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RESCUE Stroke Caregiving

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Caregiver Stress & Depression

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Understanding How Caring For A Loved One Affects You depressed older woman

Taking care of someone else can be stressful. Caregivers often sacrifice their own well-being to provide care for their loved ones. The stress of caregiving can cause headaches and chronic neck and back pain. It can affect thoughts and feelings, leading to depression. Caregiving stress can cause serious health problems.

What Do You Need to Know?

You may have feelings of anger, guilt and sadness. You may worry that you are not doing the right things. You may feel lonely and resent your new role. These are feelings that most caregivers have from time to time. Pay attention to how caregiving is affecting you. Talk to your healthcare team about your negative feelings.

Do You Feel Stressed?

Answer the questions on the Zarit scale to find out your stress level. A score of 8 or above shows a high level of stress. Talk to your healthcare team about ways to reduce stress.

Zarit Scale
Quite Frequently


Nearly Always
1) Do you feel that because of the time you spend with the stroke survivor that you don’t have enough time for yourself?          
2) Do you feel stressed between caring for the stroke survivor and trying to meet other responsibilities (work/family)?          
3) Do you feel strained when you are around the stroke survivor?          
4) Do you feel uncertain about what to do about the stroke survivor?          
Total Score:

Adapted from: Radloff, LS. (1977). The CES-D scale: A self-reported depression scale for research in the general population. Applied Psychological Measurement, 1;385-401.

Why Is It Important to Get Help?

The stress of caregiving may be overwhelming and affect the care you give. Taking care of yourself will make you a better caregiver. Get help from your healthcare team. Proper treatments help most people.

Depression and Caregiving female caregiver under stress

Caregivers suffer from depression twice as often as non-caregivers. Depression is not a sign of personal weakness. Depression cannot be wished away.

How Do You Know If You Are Depressed?

The signs and symptoms of depression vary from person to person. Without treatment, symptoms of depression can last for weeks, months or years. Here is a list of the signs and symptoms of depression. If you have any of these signs for more than two weeks, talk to your healthcare team.

  • Sadness or an “empty” mood
  • Feeling guilty, worthless or helpless
  • Problems concentrating, remembering or making decisions
  • Change in eating habits and/or weight changes
  • Feeling hopeless
  • Lack of energy or feeling tired and “slowed down”
  • Problems with sleep, such as trouble getting to sleep, staying asleep or sleeping too much
  • Easily angered or irritable
  • Wanting to be alone or spending much time alone
  • Loss of interest or pleasure in hobbies and activities, including sex, that were once enjoyed

Red Flag: Suicidal Thoughts

Una bandera roja con la palabra RESCUE escrita en letras blancas

If you or your Veteran are in a mental health crisis and are thinking about hurting yourself- or you know your Veteran is considering this- get help right away.
You are not alone.  

For immediate help you can call 9-1-1 for emergency services,
9-8-8, then press 1 for the Veteran Crisis Line,
or the National Suicide Prevention Lifeline at

What Treatments Should You Discuss with Your Healthcare Team?

Ignoring the stress of caregiving is the number one cause of “caregiver burn-out”. Be honest with yourself about what you are feeling. Do not pretend that everything is okay. Proper treatment helps most people with depression. Ask your healthcare team about the best treatment for you.

  • Medicines, such as anti-depressants are almost always helpful.
  • Psychotherapy (talk therapy) is used along with medicines. Talk therapy gives you a safe place to talk about your feelings.
  • Support groups provide a place to share your feelings with other caregivers.
  • Other caregivers understand what you are going through. They can help you find solutions to your problems.

How Can You Take Better Care of Yourself? group of friends playing cards

Taking care of yourself will make you a better caregiver.

Put taking care of yourself at the top of your list – Have regular medical check-ups. Eat right and exercise.

Ask for help – Take on only what you can manage. Don’t try to do everything by yourself. Be prepared with a mental list of ways other people can help.

Find time for yourself – You need breaks from caregiving. Do things you enjoy. Go for walks or visit your friends. Take yoga or relaxation classes. Get a massage. Treat yourself to special outings on a regular basis.

Laugh and have fun – Joke with your loved one. Laugh out loud. Read a funny book. Watch a funny movie or a comedy on TV

Helpful Tips

Accept your feelings – Feelings of anger and sadness are normal from time to time. Be patient with yourself.

Remember that caregiving has rewards – About half of all caregivers report positive feelings about caregiving. Caregiving often leads to stronger relationships with loved ones. Many stroke survivors do not show their true feelings. But, know that your loved one needs and appreciates your care.

Don’t take things personally – Your loved one may say or do hurtful things. Remember that these behaviors are due to their illness.

Practice getting rid of negative thoughts – Replace negative thoughts with positive thinking or memories. Practice this every day. Focus on the things you can do. Relax about those things that you cannot. Forget and forgive your mistakes. We all make them.

Get information – Learn about strokes. Learn about resources and ways to provide good care. This will help you plan for the future.


  • Take care of your health. You will be a better caregiver.
  • Ask for help. Prepare a list of ways others can help.
  • Depression cannot be wished away. It is not a sign of weakness.
  • Proper treatment helps most people with stress and depression. Talk with your healthcare team.

More Resources Collage of photos for the internet

Additional credible resources on this topic can be found here. Website pages may change or update, therefore if a link does not work, you may also try to type the information into your internet search bar. This Resource List will be updated frequently.

*Link Disclaimer: Links to information and Web sites outside of the Department of Veterans Affairs do not indicate an endorsement of products or services offered by the sites. In addition, these sites may have privacy and security policies that are inconsistent with those of VA.

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These materials were created for the project:

Web-Based Informational Materials for Caregivers of Veterans Post-Stroke

Project Number SDP 06-327 funded by VA HSR&D Quality Enhancement Research Initiative (QUERI)