelings of family obligation, but most of the time caregivers volunteer their time and energy to be part of a foundation of social support for those of us who need them.
A new study from David Wasley and Samantha Eden of Cardiff Metropolitan University, published in the International Journal of Mental Health Nursing, surveyed 72 caregivers. They looked for levels of social support and coping styles to predict the level of psychological distress experienced by each participant.
Forty-six percent of the participants had high levels of psychological distress associated with caring for someone with either unipolar or bipolar depression. In the general population that number is somewhere between 5%-27%. Maladaptive coping skills and lack of social support were the largest predictors of psychological distress in these caregivers.
Maladaptive coping skills include emotional withdrawal, avoidant behavior and substance abuse. The use of these coping skills can often result in aggression, hostility, the need to show dominance, manipulation and passive aggressive behavior. This can be distressful to both the caregiver and the person they are caring for, often leading to strained relationships.
Practicing adaptive coping skills did not predict less psychological distress in this study, but previous studies have shown that adaptive coping skills may reduce psychological distress in caregivers. These are practices like positive re-framing of the situation, planning, humor, acceptance of the situation, use of support (both social and therapy) and religion.
Social support for caregivers also has a large effect on the level of psychological distress experienced by caregivers. Those of us with mental illnesses that rely on caregivers are told often that social support is vital to our care. The same goes for those caring for us. They need their own support. Caring for someone is hard and they need an outlet to express that, whether it be with friends or other family members or through therapy.
If you are a caregiver, thank you for being willing to care for someone who needs it. If you have a caregiver, make sure you express your appreciation often.
Image credit: Bilwanath Chatterjee