Can Caregiving Cause PTSD?

Caregiving can be traumatic for some, leading to short-term symptoms or chronic conditions like post-traumatic stress disorder (PTSD). Caregiver PTSD is much different from stress or burnout. It’s a serious mental health condition that can develop from chronic stress, watching a loved one’s health decline, or ER visits. 

Caregiver trauma is often a “hidden” experience that can lead to symptoms like intrusive memories, social isolation, guilt, and hopelessness. 

As you care for a loved one, you must look after your own mental well-being. If you’re experiencing significant emotional, mental, or physical distress from caregiving, professional support is available.

How you can get PTSD from being a caregiver

Caregiver PTSD is a fairly common experience. A study assessed 99 caregivers with loved ones admitted to intensive care units (ICUs). They were screened for chronic PTSD risk during admission, and three months and six months after discharge. Researchers discovered clinically significant PTSD symptoms at each period, with rates ranging between 16-22%.

In an online survey involving 23 dementia caregivers, 26.1% met the criteria for a PTSD diagnosis.

Trauma can stem from one significant event or prolonged exposure over time. 

Short-term caregiver trauma may develop from:

• ER visits
• Violent incidents
• Suicide attempts
• Receiving a terminal diagnosis for a loved one

Prolonged or chronic PTSD may arise from:

• Long-term, unrelieved stress
• Constant vigilance
• Financial strain
• Sleep deprivation

Not all caregivers will develop PTSD, but they can still experience trauma symptoms.

Why caregiving for an aging parent or spouse can be especially traumatic

Caregiving can introduce experiences that can increase your risk of developing trauma, such as:

• Witnessing the decline of a loved one, including confusion, aggression, suffering, or repeated crises
• Dealing with falls, hospitalizations, ICU stays, or near-death experiences
• Recurring feelings of helplessness, loneliness, and loss of control
• Role reversal (i.e., becoming the “parent” to your parent)
• Chronic hypervigilance, or constantly being stuck in “fight-or-flight” mode
• Persistent sleep disruption

Caregiver PTSD can present differently in adult children and spouses. Adult children may feel that they need to step into a parental role. This can be a traumatic experience if that parent once held a role where they made the child feel safe, or never did. 

Spousal caregivers can feel like they’ve lost the companionship with their partner due to their declining health. And, as older adults themselves, they may face a “double-care crisis.” They now find themselves supporting their partner while also managing their own health.

How old wounds can get activated during caregiving

Caregiving may reintroduce old trauma. Caregiver attachment trauma is a type of relational trauma that stems from childhood abuse or neglect. It can break a child’s sense of safety, often resulting in PTSD or dysfunctional adult relationships.

If you had attachment issues as a child, becoming a caregiver can reopen those wounds, causing intense feelings of resentment, panic, guilt, or emotional flooding. It may also lead to emotional distancing and avoidance, making caregiving a more task-focused role to avoid emotional engagement. 

If you find yourself struggling with attachment trauma, boundary-setting will be necessary for caregiving. 

Setting boundaries for yourself can look like:

• Noticing your body cues, like discomfort, anxiety, or tension, which can indicate a violation of your personal space or needs.
• Using clear language when you’re feeling uncomfortable.
• Not over-explaining to justify your boundaries.

Attachment trauma can be deep-rooted for many people, and, in some cases, can make safe caregiving difficult. If the relationship is not in a healthy space, the hands-on care may need to be passed to another trusted family member, friend, or home care professional. 

Recognizing signs of caregiver PTSD and trauma

Knowing the symptoms of PTSD and trauma can be helpful when seeking professional help. The conditions are similar, but trauma is a temporary emotional response to a distressing event, while PTSD is a chronic mental health condition.

Common caregiver trauma symptoms include:

• Reliving traumatic events through flashbacks, memories, or intrusive images, and experiencing physical symptoms like a racing heart, headache, fatigue, or sweating.
• Avoiding places, events, objects, thoughts, or feelings that trigger reminders of the traumatic event
• Arousal and reactivity symptoms, such as constantly being on guard, easily startled, or having difficulty concentrating or sleeping. You may also feel very irritable, have angry outbursts, or engage in risky behaviors.
• Experiencing cognitive and mood symptoms, including difficulty remembering key parts of the traumatic event, negative thoughts and emotions, loss of interest in activities, social isolation, and difficulty feeling positive emotions.

There’s a lot of overlap with PTSD and trauma. However, there are three key differences between the two: duration, intensity, and presence of re-experiencing. 

Trauma symptoms can often resolve within a few days or weeks, while PTSD can last for several months or years. People with trauma can typically go about their daily life with little disruption, while PTSD can significantly disrupt work, school, and relationships. Lastly, people with PTSD frequently relive traumatic experiences, which is less common for short-term trauma.

Understanding complex trauma in long-term caregiving

If caregiving responsibilities last several months or years, and traumatic events accumulate over time, you may experience complex trauma. Complex trauma, or complex PTSD (C-PTSD), is a mental health condition that stems from prolonged, repeated trauma. It involves the same symptoms of standard PTSD — flashbacks and avoidance — but also causes severe emotional dysregulation, very low self-worth, and persistent difficulty maintaining relationships.

Potential triggers for complex PTSD in caregivers are:

• Witnessing a loved one’s decline
• Handling behavioral crises
• Navigating complex health systems
• Social isolation
• Being constantly on high alert
• Persistent helplessness or loss of self

Complex caregiver PTSD is not something you have to deal with on your own. Professional mental health support can help you navigate this trauma to find relief.

