Caregiver Anxiety: When the Future Feels More Real Than the Present

I know something about caregiver anxiety. Not just from my work as a therapist, but from walking through it myself—the years of being a caregiver, the constant worry, the weight of medical decisions, the long decline. Therapists aren't immune to life's challenges. We navigate them too, often while holding space for others doing the same.

So when I talk about what caregiver anxiety feels like, I'm speaking from both sides of that experience.

There's a particular quality to it. It's not just concern about your aging parents. It's more consuming than that. Your mind creates vivid scenes of what's coming—the hospital room, the phone call, the decisions you'll have to make. And these aren't passing thoughts. They're detailed, specific, complete with images and sensations that your body responds to as if they're happening now.

You're at work and suddenly you see it: The moment you'll have to let go. It's so real it could be a memory. Except it hasn't happened yet.

This is what happens when the future becomes more present than the present itself.

The Caregiver Anxiety Weight of Being "The One"

If you're reading this, there's a good chance you've always been "the one." The responsible child. The one who managed things, who held the family together, who learned early that taking care of others was part of how love worked.

And now you're doing it again, but the stakes feel different. Because this time, the ending is visible.

For some people, there's an added layer of complexity. Maybe the parent you're caring for was absent when you needed them. Maybe the relationship was fractured or painful or just... insufficient. And now here you are, managing their medications, coordinating their care, making sure they're safe. While part of you is still waiting for something from them that may never come.

The grief in this is particular. You're losing someone who never quite showed up in the first place. You're grieving what you had and what you didn't have, all at once. And caregiver anxiety wraps around all of it.

 The weight of what hasn't happened yet

When Your Body Lives in the Future

There's a specific way caregiver anxiety shows up in the body.

The racing heart when your phone rings unexpectedly. The tightness in your chest when you think about what's coming. The exhaustion that comes from constantly rehearsing scenarios you can't control. Your nervous system doesn't distinguish between what's happening now and what might happen later. It responds to imagined futures as if they're immediate threats.

You might find yourself:

• Running through the same scenes over and over—the hospital room, the funeral, the moment you weren't there when it happened.

• Trying to plan for every possibility, as if the right amount of preparation will make it hurt less.

• Avoiding thinking about your parents at all, because any thought leads straight to the ending.

• Feeling guilty for hoping it will be over soon, and then feeling guilty about the guilt.

This isn't weakness. This is what happens when your brain is trying to prepare you for something inevitable but unpredictable. The anxiety is trying to help, even when it makes everything harder.

The Vivid Mental Movies

One of the most exhausting aspects of caregiver anxiety is how specific the fears become.

They're not vague worries. They're complete scenarios:

The early morning phone call. The hospital room and knowing. Trying to decide about all the tough decisions. The plans you know are ahead, the parts of how to how to write or share their life story.

And underneath it all: What if I feel nothing? What if I feel relief? What does that make me?

These mental movies play without your permission. And because they're so detailed, so vivid, your body responds. Your heart rate increases. Your breathing changes. You feel the grief and the terror and the guilt as if it's already happening.

From my own experience as a caregiver, I can tell you—this is one of the hardest parts. The actual tasks of caregiving are demanding enough. But when you add the constant internal rehearsal of loss, it becomes almost unbearable. You're living the ending over and over before it even arrives.

When Midlife Brings More to the Surface

There's something about this stage of life that can make caregiver anxiety even more complex.

For many people—particularly women in menopause. Often their late forties, fifties, and beyond—midlife is when the body starts releasing what it's been holding. Old memories surface. Early experiences you thought you'd moved past show up with new intensity. Things you set aside because you needed to function, to get through, to take care of everyone else—those things find their way back.

And this is happening at the same time you're watching your parents decline.

So you might be processing your own history while simultaneously managing the practical and emotional weight of their aging. The past and the future converge, and the present moment gets lost somewhere in between.

It's a lot to hold.

The Difference Between Worry and This

People who haven't experienced intense caregiver anxiety sometimes suggest solutions that miss the point:

"Try not to think about it." "Focus on the present." "They're still here—enjoy the time you have."

And those things would be lovely if the anxiety worked that way. But it doesn't.

This isn't ordinary worry that you can redirect or manage with breathing exercises. The fear has a visceral quality. It's in your body. It disrupts your sleep, your work, your capacity to be present with anyone, including your parents as they are now.

