Caregiver burden: the strain of looking after someone, and getting support

Many people look after a partner, parent, child or friend without ever thinking of themselves as a carer. The NHS describes carers as people who look after someone regularly because they are ill, older or disabled, and lists washing, dressing and taking medicines, getting out and about and travelling to appointments, shopping, cleaning and laundry, and paying bills and organising finances. Emotional support counts too: sitting with someone to keep them company, or watching over someone who cannot be left alone.

Caregiver burden is the term used for the cumulative load this can put on the person doing the caring. Carers UK says caring can be rewarding but can also be very tiring, with demands on physical and emotional energy. Because the focus is on the person being cared for, the carer's own needs can slip down the list.

It is not a formal diagnosis, and there is no single threshold at which strain becomes a problem. What matters is noticing the signs early, and knowing that asking for help is a normal and expected part of caring rather than a failure.

Carers UK explains that stress is caused by the many demands made on your time and energy, and that the responsibilities of caring can make you more susceptible, particularly if you become isolated or cut off from others. It says stress can make it hard to cope with the demands of caring, that you can become more and more exhausted, and that tension or irritability can put a strain on relationships.

The charity lists examples of how stress can show up, noting that symptoms vary from person to person.

• Mental symptoms: anxiety, racing thoughts, anger, depression, lack of appetite, sleeplessness, crying often, tiredness and difficulty concentrating.

• Physical symptoms: cramps, muscle spasms, chest pains, dizziness, restlessness, nervous twitches and breathlessness.

• Feeling that you are losing control over your life, or that you cannot regain it (Carers UK).

• Over the long term, Carers UK says stress can affect your health and put you at risk of high blood pressure.

Carers UK advises not to struggle on hoping stress will go away. It says recognising what is happening is the first step to recovery and that simply talking about how you feel can make a huge difference. It suggests talking to your GP, who will have seen many patients with stress-related problems and who may recommend lifestyle changes, counselling or another talking treatment, and in some cases medicines.

Symptoms such as chest pain, breathlessness or dizziness can have causes unrelated to stress and should be checked rather than assumed to be caused by caring. If you are feeling very low or hopeless, speak to your GP, and use NHS 111 or emergency services if you are in crisis. The charity also points to the Samaritans, which offers a confidential helpline around the clock.

The NHS stroke recovery page makes a similar point for carers of people who have had a stroke: it says that looking after someone can be difficult, frustrating and lonely, and that carers should make sure they get all the support and help they need.

The NHS says that if you care for someone you can have an assessment to see what might help make your life easier. A carer's assessment is free, anyone over 18 can ask for one, and it is separate from the needs assessment the person you care for might have, although you can ask to have both done at the same time.

To ask for one, you contact adult social services at your local council. If you are a parent or carer of a child, contact the children with disabilities department. Someone from the council, or an organisation the council works with, will ask how you are coping with caring, including the effect on your physical and mental health, work, free time and relationships. It is usually face to face, though some councils do it by phone or online, and it usually lasts at least an hour.

The NHS says that giving as much detail as you can about the impact of caring helps make sure you get the help you need, and that it can help to have someone with you, such as the person you care for, a friend, relative or an advocate. The council tells you the result, and if you qualify it writes a care and support plan with you. If you do not qualify, the NHS says the council should give you free advice about where to get help in your community.

The NHS explains that respite care options range from a volunteer sitting with the person you look after for a few hours, to a short stay in a care home so you can go on holiday. The main types are day care centres, homecare from a paid carer, a short stay in a care home, friends and family helping out, respite holidays, and sitting services.

The NHS says councils only fund respite care for people they have assessed as needing it, so if you want the council to pay, both you as a carer and the person you care for should have an assessment. Even if they do not want council funding, the NHS says a needs assessment for the person you look after is useful because it will say which type of respite care is most suitable.

Carers UK lists taking a break among its health and wellbeing topics, and suggests small changes: it suggests taking a couple of hours each week to do something you enjoy, being active even if it is a short walk, and pacing yourself by tackling one thing at a time and learning to say no some of the time.

Carers UK offers practical self-help for stress: step out of the room for at least five minutes, take slow breaths, relax your muscles, and cut down on alcohol, cigarettes and caffeine. It encourages being active, eating regular meals with a good variety, and talking to others in a similar situation, for example through a local carers' group or online forum.

It also suggests telling family and friends how you feel, since sharing may help them realise you need more help from them.

If low mood continues, the same Carers UK guidance suggests making an appointment with your doctor and not bottling up your feelings, and notes that effects of depression can be debilitating and professional support is important.

In England the main routes are the GP for your own health, and the local council for the carer's assessment, respite funding and any carer's direct payment. Some people choose to pay privately for homecare or a care home stay, or to see a private counsellor. Whatever you arrange, it is still worth having the assessments, because they record your needs and can open up support later.