Caregiver PTSD after death: why symptoms can hit later

If your loved one passes away, their death can be very traumatic. You may experience trauma from prolonged stress or witnessing their suffering or the nature of their death. Post-caregiver PTSD can cause delayed reactions, intrusive memories, emotional numbness, or guilt. Research shows that about 20% of caregivers experience mental health symptoms like complicated grief or depression during bereavement.  

Trauma vs. grief

While PTSD can cause grief, they are separate experiences. PTSD is a mental health condition triggered by fear or helplessness, while grief is a natural response to loss that focuses on yearning. Traumatic grief can be a mixture of both, where intense longing for your deceased loved one can be accompanied by intrusive memories of death, which can disrupt the healing process.

Regardless of whether you believe you’re experiencing short-term trauma, PTSD, or grief, your feelings are valid, and you don’t have to go through this alone. With the help of a therapist, there are healthy coping strategies you can adopt to manage caregiving trauma.

Managing your trauma symptoms as a caregiver

Overcoming or managing trauma can involve prioritizing self-care, setting boundaries, building a support network, and seeking professional therapy.

Some tips for handling PTSD and caregiver burnout include:

• Setting aside time to hang out with friends and family to reduce isolation.
• Creating a strict bedtime routine to encourage restful sleep and reduce anxiety.
• Utilizing respite care (short-term relief for caregivers) to relax and reset.
• Practicing mindfulness techniques, such as yoga, meditation, or deep breathing, to manage stress and burnout.
• Learning to say no to extra tasks or commitments and limiting caregiver responsibilities that lead to burnout.
• Joining support groups to connect with other caregivers for validation, advice, and shared experiences.
• Seeking mental health services, such as trauma-informed therapy, to learn how to cope with trauma.

If caregiving becomes overwhelming, and respite care isn’t enough, it’s okay to redistribute your responsibilities or change your loved one’s care plan entirely.

Professional support for caregiver PTSD

It’s time to seek professional help for caregiver PTSD or trauma if:

• You’re reliving traumatic events through flashbacks or intrusive memories.
• You’re experiencing symptoms of burnout, such as fatigue, irritability, or difficulty sleeping.
• Your symptoms are interfering with work, school, or relationships.
• You no longer have the emotional or physical capacity to handle caregiving tasks.

More severe warning signs that require immediate help are substance abuse, suicidal ideation, and deep feelings of hopelessness.

Talk therapy is recommended for addressing caregiver PTSD symptoms. A therapist can help you learn to regulate your nervous system, process trauma, set boundaries, and develop coping strategies.

Two types of talk therapy that can help with caregiver trauma include:

Trauma-focused cognitive behavioral therapy (TF-CBT)

TF-CBT is the first-line, short-term treatment designed to help people process traumatic experiences and manage symptoms. A therapist helps you change unhelpful thoughts and behaviors, improve emotional regulation, and reduce avoidant behaviors.

In a review of 25 studies, participants who received TF-CBT had lower PTSD symptoms post-treatment — including fewer intrusive thoughts and flashbacks, reduced hypervigilance, and improved mood — compared to those who didn’t receive the intervention. 

Eye movement desensitization and reprocessing (EMDR)

EMDR is a talk therapy that uses bilateral stimulation (eye movements, taps, or sounds) to help the brain process, reprocess, and desensitize traumatic events. Studies show that EMDR is highly effective for PTSD, with between 84% and 90% of people with single-trauma experiencing remission of the PTSD diagnosis within three sessions.

Finding help for your loved one

Your spouse or parent whom you care for can also benefit from mental health support if they’re struggling emotionally or have behavioral concerns. Connecting them with a therapist can help them cope with terminal illness, declining health, or feeling like a burden. When they’re able to receive care for their mental health struggles, it can, in turn, help reduce caregiver emotional distress and burnout. 

How Sailor Health can help

Medicare Part B covers outpatient mental healthcare, including talk therapy. However, you must be a beneficiary to be eligible for coverage. 

Limited mobility, a lack of transportation, and being more susceptible to illness can make it hard for seniors to get to a therapist’s office. Sailor Health offers telehealth therapy via computer, phone, or even landline, making therapy more convenient and accessible for seniors. All of our therapists are experienced and understand the unique challenges common in later life, so you’ll receive care from someone who understands what you’re going through.

At Sailor Health, we believe that mental health care should be exceptional yet accessible. That’s why we work with Medicare to cover up to 100% of the cost for most patients, so you can focus on feeling your best without worrying about the bill. In fact, most of our Medicare patients have a $0 copay. We make it easy to get started, and you could begin therapy in as little as 24 hours after signing up. Take the first step today.

Caregiver PTSD FAQ

Can you get PTSD from being a caregiver?

Yes, caregivers can develop PTSD symptoms from chronic stress, witnessing a loved one’s declining health, or managing a trauma event, such as a medical crisis.

What are caregiver PTSD symptoms?

Caregiver PTSD symptoms can include flashbacks, intrusive thoughts or images, hypervigilance, emotional numbness, and anxiety.

What’s the difference between caregiver burnout and caregiver PTSD?

Caregiver burnout is a state of emotional, mental, and physical exhaustion that stems from long-term caregiving stress. In contrast, caregiver PTSD is a severe mental health condition that develops from experiencing a traumatic event. 

How do you recover from caregiver trauma?

Seeking professional help, setting boundaries, prioritizing self-care, and having a support network can help you manage caregiver trauma.

Can therapy help with caregiver PTSD?

Yes. Trauma-focused cognitive behavioral therapy (TF-CBT) and eye movement desensitization and reprocessing (EMDR) are effective treatments for addressing caregiver PTSD.

Does Medicare cover therapy for caregivers?

If the caregiver is a Medicare beneficiary, Medicare will cover their outpatient mental health services.

References

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