We talked to Dr Tanya Osicka, Health Psychologist at Tanya Osicka Psychology, about how carers can look after themselves and avoid burnout.
Q: What are some of the mental health challenges that carers face?
A: It has been well established by research that carers experience adverse mental health outcomes when compared to the population. For example, figures published by Carer's Australia in 2024 reported that carers experience reported reduced wellbeing; and that the most common challenges reported by carers were worries about the future of the person they are caring for, money worries in relation to the care recipient, feeling a high level of responsibility as a carer, and worries about not being able to continue providing care in the longer term.
Many carers tell me that it is an honour to provide care, but even when carers dearly love the person they are caring for, the toll of providing regular care can impact their wellbeing.
In the case of caring for a loved one with a life-limiting illness, anticipatory grief (the grief experienced whilst a person is dying) may be a longer-term experience. In general, providing care can have a high impact on the carer's finances and ability to work, rest, socialise, and attend to their own mental health and physical health needs. Even when formal or informal respite care is available, some carers experience guilt for taking time out for themselves.
When our body is stressed and/or anxious, the brain releases hormones and activates the sympathetic nervous system in what is commonly called the 'fight or flight' response. Whilst this sympathetic nervous system activation is helpful in the short term as it increases our heart rate and gives us more energy to help us resolve a stressful or challenging situation, ideally the person returns to a parasympathetic nervous system, or resting state in a short time. However, when our bodies are in this fight or flight state of arousal for a prolonged amount of time this constant activation can lead to digestive and gastrointestinal issues, high blood pressure, headaches, sleep problems, weight gain, bodily pain and tension, and depression and anxiety.
or some carers, it has been the demands and stress of the caring role that has led to their current mental health symptoms, for others the pressures of caring for others exacerbates pre-existing mental health symptoms. Many of the carers that I see are also juggling multiple life demands. Whilst Carer's Australia research (2024) shows the wellbeing benefits of carers maintaining employment; balancing care needs with employment and the care of other family members can add significant pressure. A term often used in the media is that of the 'sandwich generation' of middle-aged adults who are taking care of their children and their ageing parents, often while managing their employment and their own health needs as they age.
It can also be challenging for carers when there has been a prior negative relationship with the person they are caring for. For example where there is ongoing conflict, for those caring for a parent who was abusive, or caring for in-laws when there has not been a positive relationship in the past. It can be very helpful to discuss these challenges with an experienced psychologist, counsellor, or family therapist.
"In my work as a health psychologist, the most common issues carers report are chronic stress, worry, anxiety, low mood or depression, frustration, exhaustion and burnout, grief, and resentment."
Q: What is it about caring for someone with a medical condition that can cause burnout or exacerbate mental health problems?
A: Research in the Australian Journal of General Practice in 2019 (Wang & Du) reported a three times higher prevalence of psychological distress in the primary carers of people with disabilities compared to the general population. Almost half of the study participants reported that the caring role had impacted their physical health and wellbeing, which was attributed to the high provision of care needs, restrictions to their own social life and leisure time, and financial stresses.
Burnout is the experience of emotional, mental, and/or physical exhaustion that results from long-term chronic stress. While burnout is a term that has historically been applied to the workplace, we now know that burnout can arise due to the demands of multiple life demands, including the provision of care.
People with burnout may experience feelings of cynicism, emptiness, anger, feelings of helplessness and hopelessness. For those experiencing these or any other physical or mental health symptoms it is important to speak to your GP so that a full physical and mental health assessment can be done.
Some people do not even consider themselves a carer, particularly teenagers and younger adults who are caring for a parent or family member. However, Carers Australia reports that there are over 390,000 young carers up to the age of 25 in Australia.
'Stress is inherently part of life, and in the short term can mobilise us to act in a crisis. However, when stress occurs over the longer term, such as when providing care, it becomes chronic stress."
Q: What should a carer do if they are feeling burnt out or like they can't cope with their caring responsibilities?
A: The experience of carers who feel exhausted, burnt out and unable to cope need to be taken seriously, as this is unlikely to resolve without intervention. It is important to speak to family or loved ones and let them know what you are experiencing and to make an appointment with a GP as soon as possible, as delaying treatment is likely to further increase distress levels. As well as checking your physical health, a GP can use mental health assessment tools such as the K10 or DASS-21, and prepare a Mental Health Care Plan for Medicare subsidised psychology sessions if your symptoms indicate this.
It is important for carers to be aware of 24 hour support services, including Lifeline (phone 13 11 14) and Beyond Blue (phone 1300 224 636). If you or another person is in an emergency, or at immediate risk of harming yourself/themself or others, please phone 000.