Supporting a Stressed Caregiver

Reader’s Question

I think my adult daughter may be depressed. She is 28 years old, and has a daughter who is three years old. My daughter doesn’t have any friends. She left her boyfriend of five years because they argue a lot. She feels as though her life is a waste, since she can’t provide for her daughter because she is unemployed. She and her daughter live with my mom, and we pay her to watch my mom, who needs constant care.

My daughter was working with her child on spelling, and when she would not listen, my daughter got very angry, and told her she needed time-out. My daughter was hysterically crying about the situation, and stated that she’s a horrible parent and should never have had my granddaughter, and that my granddaughter would be better off without her.

She has a history of depression, but refuses to be on any medication. I am at my wits’ end. I don’t know what to do to help her if she doesn’t want to get help on her own.

Psychologist’s Reply

Your daughter sounds as if she is overwhelmed with caretaking responsibilities without much respite or a broader support network. She is currently caring for a toddler, a disabled elderly person, and has also just lost an important relationship in her life. Caregiver stress is difficult for anyone, but for someone with a history of depression it can be devastating and immobilizing.

My greatest concern from your description is your report of your daughter’s distress. When your daughter says things like “my child would be better off without me,” and “my life is a waste,” it is necessary to take those comments seriously, and to ask her if she has thought about hurting herself, hurting her child, or killing herself. The Mayo Clinic has a good summary of guidelines and direct questions to ask someone who may be suicidal. The Depression and Bipolar Support Alliance has more helpful information for individuals with depression who may be thinking about suicide. It is important not to judge or take a moral stance about suicide, but just to listen to her distress, talk openly about how difficult things have become, and determine if she has a plan or access to something that could be deadly. Encourage your daughter to call a suicide hotline (such as 1-800-273-TALK) or visit the National Suicide Prevention website to talk to someone who can help.

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The burden of caring for an elderly person in addition to caring for her own toddler sounds as if it may be too much for your daughter to manage. And, from what you’ve described, your daughter may be placing demands on her child that are developmentally inappropriate (that is, too advanced for the cognitive abilities of a three-year-old), in the hopes that her daughter can be more independent and require less care. This strategy, as you noted with the “spelling” example, will only frustrate your granddaughter and your daughter. Three-year-olds learn through play and exploration and do not have the ability to learn spelling tasks; nor can they sit for more than a few minutes at a time. Your daughter might benefit from some resources geared specifically toward parenting preschoolers. A very short, parent-friendly book I often recommend is entitled How to Behave So Your Preschooler Will, Too! by Sal Severe, PhD .

If your daughter can find more resources to ease her burden (such as a childcare provider with knowledge of early childhood development, a support network to help with eldercare responsibilities, and perhaps someone she can talk with about managing stress), she may be able to have some time and space to take control of her own life. Although caring for your mother may have helped your daughter’s financial situation, I wonder if caregiving is a good fit for her. What work skills and work interests does she have? A counseling psychologist could help sort through vocational exploration, in addition to helping your daughter manage her stress and depression. The American Psychological Association (APA) Psychologist Locator is a good place to start in finding someone who can help. Searching for a psychologist who works on a sliding-scale fee system may be most useful, given your daughter’s financial situation. A local university may also have a low-cost psychology clinic that your daughter might visit.

In the meantime, any small breaks that you can provide your daughter in order for her to get some time for herself (an hour a day, a two-hour block two or three days a week, etc.) may help. Encouraging her to take a walk, see a friend, do something enjoyable, or perhaps find time to get more support may help both of you feel better.