depressive symptoms caregiver stress

Depressive Symptoms Amongst Caregivers of Older Adults

In a recent 2017 study, 40.2% of caregivers for stroke survivors show signs of depression. As our population age, the role of a caregiver becomes more common however, this role is often underappreciated and undervalued. In an Asian society like Singapore, there is a greater expectation for children to care for their parents thus many caregivers often put their own needs secondary leading to a deterioration of their overall well- being and eventually getting burnt out.

What is Depression?

Depression is defined as “extreme discouragement to the point of becoming disabled” – Department of Psychological Medicine, Khoo Teck Phuat Hospital. An individual with depression will have issues maintaining their daily routines and he or she does not have the energy to go about their day.

It is normal for us to experience periods of unhappiness and loneliness but for individuals with depressive symptoms, they feel these emotions intensely for a prolonged period of time.

What are the Signs: Depressive Symptoms

Unfortunately, many individuals with depressive symptoms are not diagnosed because of the negative stigma attached to mental health, the ambiguity of the symptoms or misdiagnosis. Every individual’s experience in depression varies thus, these symptoms vary among individuals as well.

Common Depressive Symptoms:

  • Have Negative Thoughts (in the morning)
  • Bleak thoughts about the future (You feel that there is no light at the end of the tunnel)
  • Restless or Irritable
  • Restless sleep
  • Tiredness
  • Irregular eating habits (leading to weight gain or weight loss)
  • Feeling emotional and crying often.
  • Issues with concentration – unable to complete tasks, make decisions or remember things
  • Lack of motivation
  • Loss of interest in things you usually enjoy
  • Anxiety – You are often anticipating a preconceived danger.
  • Feelings of helplessness
  • A physical manifestation of pain – physical aches or pains.
  • Self-harm or suicidal thoughts

If these symptoms persist for a prolonged period of time, it is time to visit your family doctor or speak to a mental health specialist.

Causes of Depression:

  • Family History of Depression or other Mental Health Conditions
  • Emotional Stresses – E.g. Work, Personal Relationships etc
  • Hormonal Changes – Men & Women
  • Medications – Certain heart or cancer medications
  • Medical Conditions – E.g. Thyroid cancer or hormone issues, chronic or terminal illnesses.
  • Personality – Everyone copes differently to adversity and adapting to sudden life changes.
  • Social Support – The level of support you received from the people around you – e.g family and friends.
  • Life Changes – Sudden life changes or major event that happened e.g. a major stroke happening to a loved one.

What do Caregivers Need?

Many caregivers are emotional anchors for their loved ones. However, what does a stressed out caregiver actually need from others? A 2017 Duke-NUS study has shown that caregivers need a listening ear (emotional support) rather than functional care (e.g. bathing, feeding or toileting) for their caregiving responsibilities. According to Dr Rahul Malhotra (Assistant Professor of Duke-NUS), emotional support helps to provide assurance to the caregiver of his or her self-worth.

Some caregivers may feel helpless and talking it through can also reduce the stress or anger that the caregivers feels…During moments that are perceived as uncontrollable…research has shown that emotion-focused coping techniques may be more effective than problem-focused coping techniques. – Dr Rahul Malhotra

Seeking Professional Help

If you are a caregiver and you are experiencing depressive symptoms, it is time to seek professional support. It is normal to feel guilty that you cannot be 100% there for your loved one, but it is important to ensure that you are able to care for yourself before you can be a pillar of support for your loved ones.

Read our other articles for Caregivers and tips on Home Care.


  1. HealthHub Singapore (29 January 2018). Burden of Care. Retrieved from
  2. Department of Psychological Medicine, Khoo Teck Phuat Hospital. (n.d.).  A Handbook for Caregivers on Depression. Retrieved from
  3. Straits Times (3 July 2017). Caregivers need a Listening Ear, Rather than a Helping Hand. Retrieved from
  4. Channel News Asia (31 March 2019). Commentary: Three stories from caregivers show we still undervalue caregiving. Retrieved from
  5. Malhotra, C., Malhotra, R., Østbye, T., Matchar, D., & Chan, A. (2012). Depressive symptoms among informal caregivers of older adults: insights from the Singapore Survey on Informal Caregiving. International Psychogeriatrics, 24(08), 1335–1346.

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