Caregiving can be one of life’s most meaningful yet demanding responsibilities. Whether you’re a parent managing a child’s physical or behavioral challenges, an adult caring for an aging parent, or supporting a loved one through illness or disability, the weight of these responsibilities can feel enormous.
Aptly termed “invisible health systems,” there is an increasing reliance on the informal and unpaid assistance provided by family, friends, and neighbors. Millions of Americans provide unpaid care to family members and friends, often dedicating 20 or more hours per week to hands-on, hypervigilant assistance. This intense level of caregiving doesn’t just demand physical energy; it can take an emotional and psychological toll that can push even the most resilient individuals past their coping limits (Marshall et al., 2023; Rosato et al., 2019).
As we observe Suicide Prevention Month this month and look ahead to World Mental Health Day and National Depression and Mental Health Screening Month in October, it’s critical to acknowledge that caregivers can often face significant mental health risks that require further attention and support.
One of the most emotionally challenging aspects of caregiving often begins before the hands-on care starts: watching someone you love transition into needing support. For example, witnessing a parent’s memory fade, a child struggling with developmental milestones, or a loved one battling a chronic illness can trigger feelings of grief, helplessness, and loss. The person you’ve known and loved—or come to deeply care about—may seem different, and you might find yourself mourning the relationship you had while simultaneously trying to provide the best care possible. This emotional complexity adds another layer of stress to an already demanding situation.
These challenges affect not only family members and close friends with personal connections to the care recipient, but also professional caregivers who develop close attachments through their work and may internalize the emotional weight of their responsibilities.
The Hidden Mental Health Crisis Among Caregivers
Research reveals alarming patterns in caregiver mental health that cannot be ignored. Depending on the caregiving context and which studies you consult, suicidal thoughts affect anywhere from 3% to over 70% of caregivers (O’Dwyer et al., 2021).
While the true prevalence of suicide among unpaid caregivers remains difficult to ascertain due to limited research samples, two separate meta-analyses focusing on caregivers of people with cancer and dementia reported suicide rates around 6% (Low et al., 2024; Solimando et al., 2022). These numbers, though based on small samples, point to a growing crisis that demands immediate attention and comprehensive support systems.
Understanding Risk Factors
Several interconnected factors contribute to increased mental health risks among family caregivers, creating a perfect storm of vulnerability:
High Care Burden: Providing 20 or more hours per week of intensive care leads to exhaustion, sleep deprivation, and overwhelming feelings of responsibility (Marshall et al., 2023; Rosato et al., 2019). This level of intense caregiving is consistently associated with worse mental health outcomes.
Pre-Existing Mental Health Struggles: For caregivers who have previously battled depression, anxiety, or trauma, the relentless pressure of caregiving can push them beyond their coping capacity (Joling et al., 2019; O’Dwyer et al., 2021; O’Dwyer et al., 2024).
Financial Hardship: The economic strain of covering medical bills, depleting savings, or losing wages can cause significant stress. Research shows that financial difficulties can coincide with increased suicide risk, particularly after a loved one’s death (Viola et al., 2024)
Social Isolation: When society labels caregivers as “heroes” but fails to check on their wellbeing, profound loneliness can develop. The mindset of “I have to be strong” or “I don’t want to burden anyone” can deepen feelings of despair and isolation (Phillips et al., 2023; Sud et al., 2024).
Declining Personal Health: Chronic health issues, often triggered by caregiving stress, increase fatigue and stress while elevating suicide risk (O’Dwyer et al., 2014; Sud et al., 2024).
Entrapment and Grief: Live-in care can feel inescapable, and losing the person you’ve cared for can lead to devastating feelings of purposelessness (Lewis, 2014; O’Dwyer et al., 2021; Zwar et al., 2023; Sharma et al., 2022).
Lack of Training and Crisis Tools: Without proper training to handle mental health crises, caregivers can feel helpless and powerless, leading to dangerous “what’s the point” thinking patterns (Lavers et al., 2022; Le Moal et al., 2018; Marshall et al., 2023).
