Silent struggles: The overlooked risk of suicide in unpaid carers
Written by Lottie Storey, BSc (Hons), MA, MBACP. Lottie is a qualified therapist with a Masters in Counselling and Psychotherapy.
She is a registered member of the British
Association for Counselling and Psychotherapy.
Content warning. Below we explore what feelings of suicidal ideation can look like, and why those of us caring for a friend or family member may be more at risk. While it can be helpful to understand the risks, and know when and where to get help, this can also feel heavy to read about.
We may want to check in with ourselves to see if we are in a place where we feel able to keep reading. Or if we know we need support, we can skip straight to the where to go for help section.
The statistics: Suicide and carers
One in five people in the UK will have thoughts of suicide (also known as suicidal ideation) at some point in our lives. Suicide claims the lives of 18 people every day in the UK. Certain groups are at greater risk than others, including carers.
The risk of suicide and suicidal thoughts is much higher for unpaid carers. Statistics show that up to 40% of British carers experience suicidal thoughts, that’s two of the five million unpaid carers in the UK. One in six are likely to attempt suicide and one in 10 have already attempted it, but less than half have ever told anyone they were feeling this way.
This can feel shocking to read, and hard to think about, but working to open up conversations can help to break the stigma. Empowering us to ask for help when we need it, and others to feel more able to share their struggles.
What is
suicidal ideation?
Thoughts of suicide can take many forms. They can vary in frequency and intensity. Some may not even sound like suicidal ideation.
For some people, thoughts of suicide can be fleeting or short-lived. They can happen briefly during moments of stress or despair, but quickly pass.
Often, this takes the form of ‘wishing I was dead’. For example, we might have thoughts about how nice it would be to go to sleep and never wake up. Or of dying as a way to escape from our situation.
For others, suicidal ideation may be a little more detailed. This could mean a general desire to end our life without specific thoughts on how to do so.
Some carers also experience frequent, intense thoughts of suicide and have a clear plan for how they would end their lives, even if they have no intention of acting on that plan.
For anyone experiencing thoughts like this, we encourage you to seek immediate, professional support. At Mobilise, we are not therapists and do not offer emergency support, but we recommend the following services:
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Contact The Samaritans on 116123, any time, day or night, 365 days per year.
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Call your GP and ask for an emergency appointment.
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Call NHS 111 and select the mental health option, or get help from NHS 111 online.
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Visit your nearest A&E.
Why carers are at greater risk of suicide
Research into carers and suicide by Dr Siobhan O’Dwyer, has identified risk and protective factors. Risk factors are the things that increase the chance that we will think about suicide, while protective factors are things that decrease the chance.
Risk factors for suicidal ideation
Many risk factors affect suicidal ideation. Some risk factors affect everyone and some are specific to unpaid carers.
General risk factors
1. Depression
While not all people who think about suicide have depression, it remains a risk factor. This is because of the way depression can affect our thoughts, feelings and behaviours.
As carers, we’re more prone to developing depression from the constant mental and physical stresses. Read our guide on Caring alongside depression for more on this.
There are several approaches to treating depression and the GP can help. It’s important to know that some anti-depressant medication can trigger suicidal thoughts. This is usually when adjusting to the dose. We should always speak to our GP before making any changes to our medication, including changes to dose or deciding to come off it.
“I was surprised that the GP offered me anti-depressants on my first appointment. That’s fine, but it’s also OK to just talk, think on things and maybe try therapy first or as well. As long as you’ve started the conversation, that’s the important part.”
2. Anxiety
Anxiety can create a mental state that feels both unmanageable and inescapable. The combination of intense fear, anxious thoughts and social isolation makes it a risk factor. Anxiety can occur alongside depression.
Our Carers’ guide to managing anxiety and suggestions for Coping with change and uncertainty may help.
3. Dysfunctional coping strategies
Coping strategies are behaviours used to manage stress or negative emotions. Behaviours that feel good in the moment but are harmful in the longer term are called dysfunctional coping strategies. These strategies include substance abuse, self-harm, avoidance, overeating or undereating.
As carers, we may rely on these types of strategies to cope because we don’t have the time, the money, or the support to engage in healthier strategies. Read our advice on Caring and unhealthy habits and How to spot and stop impulse spending.
Risk factors specific to carers
1. Dissatisfaction
Dissatisfaction with an unpaid caring role can impact us on emotional, physical and social levels. It can contribute to chronic stress and a sense of hopelessness.
2. Feeling of being trapped
There is no legal obligation to be a carer and we do have the right to choose. However many of us may feel a moral obligation to be a carer despite the impact on our own lives. But we should recognise that the constant pressures can be overwhelming, sometimes leading to conditions such as burnout.
“My life has been consumed with caregiving for the last three years. It is draining me slowly but surely.”
For those considering ending our caring role read How to cope when our caring role comes to an end.
3. Experiencing conflict
Conflict is an experience many of us can relate to. As carers we may find ourselves in conflict with local authorities, health and social care professionals, or other family members about the caring role or the needs of the person we look after.
Feeling conflicted can bring with it feelings of guilt or resentment. This can present as ambiguity around our role and what is expected of us. It can also surface in emotional exhaustion and/or strained relationships. This can be particularly difficult for carers who face specific cultural or religious expectations to providing care.
