Signs You're Running on Empty as a Caregiver and What to Do Next

Caregiving often starts small — with a ride to a parent’s doctor appointment, a weekly grocery run or juggling a child’s schedule alongside your own. Over time, it becomes part of who you are, often before you ever call yourself a caregiver. Many caregivers don’t recognize themselves as caregivers at all. They’re simply trying to be a good daughter, son, spouse, sibling or parent.

“Some of us are actively caregiving. Some of us are going to be caregiving in the future, and some of us are going to need care,” says Heidi O’Neil, DHA, NBC-HWC, Program Director at the OhioHealth Well-Being Center. Whatever stage you are in, it helps to know what caregiver burnout looks like and when it’s time to ask for support.

What is caregiver burnout?

Caregiver burnout is a state of physical, emotional and mental exhaustion caused by the ongoing stress of caring for another person. Everyday fatigue usually improves with rest. Burnout lingers, and it affects your body, mood, sleep and thinking.

Dr. O’Neil wants every caregiver to hear this clearly: “Feeling burnt out is not a personal weakness. It’s that they’ve had so much land on their plate that they’re experiencing chronic stress.” Burnout is not a sign that you are failing. It is a sign that you have been carrying too much for too long.

Signs of caregiver burnout

The earliest signs of caregiver burnout often show up in small, everyday habits. When your attention stays focused on someone else, these changes are easy to miss.

Common caregiver burnout symptoms include:

• Feeling more irritable or noticing shifts in your mood.
• Changes in appetite, or realizing you haven’t sat down to eat all day.
• Dropping routines that used to keep you well, such as exercise.
• Trouble falling asleep because your mind won’t turn off.
• Waking up in the night with racing thoughts about your to-do list.
• Skipping your own checkups, dental visits or primary care appointments.

Dr. O’Neil often sees caregivers who realize they’ve fallen behind on routine healthcare appointments, aren’t eating well, aren’t exercising and aren’t getting enough quality sleep. Others notice they’re becoming short-tempered with their children, spouse or the very person they’re caring for. These aren’t signs of failure. They’re signs that your reserves are running low.

If you’ve caught yourself thinking, “I don’t even know when I last saw my doctor,” or “I haven’t done anything for myself in months,” it may be time to pause and evaluate what you need.

When caregiver stress reaches a breaking point

Short-term stress comes and goes. Chronic stress — like that associated with caregiver burnout — stays, and that is when burnout begins to take a physical and emotional toll. This sort of constant stress keeps the body’s emergency response system turned on continuously.

According to Dr. O’Neil, signs that stress has become chronic can include:

• Frequent fatigue that rest doesn’t fix.
• Higher blood pressure and greater cardiovascular risk.
• Slower thinking or difficulty making decisions.
• Feeling more emotional or tearful.
• Heightened anxiety or moments that feel like panic.
• A weakened immune system.

One of the hardest parts is how this exhaustion can start to feel normal. “We know our baseline, but then we almost feel like running on empty becomes a new baseline,” Dr. O’Neil says. “And we want to try to avoid that as much as possible and try to get back to caring for ourselves.”

When to seek help

Dr. O’Neil recommends a simple self-assessment. Ask yourself:

• Am I showing up as the person I typically am?
• Am I more irritable or impatient than usual?
• Am I reacting strongly to things that wouldn’t normally bother me?
• Am I consistently exhausted?
• Have I stopped taking care of myself?

If your answer to any of these questions points to a change in your typical behavior, don’t ignore it. Many caregivers feel guilty about wanting a break. Dr. O’Neil sees that guilt differently: “I would say that it’s a pretty good indicator that you do need one.”

A good place to start is by reaching out to someone you trust. “It could mean asking a family member for help, sharing responsibilities with a co-caregiver, talking to your primary care provider, working with a health coach or connecting with a therapist,” she says. Seek out your support system, especially those who will help recharge your battery before it’s drained.

Strategies for managing caregiver stress

Caregivers need to consider their own well-being as an important part of being a caregiver. While you can’t always remove the source of stress, you can take steps to support your own well-being.

Try these strategies:

• Take small, manageable breaks. “Going for a walk, deep breathing exercises, participating in some type of mindfulness work can be really great for reducing stress,” Dr. O’Neil says.
• Schedule self-care like any other appointment. When you schedule appointments for everyone else, schedule time for yourself, too. Make space for self-care on your calendar and stick to it.
• Set healthy boundaries. If you share caregiving duties, have a respectful, candid conversation about what you need, even if it’s just a little more help this week.
• Be mindful of how you talk to yourself. Many caregivers say, “I’m just being a good daughter” or “I’m just being a parent.” Dr. O’Neil gently pushes back on that word: “Caregiving is never ‘just.’ It’s a lot of things.”
• Talk it out. “I always recommend to talk it out or else you’ll act it out,” Dr. O’Neil says. A trusted friend, support group or counselor can offer a safe space.
• Explore the benefits you already have. Review your health insurance or employer wellness programs to find out if counseling and stress-management resources are already available to you.

There are resources available at OhioHealth and in the community to help manage the stress of caregiving. The Ohio Department of Aging provides information about the National Caregiver Support Program and a breadth of caregiver support resources. For those living in Franklin County, there are caregiver and kinship support programs and assistance available. If you are caring for someone with a neurological condition, visit the Dempsey Family Education and Resource Center at OhioHealth Riverside Methodist Hospital. You can also talk to your primary care specialist about what other support services might be available to you and your family.

You are not alone

If you saw yourself in this article, that recognition is a meaningful first step. “Caregiving is something that a majority of the people in the world are doing now,” Dr. O’Neil says. “They’re not alone.” Millions of people are caring for aging parents, children, partners or friends, often all at once. Find support and talk to someone about what you are experiencing. Remember: Caring for yourself is part of caring for the people you love.

Frequently asked questions

What is caregiver burnout?

Caregiver burnout is a state of chronic stress and exhaustion from prolonged caregiving duties.

What are signs of caregiver burnout?

Early signs include mood swings, sleep disturbances, neglect of personal care and persistent fatigue.

What is the difference between caregiver burnout and fatigue?

Fatigue is tiredness that usually improves with rest or a short break. Caregiver burnout is deeper, longer-lasting exhaustion caused by chronic stress. It can affect your sleep, mood, thinking and physical health, including blood pressure.

Do I need a mental health diagnosis to see a counselor?

No. “There’s a misconception that somebody has to be diagnosed with a particular mental health concern before they seek counseling, and that’s just not true,” Dr. O’Neil says. Counseling can help you stay well, not just recover when you’re unwell.

When should a caregiver seek help?

Ask for help when you notice you aren’t showing up as your usual self. Ongoing irritability, poor sleep, skipped meals or missed health appointments are all clear signals. Feeling guilty about needing a break is often a sign that you need one.

What self-care practices can help manage caregiver stress?

Engaging in regular exercise, mindfulness practices, setting boundaries and scheduling personal time are effective self-care strategies.