Chronic illness and mental health

Depression is one of the most common complications of chronic diseases. According to a study published in The Western Journal of Medicine, the link between depression and chronic disease is established in three ways: 

• Depression results from specific biological effects of a chronic disease: this is commonly seen in patients suffering from Parkinson’s disease, Alzheimer’s disease, cerebrovascular diseases, multiple sclerosis or endocrine (hormone-related) diseases like hypothyroidism, diabetes or polycystic ovary syndrome (PCOS).
• Some medicines for chronic illnesses can also cause depression - it is a good idea to discuss your symptoms with your doctor to see if he or she can prescribe a different medication in this case.
• Depression results from the behavioural or lifestyle changes brought about by the chronic disease: this occurs commonly in patients suffering from diabetes, heart diseases, epilepsy or autoimmune diseases like rheumatoid arthritis and lupus. The most common reasons for this are:
  • If the disease puts limitations on the patient's mobility.
  • If the disease puts dietary restrictions on patients, as in the case of irritable bowel syndrome.

It’s important to remember that suffering from any chronic illness is difficult and stressful. You must consult your doctor or seek the help of a mental health professional to figure out if your depressive thoughts are symptoms of depression or initial (and perhaps temporary) results of stress and the shock of being diagnosed with a chronic disease.

There are many types of chronic diseases, and suffering from any of them can put you at risk of depression. The rates of depression can be quite high for some types of chronic diseases. The diseases with the highest risk of depression as a comorbidity are:

• Heart attack
• Coronary artery disease (without heart attack)
• Parkinson’s disease
• Multiple sclerosis
• Stroke
• Cancer
• Diabetes
• Chronic pain syndrome

Depression is a serious medical condition and has many symptoms, including physical ones. It’s easy to overlook these symptoms, especially if you have a chronic disease. This is because symptoms like fatigue, loss of appetite, lack of concentration, increased or decreased sleepiness, etc., occur in both depression and chronic diseases. These overlaps might make the diagnosis of depression in chronic disease more difficult, but you should be on the lookout for the following common symptoms of depression any way:

• Feeling sad or anxious and irritability
• Feeling empty, hopeless, guilty or worthless
• Loss of pleasure in everyday activities, including those that previously gave your pleasure
• Fatigue and decreased energy levels
• Lack of concentration
• Inability or trouble making decisions, even the simplest ones
• Not being able to sleep or sleeping too much
• Not being able to eat or eating too much, leading to unplanned weight loss or weight gain
• Body pain, headaches, cramps or indigestion that do not ease with treatment
• Thoughts of death, suicide and suicide attempts

Chronic diseases include all types of cancer, cardiovascular diseases, autoimmune diseases, endocrine disorders, etc. A number of these diseases can cause pain, disability, lifestyle limitations and social isolation, which can cause depression. Depression, in turn, can intensify pain, fatigue, self-doubt, loss of self-esteem and social isolation. This is a vicious circle, and once you are stuck in it, getting out requires proper intervention and support.

The first step you need to take, according to the National Institutes of Mental Health, US, is to never dismiss depression as a normal part of having a chronic disease. Effective treatment for depression is available and it works whether you have a chronic disease or not. If you, or a loved one, are showing signs of suffering from depression, tell your primary healthcare provider and explore the treatment options.

It’s important to involve your primary healthcare provider who is treating the chronic disease because this doctor is prescribing a treatment course to manage your chronic illness, and would know what sort of treatment option for depression would help you the most without medications or therapies for both diseases interfering with each other. This doctor will also be able to deduce if any medications prescribed to treat your chronic illness are causing symptoms of depression to manifest, and prescribe alternative medications to relieve the depression.

You might also be interested in: What to eat and what not to eat in arthritis

While a doctor or mental health professional will be able to treat you for depression while you are also coping with a chronic disease, a large part of the healing process will depend on the primary care you can get by yourself or from your family and friends. You can use the following tips to cope with depression in chronic disease.

You might also be interested in: Exercises for diabetes