CONCORD, N.H. (AP) — For Jessica Renda, the breaking point was a particularly chaotic Christmas season. Consumed by her eldest daughter’s mental and behavioral health struggles, she stopped exercising or doing anything else that brought her joy. Forget holiday magic, she was barely hanging on.

“After that, I was like, ‘I really need to take care of myself,’” she said. “We always tell people that old cliché: It’s like the oxygen mask on a plane. But it’s really true. You can’t be a successful or good caregiver to somebody else if you’re not taking care of yourself.”

Renda leads a support group for parents and caregivers for the New Hampshire chapter of the National Alliance on Mental Illness, where she vigorously promotes self-care. And she’s gotten better at taking her own advice, finding time for herself and setting better boundaries.

“It’s not easy,” she said. “I joke sometimes, ‘Is 10 minutes in the shower crying self-care?’ Sometimes it is.”

Caregivers are growing in number

Nearly one in four adults in the United States, or 63 million people, provided care to adults or children with medical conditions or disabilities in 2025, a total that jumped by almost 50% in 10 years, according to a report by the National Alliance for Caregiving and AARP. Their work — most of it unpaid — has gotten longer and more intense, the study found, and nearly two-thirds described feeling high emotional stress.

Recognizing those trends, Dartmouth College and its associated healthcare system recently announced the creation of an institute to provide caregivers with services, education, support and access to home health aides. The Family Caregiver Institute will be part of a broader program exploring best practices for serving the nation’s aging or chronically ill population.

In the meantime, experts say there are small steps individual caregivers can take themselves to prevent burnout.

That could mean asking a neighbor or another family member to fill in for a brief time to provide a break, said Susan Stearns, executive director of NAMI New Hampshire. She also advises prioritizing sleep and movement, even just quick walks outside.

“And if it’s winter and you can’t get outside, I’ve been known to just pace around my house for 10 minutes just to get some movement in because I know I’ll feel better,” she said.

Staying connected to a community also is key, Stearns said, whether that’s meeting friends in person, talking on the phone or participating in online support groups.

“This is a place where social media can serve us,” she said.

Self-care also can mean saying no to others and letting go of unreasonable expectations, she said.

“Caregiving’s hard, and I think sometimes, moms especially can set the bar high and be in pursuit of perfection and not realize, this is good enough,” she said.

In her peer support groups, Renda emphasizes that self-care looks different for everyone. She gets antsy trying to meditate, but others find it calming.

“Self-care doesn’t have to be a day at the spa. It can be sitting for 10 minutes in your car when you get home and just kind of decompressing from the day before you go inside,” she said.

The first step to better self-care is self-identification

Jennifer Rabalais is the co-director of the Center on Aging and Community Living at the University of New Hampshire and coordinator for the New Hampshire Alliance for Healthy Aging. She’s worked to support family caregivers in part by highlighting their impact on the healthcare system.

Many caregivers aren’t aware of available supports, she said, in part because they might not even consider themselves caregivers until someone else points out the duties they perform.

“If you ask them, ‘Do you shop for someone? Do you help someone pay a bill? Do you ever do yard work?’ That same person who is identified as not being a caregiver will often say yes,” she said.

“They are the backbone of our healthcare system, and so if they’re not taking care of themselves, they may end up in a position where they themselves need care,” she said.