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How Caregiving Can Impact a Caregiver's Mental Health

On November 4, 2014, Oregon resident Jillian McCabe drew international attention when she threw her 6-year-old autistic son to his death, over the side of the Yaquina Bay Bridge. Public response to the horrific event was divided. While some people, particularly parents of disabled or autistic children, advocated vigorous prosecution, others felt pity—pointing to the daunting physical, psychological, and emotional challenges McCabe faced while caring for her family.

Jillian McCabe was a live-in caregiver for her autistic son, as well as her husband who developed multiple sclerosis shortly after their son’s birth. She regularly blogged about the stress and frustration she faced as a caregiver and frequently stated that she was “trying to hold it together.” McCabe complained about hearing voices, which suggests that she may even have been experiencing symptoms of a serious mental health issue. Relatives also reported that she tried to commit suicide several times. Despite McCabe’s efforts to get help, relatives say she did not receive the services she needed.

While these psychological symptoms and the added stress of being a caregiver to multiple people certainly do not excuse an act of murder, it is possible that they played a role in the tragic outcome of the McCabe family. Could preventative steps have been taken?


The mental, emotional, and physical demands of caring for chronically ill or disabled relatives can be particularly debilitating for caregivers. According to the Family Caregiver Alliance (FCA) (2006), more than one-third of America’s live-in caregivers provide health care assistance to others despite experiencing bad health themselves.

The FCA also reports that caregivers show higher levels of depression than family members who do not have caretaking responsibilities. It is estimated that 25% to 50% of caregivers meet the diagnostic criteria of major depression, and 40% to 70% show significant depressive symptoms. People who fill caregiving roles are also at higher risk of developing concurrent anxiety issues, chronic diseases, and substance dependence.

Caregivers also tend to experience higher levels of stress and frustration. A study by Schulz and Sherwood (2008) posits that caregiving is equipped with all the features of a chronic stress experience with high levels of unpredictability, uncontrollability, vigilance, and physical and psychological strain being major contributing factors. Roughly 26% of caregivers report feeling emotionally drained, and chronic caregiver stress has been linked with cognitive decline, including deficits in attention, memory, and verbal ability.

It is important to note that caregivers tend to go through greater psychological and emotional distress as the care-receiver’s functionality deteriorates (as in the case of a person with dementia), and these feelings might persist even after the care-receiver is placed in a nursing home.

Physical setbacks may also be experienced during caregiving. Caregivers are at greater risk for headaches, bodily pain, obesity, high blood pressure, heart disease, and cancer. Caregiver stress can also contribute to increased mortality. Elderly spousal caregivers (aged 66-96), who are exposed to caregiver stress, have a 63% higher mortality rate than non-caregiving peers of the same age.

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