Protective Factors and Hope
Despite these sobering realities, research also reveals encouraging protective factors that can significantly reduce mental health risks among caregivers:
Manageable Hours and Good Baseline Mental Health: Caregivers with lighter caregiving loads (1-19 hours per week) who don’t report poor mental health prior to caregiving show decreased suicide risk. These manageable hours create opportunities to maintain work, hobbies, and social connections that help maintain emotional balance (O’Reilly et al., 2015; Rosato et al., 2019).
Multiple Social Roles: Evidence suggests that maintaining employment or volunteering alongside caregiving can diversify one’s identity across multiple roles, helping alleviate mental health decline—assuming relatively stable current mental health and manageable caregiving responsibilities (Rosato et al., 2019).
Positive Identity Shifts: For some individuals, stepping into a caregiving role provides a valued identity that may lower suicide risk (Chen et al., 2021).
Strong Support Network: Regular breaks, peer support groups, respite services, and crisis-management training can effectively counter the loneliness and helplessness that often accompany intensive caregiving (Byrne et al., 2008; Lavers et al., 2022; Phillips et al., 2023).
Establish Your Support System
If you’re struggling with the stress and weight of caregiving responsibilities, remember that seeking help isn’t a sign of weakness. It is a crucial step in protecting both your mental health and your ability to continue caring for your loved one.
Build a Support Network: You don’t have to face these challenges alone. Lean on your community—family members, friends, colleagues, or fellow congregants. Surrounding yourself with positive people who encourage help-seeking is a critical aspect of suicide prevention. Identify people you can confide in and contact anytime and express your appreciation for their companionship.
Create a Safety Plan: Develop a comprehensive safety plan that includes recognizing personal warning signs, such as thoughts, images, moods, situations, and behaviors that indicate a crisis may be developing. List coping strategies you can use independently, identify supportive people and social settings that can provide a distraction during difficult times, and compile contact information for family, friends, mental health professionals, and crisis resources like the 988 Suicide & Crisis Lifeline.
Utilize Community Programs: Family caregivers face a wide range of challenges, from balancing their own needs with those of their loved ones to navigating complex systems of care. Access to community-based support is essential, offering practical tools and programs that benefit both caregivers and the people they support. For example, Vibrant Emotional Health offers a variety of programs in New York City aimed at supporting youth behavioral and educational development, as well as helping parents and guardians navigate complex, child-serving systems, coordinate care and advocate for their needs – ultimately strengthening family resilience and easing adult caregiver demands.
A Call for Recognition and Action
It’s time to shift the narrative around family caregiving. While we rightfully honor the dedication and love that drive people to care for their family members, we must also acknowledge the very real mental health challenges they face and provide concrete support systems.
Caregiving doesn’t have to be a solitary journey marked by sacrifice and suffering. The strength to care for others begins with caring for yourself. With proper support, manageable expectations, and access to mental health resources, caregivers can maintain their own wellbeing while providing compassionate care to their loved ones.
If you or someone you know is struggling with mental health challenges, emotional distress, or simply needs someone to talk to, remember that help is available 24/7. Call or text 988, or chat at 988lifeline.org. Visit Vibrant Emotional Health’s Safe Space for additional resources and explore NYC-based resources at vibrant.org.
Following World Mental Health Day, let’s commit to supporting the supporters, because every caregiver deserves to thrive, not just survive.
Wendy Martinez Farmer, LPC, MBA, is the Vice President of Strategy, Quality Improvement and Clinical Standards at Vibrant Emotional Health, overseeing strategy as well as standards, training, and practices for the 988 Suicide & Crisis Lifeline.
Jantra Coll, Vice President of Community Services at Vibrant Emotional Health, overseeing several of Vibrant’s citywide initiatives which deliver direct mental health services to over 3,000 individuals annually through partnerships with community-based organizations in New York City.
