Three Steps to Prevent Caregiver Burnout

Caregivers Need Care: A Newsletter & Podcast Episode

Feb 07, 2023

Hats off to those of you who can cajole a screaming toddler, console an anxious teen, or tend to a sick loved one with ease. If you’re anything like me, caring for other people is deeply fulfilling, but it comes with a cost.

As human beings, we all have our limits. When I reach the edge of my capacity, I can feel my patience waning, my empathy draining, and my body blowing a gasket. The more technical term is “burnout.”

I learned this lesson the hard way. Pregnant with my first child as a first-year medical resident at Johns Hopkins Hospital, I got quite sick. My mental and physical health suffered as I cared for some of the most vulnerable patients in East Baltimore. I wasn’t accustomed to asking for — or accepting — help. I didn’t have a vocabulary for the array of emotions I was experiencing; I didn’t even realize they mattered. I thought to myself: What could a privileged young doctor, married and pregnant, possibly have to complain about?

What felt like an impossible situation provided an essential life lesson: Caregivers also need care.

This seems completely obvious now, but it certainly wasn’t to me in my 20s. What’s more, it turns out that burnout applies not only to doctors but to anyone in a caregiving role.

At some point in our lives, that’s all of us.

hippopotamus lying on surface near body of water — Photo by Tim De Pauw on Unsplash

What is burnout?

At the height of the pandemic, I wrote a piece about burnout for The Atlantic. I thought it was odd that expert groups — i.e., the World Health Organization and the Mayo Clinic — insist that burnout should refer only to workplace-related phenomena of physical and emotional depletion.

I thought: Why should burnout apply only to people doing paid work?

When I wrote the article, caregivers were uniquely burned out. From high blood pressure and alcohol overuse to insomnia and anxiety, I witnessed every bodily manifestation of emotional distress during the pandemic in my medical office.

The same holds true today.

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Anyone who has ever cared for aging parents, agitated teens, or sick friends has experienced symptoms of emotional and physical exhaustion. It’s also clear that caregiver burnout affects our health. Just as caregiving bleeds into everyday life, there’s no partition between our body and mind.

It turns out that caring for others — paid or unpaid — carries occupational risk.

Here are three steps to avoid caregiver burnout

Validate and practice self-compassion
Shift your locus of control
(Re)stock your coping toolkit

Step 1: Validate

If you find caregiving frustrating, you’re normal. If you feel guilty about not doing more for the person(s) you care for, welcome to the club. If your empathy for someone’s situation triggers guilt about naming your own suffering, I have a diagnosis for you: HUMAN.

It’s normal to have complicated feelings and disquieting thoughts when we’re caring for others. Who among us has never felt loving compassion and murderous rage toward the same person, all at once? I have.

Caring for others can steal significant emotional, physical, and financial reserves. It takes time out of our already hectic lives. It involves shelving our own needs for the sake of someone else’s. It requires equally hefty doses of acceptance, flexibility, and managed expectations.

Spouses and children of patients with dementia or Parkinson’s, for example, not only mourn the loss of their loved one while they are still alive, they also experience significant financial, emotional, and physical distress. Parents of children with special needs suffer disproportionate levels of caregiver burnout — on top of managing the more typical, routine challenges of parenting.

Every day in my office, I witness the bodily and mental health toll of caring for infants, toddlers, depressed and anxious teens, sick parents, substance-abusing loved ones, or ailing partners.

No wonder caregivers get burned out; we’re human.

When we deny ourselves permission to experience distress in the first place, the unpleasant feelings and thoughts fester in other places. They tighten our jaw, tense our neck muscles, wrench our low back, upset our digestion, elevate our blood pressure, and quicken our heart rate. They also trigger us to ruminate, overeat, drink too much, shout, act out, and avoid important aspects of our well-being.

Stress thrives when we give it a home. So instead of parking it inside your body and mind, first try giving yourself some grace. You are more normal than you think.

Step Two: Shift your Mindset

Psychologists have long understood that people’s perception of whether they control their own fate — or are at the mercy of outside events — affects their health. Shifting from an externalized locus of control to an internal locus of control — that is, taking charge of our own lives again — can restore our sense of agency and self-determination.

So, take a pause and zoom out on your caregiving role. Recognize the areas where you have little-to-no control (i.e., trouble-shooting a difficult diagnosis or a tough relationship with the recipient of your care) — and accept them. Next, try to recognize what agency you do have (i.e., the ability to make meatloaf or to listen without judgment) — and lean into it.

Note that this is a lifelong exercise. Be gentle with yourself if it takes you more than a minute.

Step Three: Tools to Manage Caregiver Stress

“Self-care” is not a luxury. It’s not just a cute saying on workout clothes. Yet for many of us, caring for ourselves as we would care for other people is a tall order. Burnout itself — as a state of low energy and low motivation — is a common barrier to realizing even the best intentions. As such, it’s critical to create strategies to better meet our biological needs.

My advice?

Assess — and then meet — the four non-negotiables for health (aka “STEM”):

S = Sleep. Our brains and bodies can’t function without rest. Most humans need 7-9 hours. Prioritize it.
T = Talk. To loved ones, friends, and/or a therapist, if you have one. Externalize your thoughts and feelings. Tell your story.
E = Eat. We need protein, fiber, healthy fats, and whole grains. Satiety at regular intervals is critical for our bodies and brains. Experience it.
M = Move. Walk, cycle, get outside. Connect with your body in any way, shape, or form. Just do it.

When we’re caregiving, meeting these needs seems impossibly hard. So here are a few ideas to promote calm amidst chaos: Declutter your inbox, your bedside table, and your desk. Turn off notifications on your phone and computer. Unsubscribe to newsletters and emails you don’t read (except this one - heh). Say no to optional obligations. Ask for, and accept, help.

Last week I felt myself getting overwhelmed — with patient care, parenting, and managing a busy life. So I did what I recommend to my patients: I removed nonessentials from my calendar, slept 9 hours, and asked for more support. I reminded myself: It’s Okay to Not Be Okay every day of the week.

Sometimes the best medicine is a dose of self-compassion.

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