4.5 Impact on caregivers

A Family Guide to Concurrent Disorders - Part II: The impact on families

Family members may be concerned about leaving their relative alone because they are worried that he or she will take harmful drugs, forget to take medications, take part in dangerous or criminal behaviour to get illegal drugs, or harm him- or herself during a serious episode of illness. If family members are constantly watching for symptoms and dealing with the impact of the illness, they may feel overwhelmed.

You become extremely protective of [family members who are ill]. It takes incredible emotional energy.

Some family members may find it almost impossible to soothe their own anxieties, and distract themselves from the strain of coping with their relative. They may feel unable or even guilty to take time for themselves, to relax, care for their own emotional and physical health, and rebuild their own coping resources. Sometimes, family members even feel guilty if they experience resentment or anger. They should admit if they are extremely tired, worn out, angry or bitter. Denying these emotions can lead to exhaustion, depression, isolation and hopelessness.

They may feel isolated from others who were once very good friends. They might feel that they don't have the time to maintain friendships, or they may be embarrassed or ashamed about the concurrent disorders.

Think about your own situation and how your life has been affected. Remember that all family members experience difficult circumstances and negative feelings. It is very common for family members to feel guilty when they are asked to think about how this has affected their own lives. However, before you can begin to take care of yourself and play a positive role in your loved one's recovery, you need to think honestly about the different ways that your life has been changed.

Caregiver burden and compassion fatigue: A note about language

The term caregiver burden is used in professional literature to describe the emotional, social and psychological toll on the family that comes from caring for someone with a substance use and/or mental health problem. Many caregivers, while they like others to recognize how difficult it is to care for a family member with concurrent disorders, don't like the term “caregiver burden.” They feel it ignores the positive side of looking after the needs of someone important to them and negates the fact that, in spite of the stress, they love the person and would go to the ends of the earth to help and protect them. It also dehumanizes their loved one, and reduces him or her to a “burden,” which the caregiver hopes will not always be the case.

The stress and feelings of powerlessness that are such a large part of caring for a family member with concurrent disorders may be better described as compassion fatigue. We use compassion fatigue here to describe the overwhelming physical, emotional, social and spiritual exhaustion that can strike family members affected by concurrent disorders. It is a much more user-friendly term for describing the results of ongoing coping with extreme adversity.

You can find some strategies for dealing with compassion fatigue by clicking here.

Click the link(s) below to view/print the following PDF's:

• Activity 4-1: Personal impact log (PDF)
• Activity 4-2: Preoccupation and impact (PDF)
• Activity 4-3: The family concurrent disorders index of concerns quiz (PDF)

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