Signs of Caregiver Stress Syndrome

mother and daughter laughing
February 18th, 2021

That constellation of physical, mental and emotional stress you’re feeling as a family caregiver, has a name: Caregiver Stress Syndrome (CSS). A syndrome is a set of symptoms that consistently manifest together.

CSS is characterized by these symptoms:


Licensed marriage and family therapist Colleen Mullen, PsyD, LMFT, of San Diego describes this as “withdrawing from your normal activities and avoiding others so you don’t have to keep talking about your life.” Learn more about dealing with caregiver isolation.

Trouble sleeping

It can be difficult to get to or stay sleeping because of hypervigilance, being easily frustrated, developing a quick temper, back and shoulder pain, etc., according to Iris Waichler, MSW, LCSW, author of Role Reversal: How to Take Care of Yourself and Your Aging Parents. Instead of waking up restored, you wake up still tired.

Difficulty processing

Executive functioning — our ability to focus, organize, prioritize and manage our life and time — is impaired. “Sometimes when we become overwhelmed, we don’t even know where to start to ask for help or who to ask,” explains Houston-based Amy Rollo, MA LPA, LSSP, LPC-S.

Compassion fatigue

“Compassion fatigue is often described as a loss of caring about those you are serving, often to a degree of feeling irritated by their problems,” Rollo says. “Everyone is susceptible to burnout, only those giving of themselves as helpers and caregiver experience compassion fatigue.” This doesn’t mean that you’ve lost your sense of compassion, but that it has been overwhelmed by the demands of constant caregiving.

Anger and frustration

It’s not unusual to depersonalize, “becoming cynical and sarcastic about the person you are caring for and/or flying off the handle over small things the person you are caring for does,” notes Jill Johnson-Young, LCSW, of Central Counseling Services in Riverside, Calif. You may also experience reduced accomplishment, “a sense of hopelessness or pointlessness – ‘why bother cleaning it up, it’s just going to happen again’ or ‘does any of this really matter?’”. The feelings cause frustration. Read about dealing with conflict.


“Guilt, which often arises when a person feels that they have done something wrong, insufficient, or socially inappropriate, can create a great deal of stress” explains clinical psychologist Carla Marie Manly, author of Aging Joyfully. “Feeling guilty does not necessarily mean that anything wrong or inappropriate has been done, only that one feels — or is made to feel by others — that guilt is an appropriate response. In general, a greater sense of feeling guilty will result in a greater level of stress.”

Physical complaints

Caregivers can experience loss of appetite, increased use of alcohol and other substances, and weight gain or loss. According to Waichler, they may also develop medical problems like high blood pressure, headaches and intestinal difficulties. Back problems also are a major concern for caregivers who move or lift the people they care for.

Mental health conditions

Left untreated, this blend of symptoms can also impact our mental health, leading to anxiety and depression. Anxiety includes feelings of worry and tension, and physical issues like high blood pressure. Depression can include loss of interest and enjoyment life, less energy, difficulty concentrating, dramatic changes in weight or sleep, and feeling worthless or guilty. These are serious conditions that may require treatment with therapy.

It’s easy to ignore any one or two of these signals, but resist that temptation. “I’ve seen caregivers get so wrapped up in their role that they skip their own doctor’s appointments and neglect their own medical health,” Michael Bobrowski, director of social services for United Hebrew of New Rochelle. “Caregiving can be emotionally draining and physically taxing. Ignoring our own stress can be harmful to our health, and potentially, the health of the loved ones we are caring for.”

You may feel like you can address these situations on your own, or that you don’t have the time or resources to get treatment. Talk to a nurse or doctor about the realities of your situation and accept the help they offer. This may feel awkward or uncomfortable at first, but you deserve to be cared for, too.

When time and money are tight, carve out a few minutes to speak with the nurse at your doctor’s office. These professionals aren’t just skilled at providing healthcare. They often know about opportunities to access programs that keep costs down or take little time, like prescription drug discounts, online therapy services, affordable health clinics and community resources for you and your older relations.

Getting the care you need isn’t a sign of weakness – it’s a sign of good decision-making and strength. The most effective caregivers seek out physical, emotional and mental care to balance everything. Even superheroes get assists.

Don’t disregard professional medical advice, or delay seeking it, because of what you read here. This information is not intended as a substitute for professional consultation, diagnosis or treatment; it is provided “as is” without any representations or warranties, express or implied. Always consult a healthcare provider if you have specific questions about any medical matter, and seek professional attention immediately if you think you or someone in your care may be suffering from a healthcare condition.

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