Can Caregiving Lead to PTSD?

Q. I was a caregiver for my father-in-law two decades ago, and I experienced a terrible scare. I took him into my home when he developed fronto-temporal dementia and he lived with my family. He would get angry at me a lot and sometimes even violent, and it terrified me to be around him. I did my best to care for him, but the truth is that I was stressed beyond measure, and should’ve gotten him skilled care instead of completely shouldering the burden myself, not sleeping, losing my friends, and not being there for my own children (who were young at the time).

Now, I am a caregiver once again, for my husband who is in the beginning stages of Alzheimer’s, but I still get very anxious and traumatized when I look back to the time I was caregiving for his dad. I think that my anxiety is beyond normal, as I still experience physical reactions, such as increased heart rate and rapid breathing just by thinking about it. Even certain sounds or smells make me anxious and I have distressing dreams and flashbacks of his angry tirades often. My symptoms sound like PTSD, from what I have read. But, I’m curious — is it actually possible for caregivers to develop PTSD? I made an appointment with a therapist, and hopefully that will help. I want to be there for my husband in his time of need also. Do you have any suggestions for people like me, so I can be the best caregiver I can be and to lessen my stress as much as I can? Thanks!

A. Being a caregiver is arguably one of the most stressful life events, sometimes even after it is over. Caregiving is so much a part of our lives that it can determine your career path, your friendships, your income, your mental state, your health, your ability to think clearly, and your ability to care for yourself.

You mentioned that you are experiencing severe stress, with symptoms similar to PTSD from caregiving for an angry and violent relative. I recently read an article about Barry Jacobs, a clinical psychologist and author of “The Emotional Survival Guide for Caregivers,” who often sees caregivers who struggle with intrusive thoughts and memories months and even years after a loved one has died. According to Jacobs, “[m]any people find themselves unable to stop thinking about the suffering they witnessed, which is so powerfully seared into their brains that they cannot push it away.”

Flashbacks ARE a symptom of post-traumatic stress disorder, along with feelings of numbness, anxiety, guilt, dread, depression, irritability, apathy, tension, and more. Though one symptom or several do not prove that such a condition exists — that’s up to an expert to determine — these issues are a “very common problem for caregivers,” Dr. Jacobs said.
Dolores Gallagher-Thompson, a professor of psychiatry at the Stanford University School of Medicine who treats many caregivers, said there was little evidence that caregiving on its own caused post-traumatic stress. But if someone is vulnerable for another reason — perhaps a tragedy experienced earlier in life — this kind of response might be activated.

Restoring Balance in Your Life

It is wise that you are getting therapy and help for the emotions that linger from your father-in-law. Now, you should do what you can to care for yourself, as well as for your husband.

As you are aware, caregivers place a significant amount of energy and attention focusing on the needs of others. An unintended consequence of this outward focus on others is the risk of losing sight of your own needs and becoming depleted. The thing that keeps you resilient and engaged in living is the balance you have in your life. Here are some things you can do to help with life balance. Hopefully, coupled with therapy, these things will help you heal and be the best caregiver you can be!

Schedule Time for Yourself for Caregiver Life Balance

Everyone needs time to clear their own mind and focus on their own life and health. While it may seem impossible to find additional time in your busy schedule, insisting on time for yourself will make you a better caregiver.

First, schedule personal time. Plan out your week in advance and treat your personal time as a high priority. Reserve a part of each day just for you and schedule that time as you would any other appointment. Then, designate a space for yourself. A couch with your favorite pillows or a room with your favorite photos on the wall. Retreat to that space to nap, journal, or meditate.

Stay Energized with Exercise and Movement

When you are taking care of someone, it is easy to fall into a sedentary lifestyle yourself. Even if you aren’t feeling like you are in the mood for exercise, getting in some movement will be energizing. This could be from a walk, a jog, or a dance class. Do something good for your body and you are doing something good for your mind. Caregiver life balance means keeping your body in tip top shape. Exercise is also good for the mind, and can help stave off dementia!

Make Healthy Eating Choices

Your diet impacts your mindset. Healthy eating will give you more energy and can actually help your body physically repair from stress. If you are struggling with your diet and are quick to grab snacks that are high in calories and salt, try making more healthy foods accessible. For example, when you buy vegetables from the grocery store, get them washed and prepped in bite-sized pieces when you get home so they are just as available for snacking as a bag of chips. Fruits and nuts are good snacking choices, too.

Do Things You Love

In addition to time for meditation and self-reflection, take time to do the activities and hobbies you love. Whether it is watching sports, reading books, or crafting, your interests outside of caregiving help to maintain your identity beyond caregiving. With your own goals and interests, you are able to grow as an individual. Besides, research has shown that people who have hobbies are generally healthier, and that these interests can lower the risk of depression and dementia.

Taking care of yourself

It is good that you are seeing a therapist and getting the help you need to get over the stress you are still feeling from caregiving for your father-in-law. If caregiving for your husband becomes too much to bear, be sure to seek help and respite. Please see our recent article, “When Caregiver Stress Becomes Extreme” for additional tips and ideas for what to do when you’re in a highly stressful caregiving situation.

Planning in Advance for Your Husband with Alzheimer’s

It is prudent to start planning for your husband now, for when more care is needed for him than she can provide. Please contact us for an appointment for a no-cost introductory consultation to discuss Life Care Planning and Medicaid Asset Protection at:

Fairfax Elder Law: 703-691-1888
Fredericksburg Elder Law: 540-479-1435
Rockville Elder Law: 301-519-8041
DC Elder Law: 202-587-2797

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About Evan H Farr, CELA, CAP

Evan H. Farr is a 4-time Best-Selling author in the field of Elder Law and Estate Planning. In addition to being one of approximately 500 Certified Elder Law Attorneys in the Country, Evan is one of approximately 100 members of the Council of Advanced Practitioners of the National Academy of Elder Law Attorneys and is a Charter Member of the Academy of Special Needs Planners.