It was over a year ago when I was invited to be a guest on The Doctor Oz show to talk about my experience of coping with depression. The show’s producer had a lot of questions for me prior to the show and especially about my life experiences. When I told him that I had lived with a mother who has schizophrenia for some years and that I also have a child with autism, he said a very interesting thing. He said something to the effect of, “There are some viewers who might wonder if your life situation caused your depression.” In other words he was asking, “Who wouldn’t be depressed with all this going on?”

One of the repeating themes in my life has been my role as a caretaker. Throughout my childhood and early adulthood I was placed into a role of taking care of my mother. Then I pursued a career in the helping profession. And now here I am parenting my teen-age boy with severe autism. It was an interesting question to ponder because I honestly did not know how to answer. It is one of those things, which came first? The chicken or the egg? In this case one wonders if depression develops as the result of these life experiences including the stress of caretaking or whether depression is independent of our role in life.

My answer to the producer was that in my case, I believe my depression is biological but that the challenges inherent to caregiving can exacerbate my depression symptoms. There is much joy to being a caregiver and many rewards. But I am not going to lie. It can also be one of the most difficult and emotionally wrenching experiences one can have in life.

If you are a family member who is giving care to a parent, spouse, or child it is all the more challenging because this is your loved one. In situations where your loved one’s condition or disorder is chronic or life-long, you may feel exhausted from the thought of providing long-term care. The financial expense can be great but you don’t get paid for your work. In fact you may have to quit your job in order to become a caretaker. The day to day stress of caring for a family member can affect the healthiest among us. But what about those of us who are not only caregivers but also suffer from depression and/or a medical condition ourselves? It becomes a case of who is going to care for the caregiver? There are no easy answers.

The one thing I definitely know is that I am not alone. The Family Caregiver Alliance estimates that there are approximately 44 million American families who provide unpaid care to another adult. So this doesn’t even include parents who are caring for children having special needs. Caregivers provide about 80% of long-term care in the United States. In fact, there is one study which shows that caregivers are the backbone of the health industry. There are millions of us who will provide an average of 21 hours a week of care to another adult, usually an elderly parent or spouse, worth more than $10 an hour in the marketplace.