Understanding and Management of Caregivers' Stress and Burden of Person with Obsessive Compulsive Disorder

Understanding and Management of Caregivers' Stress and Burden of Person with Obsessive Compulsive Disorder

Shikha Soni (NIMHANS, India), Poornima C. (NIMHANS, India) and P. C. Ashfak Ahamed (NIMHANS, India)
DOI: 10.4018/978-1-5225-0519-8.ch007


The objective of the chapter is to understand the processes involved in care giving for those with a Chronic Mental Illness and to develop an effective intervention incorporating methods and strategies that aims at reducing caregiver stress and burden. OCD is a neurobiological disorder characterized by the presence of symptoms such as obsessions and compulsions. Literature is reviewed on prevalence, intervention and tools that can assess caregiver stress and burden in OCD. Accommodation and Expressed emotion plays key roles in interpersonal relationships that exist in the families of those afflicted with mental illness and may affect the treatment. Psycho education found to be helpful in educating the family about all the relevant aspects of OCD and to determine their role as a caregiver in order to deal with the illness in an effective way. Family intervention beyond the scope of psycho-education programme is required to prepare caregivers to take on the role of care giving more effectively.
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A positive attitude may not solve all your problems, but it will annoy enough people to make it worth the effort. – Herm Albright



The concept of Burden of care due to the mental illness emerged following the evolution of the deinstitutionalization of the mental hospitals and was first acknowledged by Grad and Sainbusry, who defined the caregiver burden as the physical, psychological, or emotional, social and financial problems that can be experienced by caregivers while caring for their mentally ill relative (Grad & Sainsbury, 1963).Being the principal caregiver to a mentally ill family member is a stressor that often creates high level of burden and contributes many stressful symptoms in caregivers itself. Caring for a mentally ill can be strenuous and a difficult task and involves adequate knowledge and support on part of the caregivers to support.

Family and the Burden of Care

Burden on the family refers to the consequences for those in close contact with a severely disturbed person with mental health problems. Some authors further distinguish between objective and subjective burden. Objective burden relates to the patient’s symptoms, behavior, and socio demographic characteristics, and factors such as changes in household routine, family or social relations, work, leisure time, and physical health. Subjective burden is the mental health and subjective distress among family members (Reine, Lancon, Simeoni, Duplan, & Auquier, 2003). From the 1970s to 1980s, the term caregiver burden has been used to describe the adverse consequences of mental disorders for family caregivers. In recent years, the view of caregiving burden has been broadened to involve the physical, psychological, social, and financial problems experienced by families caring for a relative with a chronic or mental illness. This view has been accepted by the global community (WFMH, 2010)

Caregiver Stress

Providing the direct care or simply called “Caregiving” brings to mind caring for someone who is chronically ill or caring for a small child. If caregiving is planned well, it can be fulfilling and healthy. On the other side “dark side of caregiving” includes anger, frustration, exhaustion etc. Many times when it comes as a crisis and one is not prepared for it, often ends up feeling the darker side of caregiving. Being thrown into the role of caregiving unexpectedly and without the opportunity to equip oneself emotionally will be very difficult. Becoming a caregiver gradually will give the time to develop caregiving skills. To determine the best options for the person with mental illness, the whole family should be involved in the decision making process.

According to Webster’s Dictionary, stress is a physical, chemical, or emotional factor that causes bodily or mental tension. It is a reaction to changes that require adjustments orresponses and our stress level will depend upon how we respond to these adjustments. Stress is the way human beings react both physically and mentally to changes, events, and situations in their lives. People experience stress in different ways and for different reasons. The reaction is based on the perception of an event or situation. Stress as a condition or feeling experienced when a person perceives that demands exceed the personal and social resources the individual is able to mobilize. Stress is an unpleasant external forces or an emotional response. Early on in your caregiving experience you will notice increased stress. Accepting a caregiver role will cause you to redefine your life. Recognizing the changes that come with this adapting to the new role, yet still having expectations of life returning to normal during the caregiving period, will cause immense stress.

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