Our guides to Caring for someone we don’t always like or Managing feelings of resentment and guilt, as an unpaid carer might help. Read our guide to Cultural expectations to caring for other carers experiences.
4. Isolation and Entrapment
We may find ourselves becoming isolated if we have had to give up work, or have taken on a caring role that limits our opportunities for leaving the house. Some of us may feel isolated because we care for a person with a condition that is highly stigmatised (like mental illness or addiction). Isolation can be physical and/or emotional.
If we are looking after someone who cannot be left alone, or who has a long time left to live, it can make us feel very trapped. We might also lose some of our connections with friends, family or colleagues due to the demands of our caring role. Sometimes we can even feel lonely with friends if we feel unable to open up or be understood.
One carer has shared his experience with overcoming loneliness.
Carers who live outside major cities might have access to fewer healthcare facilities, mental health services and community support networks, which can make it challenging to access the help we need.
5. Lack of access to healthcare
As carers, we don’t always receive the medical attention or psychological support we need. Untreated health issues and the stress that comes along with this can lead to feelings of hopelessness and despair.
Without the right health care, we may feel responsible for managing complex medical needs without professional support. This can be overwhelmingly stressful, leaving us feeling ill-equipped and distressed.
6. Poor physical health
When we have challenges with our own physical health, caregiving can become overwhelming. Chronic pain, fatigue or other health issues can reduce our ability to cope with the demands of looking after someone. This can lead to increased stress, frustration, and a sense of being trapped in an unsustainable situation.
Poor physical health can impair our ability to engage in self-care, further worsening stress levels. This can lead to a decline in our mental health.
This can also be the case if we have our own mental health challenges.
Read our guides on Caring for someone when we have our own healthcare needs and Focusing on our own health as unpaid carers.
Protective factors for suicidal ideation
The above factors increase the risk of suicidal ideation in unpaid carers. The following factors can protect us against thoughts of suicide.
1. Being an older carer or carer to an older person
Those of us who have been caring for a while, or older carers with more life experience may have better coping strategies in place for dealing with the stresses of looking after someone.
Perhaps we’ve had to manage loss, change, or even caring responsibilities before. We may then be better equipped to handle feelings of overwhelm and despair.
2. Having reasons to live
Caring can be an extremely meaningful role because it is rooted in our relationships with those we care for. For some carers the role provides emotional satisfaction, a sense of responsibility and a true reason to live.
“It’s an honour being the person who can hold them through that new reality with respect and dignity, and ensure they feel safe and loved.”
Having other reasons to live outside of our caring role, such as nurturing relationships, personal goals, hobbies, or career aspirations, can also help to create a strong sense of purpose and life satisfaction.
Read our guides on How to care for yourself when there is no time to care for yourself, Setting and achieving personal goals while caring, and 10 ways to prioritise ourselves every day.
3. Optimism
Maintaining a hopeful outlook on life can shift our focus to potential solutions. We’re less overwhelmed by difficulties when we believe challenges can be overcome.
Optimism reduces the risk of despair. When we view caregiving challenges as manageable, we have more resilience to navigate stressful situations.
If we are struggling to find things to be optimistic about we can find inspiration from other carers in 30 simple things that can help us feel great.
4. Being employed or a volunteer
Employment or volunteering often involves being part of a community. This provides social interaction, support and a sense of belonging. This can alleviate feelings of isolation and enhance emotional support.
Having a job or financial support can reduce the financial stress that many of us face. Financial stability allows us to focus on our caregiving role.
Read our guide to Unpaid caring and work.
We can find comfort and strength from other forms of community and connection too. We can join the Mobilise community hub to connect with other carers who understand, access expert advice and join supportive sessions.
5. Having a strong faith
Faith can foster hope and resilience. It can provide a framework for understanding life’s challenges, offering a sense of meaning in difficult times. This can help us cope with the emotional and physical demands of caregiving.
Read about the importance of faith for one member of the Mobilise caring community.
Where to go for help
Support for ourselves
For anyone in immediate danger of suicide:
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Call 999 for an ambulance
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Go straight to A&E
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Call the local NHS crisis team or urgent mental health helpline
It’s always ok to ask for help with this if it doesn’t feel possible to do it alone.
Talk to someone now:
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Dial 111 and select the mental health option
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Call Samaritans on 116 123 (UK-wide). We can also email them, or write to them - whichever feels best for us right now.
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Call C.A.L.L. on 0800 132 737 (Wales only)
Safe for now but need advice?
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Contact NHS 111 England or NHS 111 Wales. If you call 111, select option 2 to access a 24/7 helpline offering urgent mental health support.
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Contact the GP and ask for an emergency appointment. Many GPs are now offering these remotely.
If you are not in crisis but would like to find ways to support your mental health, therapy can help. Read our Carers’ guide to therapy to find out more about what you can expect.
Support for someone else
There is help and advice in our guide to Five ways to help someone struggling with their mental health. We can also use the crisis numbers above for someone else.
When we’re caring for someone, we must remember that while we can be there to listen, we shouldn’t try to ‘rescue’ them. This is especially true when we have our own healthcare needs.
Suicidal ideation needs a lot of support and we may not be the best person. But if we do want to be their support we can look into free training from places such as ZSA on suicide awareness and support.