The "what ifs" aren't intellectual questions. They're felt experiences:

What if they die and I wasn't there? What if I have to make a decision I can't live with? What if I feel relief and spend the rest of my life knowing I'm a terrible person? What if I never get the relationship I wanted with them, and then it's too late?

These aren't things you can think your way out of.

A Different Approach

What I learned through my own journey with caregiver anxiety, and what I've come to understand in my work with others, is that sometimes the most disruptive thing isn't what happened in the past. It's what we're certain will happen in the future.

There's a specific way to work with future-focused fears in EMDR therapy—fears that are so consuming they function almost like traumatic memories, even though they haven't occurred yet. It addresses the vivid mental images directly, the catastrophic scenarios that your brain keeps creating and your body keeps responding to.

This isn't about positive thinking. It's not about convincing yourself everything will be fine or that you shouldn't feel what you're feeling.

It's about changing your relationship to the images themselves. So when you imagine the hospital room or the funeral or the difficult moment, you can hold it without your entire system going into crisis. So the future scenarios don't hijack the present moment.

The goal isn't to stop caring. It's to trust that whatever you feel when the time actually comes—whether that's devastating grief or complicated relief or anger or peace or all of it at once—you'll be able to handle it.

What Shifts

When people work through this kind of anticipatory anxiety, something changes. Not in what might happen—that remains uncertain. But in how they hold it.

The mental movies are still there, but they don't carry the same charge. You can think about your parents' decline without immediately spiraling. The practical tasks of caregiving become just that—tasks. Still hard, still exhausting, but not saturated with the terror of an imagined future.

And perhaps most importantly, you can be more present. With your parents as they are, not as they will be. With your own life, your own body that's been trying to tell you something needs attention.

There's a strange kind of relief in accepting that you don't know what you'll feel when the moment comes. You don't know if you'll cry or be numb. If you'll feel devastating loss or complicated relief or both. If the relationship will resolve itself or remain unfinished.

And that's okay.

The terror comes from believing there's a right way to feel, and you won't feel it. The relief comes from recognizing that whatever arises will be what arises. You'll meet it when it gets here.

All the Feelings Are Allowed

One thing I wish someone had told me earlier in my own caregiving journey: you're allowed to feel all of it.

The grief for what you're losing. The anger at what you never had. The relief that the weight might eventually lift. The guilt about the relief. The love that exists alongside everything else.

Your feelings don't make you good or bad. They make you human.

If you've been the responsible one, the caregiver, the one who holds things together—you've probably spent a lot of energy managing how you feel, making sure you feel the "right" things. But there are no right things. There's just what's true for you.

You can grieve someone who wasn't fully present for you. You can feel exhausted by caregiving and still love the person you're caring for. You can want it to be over and dread it being over at the same time. You can feel things that seem contradictory because feelings don't have to make logical sense.

And you can trust yourself to handle whatever comes, even when you can't predict what that will be.

If This Resonates

If you recognize yourself in this—if the future feels more real than the present, if caregiver anxiety has taken over, if you're exhausted from rehearsing scenarios you can't control—you're not alone.

The fear makes sense. Your brain is trying to prepare you, even if the preparation is making things harder. Your body is responding to a real threat, even if the timing is uncertain.

There are ways to work with this that don't involve just pushing through or trying to think differently. Ways to address the vivid, consuming images so they lose their grip. So you can think about what's coming without being swallowed by it.

I know from my own experience how isolating this can feel. How much you might be holding that others don't see. How tired you are of being strong and responsible and prepared for every terrible possibility.

You don't have to carry this particular weight alone. And you don't have to wait until it's over to get support for how hard it is right now.

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About

Julie Cardoza, LMFT, is an EMDR practitioner working with individuals in midlife transitions through somatic, body-based therapy. Her practice is depth-oriented, relational, and intentionally paced.

Disclaimer

The content on this blog is for educational and informational purposes only. It does not constitute therapy, medical advice, or establish a therapeutic relationship. Reading this blog does not make you a client.

If you are experiencing a mental health crisis, please contact 988 (Suicide and Crisis Lifeline) or go to your nearest emergency room. For professional support, consult with a licensed mental health provider in your area.

You are responsible for how you use the information shared here. This content reflects my professional perspective and lived experience but should not replace individualized care.

Land Acknowledgment

I acknowledge that I live and practice on the traditional and ancestral lands of the Yokut and Mono peoples.