Caregivers: Take Your Oxygen First
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In her book “Take Your Oxygen First,” Leeza Gibbons shares the story of her mother, who was diagnosed with Alzheimer’s disease. With the help of medical professionals, Gibbons provides a guide for caregivers to take care of themselves first. An excerpt:
Leeza: Bad news has no regard for timing. Your bubble of domestic bliss is not immune, nor is your job or career. I was happily mothering my children and producing and hosting my own talk show on Paramount’s Stage 26 when Mom's stage went dark. My anxiety spread to every aspect of my life and as much as I tried to present a facade of calm and acceptance, my persona never lasted past my driveway and once home, I became as tightly wound up as an angry fist. I snapped at the kids, withdrew from my husband and stayed up until dawn searching and searching for the latest treatments, the slimmest hope.
As Mom declined, I was trapped on a tilt-a-whirl of emotion. I managed to convince myself that if I just did more, she would be O.K. The talk show ended its run and I immediately went on to the next stop on my career train, hosting the nightly entertainment news magazine Extra. I was all coifed and poised in front of the camera as I delivered the latest celebrity headlines, but the minute the lights went out on the stage, I fell apart. I spent most afternoons leaving through the back door of the lot to wander the neighborhood streets trying to reclaim some control over myself. But bad news can't be controlled and I realized that I was no match for its increasing shadow over my life. My marriage was strained to the breaking point and I was depressed. I needed to let go of the way things were and accept this beast which had pulled up a chair to my dinner table.
I sought the help of a therapist. It turned out to be more than a lifeline, it was the exploration I needed to reclaim my sanity. Robert, my therapist, provided a safe sanctuary in which to share my feelings. Jamie Huysman, the co-author of this book, was my tether to what would become a new life and a new sense of purpose. He was the friend who always had time for me, who never judged and who always reminded me to be kind to myself. When I was unsure, he was certain. When I was a squishy ball of frayed nerves, he was solid, strong and firm in his belief that I could make a difference. Jamie showed me how to fulfill the promise I made to my mother, to tell her story so that others might be helped and inspired.
Grief is healthy when it helps us to cope with painful changes in our lives, allowing us to heal from loss and embrace a new reality. Healthy grief releases feelings rather than keeping them bottled up inside and lets us move forward in life with renewed vitality. The ideal result of grief is achieving closure, or an end to our feelings of loss or pain. However, when closure is not reached within a reasonable amount of time, normal grief can become depression.
Coping with a loved one’s dementia demands a great deal from caregivers, who often struggle to make do without a strong support system in place to help shoulder the burden. Caregivers are forced to let go of a loved one little by little, again and again, sometimes over a span of many years, and grief over these losses is often experienced over and over. The grief associated with care-giving is uniquely burdensome: often, when illness and subsequent death strike, a caregiver must face not only the loss of the loved one, but loss of control and loss of independence, as well as the possible loss of his job and plans for the future. This experience may explain why caregivers are more likely to suffer from symptoms of depression: a Harvard University Medical School study of the emotional state of caregivers reports that up to 60% are, to some degree, depressed.
While feelings of sadness associated with grief lessen with time, depression can dim the joy of life for months, even years. People who have experienced depression are familiar with its disabling heaviness, which is markedly different from normal sadness. Depressive illness is not just about “having the blues” for too long. It interferes with daily life and causes pain and suffering not only for those who have the disorder, but for those around them.
“I was heartbroken and stunned when we first heard Art’s diagnosis”, recalls Rose, one of our Leeza’s Place clients, whose husband was diagnosed with Alzheimer’s disease. “It was so hard to accept that he was really ill. Eventually though, I moved into my new role and our new relationship and made the best of it. Then suddenly, after 42 years of marriage, Art didn’t know who I was.” At this point, Rose experienced what she called “a loss of meaning”, not just in her role as caregiver, but in her life. She stopped visiting with friends and called her children less and less often. “I couldn't’t bring myself to leave the house much. I had been taking Art to church with me every week, but I stopped taking him anywhere and we ended up at home in front of the T.V. most of the time. I found myself crying the first thing in the morning most days, or wanting to stay in bed all day. Finally my daughter came to visit and convinced me to talk to my doctor about what I was feeling.”
Like Leeza, Rose was lucky to have someone who could see what was happening and encourage her to seek professional help. Although she had been able to experience healthy grief at the onset of the disease, Rose began to experience depression once her husband lost his memory of her.
While grieving, you might be fairly dysfunctional for a short period of time, unwilling to do the things you might normally do. However, a person experiencing healthy grief recognizes that life does go on and eventually seeks to move forward, with energy and healing. Clinical depression, on the other hand, lasts without relief. It sinks into you and prevents you from moving forward in life. You might instead obsess about the perceived futility of life and not even take comfort from talking with others. Depression may isolate you entirely, and in isolation the depression only deepens. You may feel exhausted, worthless, helpless and hopeless, negative views that typically do not accurately reflect the actual circumstances of your life.
The danger of depression is physical as well as mental. Caregivers who suffer from depression tend to have weakened immune systems and an increased chance of developing chronic illness. Depression can increase the risk of osteoporosis and high blood pressure and also increase levels of stress hormones, such as adrenaline and cortisol, which can, over the long run, increase the risk of heart disease and digestive problems. It can even shrink the hippo-campus, the area of the brain involved with learning and memory. Because of the toll depression takes on caregivers and on those around them, it is important to recognize the warning signs of depression and understand how they differ from necessary and healthy grieving.
Recognizing Depression
Depression must first be recognized before it can be treated. But many don’t realize the need for help because they assume that it is only natural to be feeling sad, given the stresses and sorrow caused by a loved one’s memory loss.
If you are concerned about the possibility of suffering from depression, look at the following list. If you have five or more of the symptoms listed and they have lasted for two weeks or more, you may be at risk for depression:
- Sadness most of the day.
- A markedly diminished interest or pleasure in activities.
- Significant weight loss or weight gain, or a decrease or increase in appetite.
- Insomnia or hypersomnia, the prolonged nighttime sleeping or daytime sleepiness.
- Psychomotor agitation which include excessive pacing, handwringing, or nail biting.
- Recurring thoughts of death (not just fear of dying), or recurring thoughts of suicide.
- Fatigue or loss of energy.
- Feelings of worthlessness or excessive or inappropriate feelings of guilt.
- A diminished ability to think or concentrate or indecisiveness.
If you are at risk for depression, see your doctor.
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Video: MSNBC TodayShow.
Article: Excerpted from “Take Your Oxygen First” by Leeza Gibbons. Copyright (c) 2009, reprinted with permission from LaChance Publishing.
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