Published Oct 10, 2026 | 12:26 PM ⚊ Updated Oct 10, 2026 | 12:26 PM
Caregivers sometimes hesitate to share responsibilities because they feel no one else will understand the situation as well as they do.
Synopsis: When a family member experiences mental illness, caregivers often put their own needs aside to provide support. Psychiatrists and psychologists explain how prolonged caregiving can lead to exhaustion, guilt, anxiety and isolation, why caregivers hide their distress, and how families can support those who quietly carry the emotional burden of caring for a loved one.
When someone in a family develops a mental health condition, everyone worries about the person who is unwell. A mother makes sure her son takes his medicines. A husband accompanies his wife to the doctor. A daughter watches over an ageing parent, while a sibling tries to help a brother or sister through a difficult phase.
They do what needs to be done. They manage the household, attend appointments, watch for changes in behaviour and try to keep life running as normally as possible.
But who asks them how they are doing?
Behind the familiar response of “I am fine” could be a person who has not slept properly in weeks, worries about the next crisis or feels guilty for being tired of a responsibility they never imagined would become so demanding.
“Caring for someone with a mental health condition can be emotionally and physically demanding, especially if the caregiver has to manage it for a long time,” Dr Sachin Baliga, consultant psychiatrist at Fortis Hospital, Bannerghatta Road, Bengaluru, told South First.
“They may be constantly worried about the person’s symptoms, medication, safety and recovery. This can lead over time to stress, anxiety, emotional exhaustion and sometimes to depression. The caregiver can slowly start putting their own needs aside because they are focused on the person who is unwell,” he said.
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Caregivers often feel they must remain strong because someone else depends on them. They may put aside their own worries, avoid discussing their frustrations and continue with their responsibilities even when they feel overwhelmed.
Some fear that admitting they are struggling will make their loved one feel worse. Others believe they have no right to complain because they are not the ones living with the illness.
Anuvinda Sadanandan, consultant psycho-oncologist at Apollo Hospitals, Bannerghatta, Bengaluru, said caregivers could remain silent because they feared appearing selfish or uncaring.
“They may believe that expressing their own stress or distress can make things more difficult for the person who’s going through the illness. With these thoughts and feelings of guilt about talking about their own struggles, it becomes more complicated,” she told South First.
She pointed to a familiar problem in many families: the person everyone relies on may be the one whose wellbeing receives the least attention.
“Sometimes the person everyone depends on is the person nobody thinks to ask, ‘How are you?’” Sadanandan said.
This pressure can become particularly difficult when caregiving continues for months or years. A person may initially put their feelings aside to help a loved one through a crisis. But when that becomes their everyday routine, exhaustion can build up.
Dr Nikita Ravtani, consultant in mental health and behavioural sciences at Fortis-Gleneagles Hospital, Chennai, said being strong should not mean ignoring one’s own feelings indefinitely.
“During a crisis, putting personal feelings aside may be necessary for a short period. But if this continues for months or years, the caregiver may become increasingly exhausted, irritable or emotionally withdrawn,” she told South First.
Baliga said caregivers could also suppress their feelings because they believe they must be strong for the person they are supporting. Some worry that talking about their problems will add to family pressure, while others fear being judged.
The result is that they may continue fulfilling their responsibilities without acknowledging how much they are struggling.
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Caregiver distress does not always look like a breakdown. Sometimes, it starts with small changes that are easy to dismiss.
A caregiver who once enjoyed meeting friends may begin avoiding social gatherings. Someone who was usually patient may become irritable over minor issues. Another person may struggle to sleep, lose interest in hobbies or constantly worry about what might happen to their loved one.
They may continue going to work and managing the home, convincing themselves that this is simply what caregiving requires.
Ravtani said one of the first warning signs was a change in a person’s usual behaviour.
“They may become more irritable, lose interest in activities they previously enjoyed, sleep poorly, constantly worry or feel overwhelmed by relatively small things,” she said. “If these changes persist and begin affecting daily functioning, it is worth seeking professional help.”
Baliga similarly identified ongoing tiredness, disturbed sleep, irritability, loss of interest in activities and difficulty concentrating as early signs of caregiver distress.
