Coping with Chronic Illness and Depression

by Dr. David Schopick

Chronic illness affects millions of Americans nationwide, and many of those victimized by illness are also suffering from depression. A chronic illness is considered to be one that either lasts for a very long time, or cannot be cured. Those that cannot be cured can often be successfully managed with medications, other treatments, or lifestyle changes, but the concern over possible flare-ups, illness progression, possible limitations, and what the future holds can affect mood. Some examples of chronic illnesses are: diabetes, heart disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis.

It is estimated that one-third of those suffering from chronic illness also suffer from depression. Side effects from medication, and the illness itself, may also be contributing factors.

Do certain illnesses trigger depression more than others?

First, let me state that any illness can be associated with depression, but the risk of depression gets higher when the illness is chronic, and higher still if the illness is severe. The risk is especially high in someone who already has a history of depression. People suffering from chronic pain or having had a heart attack have the highest risk of depression, followed by those suffering from multiple sclerosis, Parkinson’s disease, cancer and diabetes.

What are the symptoms of depression?

Family members may miss symptoms of depression because they assume it is normal for someone with an ongoing illness to feel sad. Sometimes the patient may not be aware that some of what is being experienced is depression. Medications can hide symptoms, as can the illness itself.

Typical signs of depression are listed below. If you, or someone you love, has a chronic illness and exhibits most of these symptoms, consult a mental health provider.

  • Loss of appetite
  • Insomnia
  • Overwhelming fatigue
  • Loss of interest in sex
  • Taking no pleasure in life
  • Feelings of shame, guilt or inadequacy
  • Severe mood swings
  • Difficulty bonding with loved ones
  • Withdrawal from friends, family and social contact
  • Thoughts of harming yourself or others

How does depression affect illness?

Depression can keep patients from getting the most out of life, despite their illness. It can become self-perpetuating as the depression causes more limitations, which in turn fosters more depression. Depression can also place a patient’s health at further risk as it can cause them to forget to take medications, miss doctor appointments, skip treatments, and stop pursuing a healthy lifestyle.

Heart disease is a good example of the association between depression and greater health risks. Heart disease patients have a greater likelihood of depression than otherwise healthy people. Depression can be closely linked with angina and heart attacks; it can increase your risk for heart disease, or make heart disease symptoms worse.

By contrast, once depression is treated, many patients find their overall medical condition improves, their quality of life is better, and they are more likely to maintain a long-term treatment plan.

How is depression treated?

• Talk to your doctor. If you feel that some of your current medications are causing depression, see if there are other medications or treatments available. If chronic pain is part of your illness, ask your doctor about pain management options.

• Learn as much as you can about your condition. This knowledge will help you get the best treatments possible and restore some sense of control.

• Antidepressant medications can help improve mood, and if the illness also causes chronic pain, they may assist in this regard as well. Antidepressants affect the same chemical pathways in the brain as pain receptors.

• Psychological counseling can also help patients get to the root causes of their depression and learn coping techniques. Cognitive therapy can also help patients learn how to use the power of their mind to combat chronic pain.

• Stress-reduction efforts, such as exercise, meditation, yoga, journaling and other activities may help. Exercise, as allowed by the illness, is very important. The better fitness level you can maintain, the less likely you are to suffer injury or from other physical difficulties. Exercise also releases endorphins, the “feel good” hormone. Gentle, regular physical activity helps chronic pain; your physician can help you devise an appropriate plan.

• Maintain a support team. Reach out to family and friends and try not to become isolated. Maintain as many of your social interests as possible. You will stay connected and feel better about yourself. Your doctor can also recommend support groups for others with your illness.

Remember, more than 80 percent of people with depression can be treated successfully with medication, psychotherapy, or a combination of both. Help is available, so talk to your doctor. bullet

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