A caregiver may also begin withdrawing from social events or feel that there is no time or energy for personal interests. Some experience emotional numbness or guilt about finding enjoyment in anything while their loved one is unwell.
“If these changes persist for several weeks and begin to impact daily life, it is crucial not to ignore them,” Baliga said.
Sadanandan said caregivers could also experience headaches, reduced appetite, poor sleep and a decline in physical activity. Some begin neglecting their own health because they feel they cannot step away from their responsibilities.
The effects can extend into the workplace and family relationships. Worrying at night can disturb sleep, while the emotional demands of caregiving can make it difficult to concentrate at work. Caregivers may also have less time for their spouses, children and friends.
“The caregiver may continue going to work, managing the home and attending appointments, so the family assumes they are coping,” Ravtani said. “But functioning and coping are not necessarily the same thing. Someone can continue meeting their responsibilities while struggling significantly on the inside.”
The problem is that these changes can gradually start to feel normal. When someone spends most of their time worrying about another person’s wellbeing, they may stop noticing their own.
One of the hardest parts of caregiving can be admitting that it is difficult.
A parent may feel frustrated when a child refuses treatment. A spouse may feel exhausted by repeated crises. A sibling may wish for a day without worrying about what might happen next.
These feelings can bring guilt. Caregivers may wonder whether they are being selfish or whether their frustration means they no longer care enough.
Baliga said guilt was common because caregivers often felt they should always be available for the person they love.
“They may think, ‘How can I feel tired when someone else is suffering more?’ But feeling tired or frustrated does not mean that they love the person any less,” he said.
Wanting personal time, he added, is not abandonment. Taking breaks can help caregivers continue supporting their loved ones without becoming completely exhausted.
Sadanandan said caregivers could feel guilty about becoming frustrated, wanting personal time or wishing their circumstances were different.
“Experiencing these feelings does not mean that caregivers lack compassion or commitment,” she said.
Understanding a mental health condition does not necessarily make caregiving easy, either. A family member may know that depression, bipolar disorder or schizophrenia is not simply a matter of willpower, yet still struggle with the emotional demands of supporting someone through it.
Baliga said a lack of understanding could cause fear, confusion and frustration because caregivers might not know why their loved one was behaving in a particular way. Learning about the condition can help reduce some of this confusion, but it does not eliminate the burden of long-term care.
“Knowledge helps, but caregivers also need emotional and practical support,” he said.
This distinction matters. Caregivers need not be blamed for feeling tired or frustrated, just as the person living with the illness should not be blamed for being unwell.
Both may be struggling, albeit in different ways.
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Caregivers sometimes hesitate to share responsibilities because they feel no one else will understand the situation as well as they do. Others worry that taking time off will leave their loved one unsupported.
But trying to do everything alone can make caregiving harder to sustain.
Ravtani said caregivers needed to recognise that setting limits did not mean abandoning the person they loved.
“A boundary is not abandonment. It is a way of making caregiving sustainable,” she said. “The aim is not to become less caring, but to ensure that one person does not become the entire support system.”
That could mean asking another family member to take over an appointment, arranging help with household responsibilities or setting aside time to rest. The arrangements will depend on the person’s care needs and safety.
Baliga said caregivers should be clear about what they can manage and when they need rest or assistance from other family members.
“Taking time for oneself does not mean leaving the person behind; it means protecting the caregiver’s ability to continue supporting them,” he said.
Families can help by asking caregivers directly how they are feeling, listening without judgement and recognising when they need support. They should also share responsibilities instead of assuming that one person can manage everything indefinitely.
If persistent anxiety, low mood, sleep problems or exhaustion begin interfering with daily life, caregivers can seek help from a mental health professional themselves.
Support groups, counselling and respite care can also give caregivers time to rest or speak openly about their experiences.
Baliga said these forms of support could make a significant difference. Caregivers often feel alone in their experiences, and speaking to others who understand the challenges can help reduce that isolation.
“Support should not be seen as an extra; for long-term caregiving, it can be an important part of maintaining the family’s wellbeing,” he said.
(Edited by Dese Gowda)
