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Does chronic illness lead to depression?

Being diagnosed with a chronic illness is life-altering: it not only changes the way you think about your daily existence but can also cast a shadow over future plans. And yet so often we focus only on the physical effects of a long-term illness – to the detriment of our psychological well-being.

Most people don’t realise that chronic illness is a major cause of depression. It follows that a significant change to a person’s life would likely trigger this but the extent of it may be surprising.

Being diagnosed with a chronic illness may produce many intense and complex feelings – including exhaustion, fear, guilt and resentment. It’s normal to feel frustrated and sad, too, on realising your life is likely to be very different from what you’re used to, and limited in many ways.

People with chronic medical conditions have a higher risk of depression, and those already diagnosed with depression tend to have more severe symptoms.

Dr Fayeda Mahomed, a psychiatrist at Mediclinic Pietermaritzburg, says that treating early, mild symptoms of depression with therapy (instead of ignoring it) can help prevent psychological deterioration and the need for medication.

Depression is common among people who have serious or chronic illnesses such as cancer, coronary heart disease, diabetes, epilepsy, multiple sclerosis, stroke, Alzheimer’s disease, HIV/AIDS, Parkinson’s disease, and rheumatoid arthritis.

It is likely that symptoms of depression may follow a recent medical diagnosis but lift as you adapt or as your physical condition is treated. In other cases, certain medications used to treat the illness may trigger depression, which may persist even as physical health improves.

“An acute stress reaction would likely follow an initial diagnosis but resolves as the patient comes to terms with it. However, ongoing, persistent symptoms require assessment by a psychiatrist, first. This helps treat both conditions without further complications,” says Dr Mahomed.

The emotional dimensions of chronic conditions are often overlooked, which has prompted many professionals to recommend a patient be treated for both depression and their long-term illness at the same time.

Learning to cope

There are several ways to manage the psychological effects of a long-term illness, including intervention from a mental-health practitioner, learnt coping skills, and lifestyle changes.

This may include several methods, such as:

  • Life plan – Formulate a plan for your new life/changed circumstances, and know you’re not alone. Surround yourself with people and things that lift you up and make you feel positive.
  • Therapy – Adjusting to a new way of life can be psychologically exhausting; many people turn to different forms of therapy. Cognitive behavioural therapy, for example, helps to change negative thought patterns that are the basis for depression.
  • Ask for help – It’s crucial to surround yourself with a personal and professional support system. Life with a chronic illness can make you feel lonely, isolated and hopeless, making it difficult to connect with other people.
  • Create a healthy lifestyle – In tandem with your medical practitioner’s recommendations for treatment, it’s important to live with low-stress levels, consistently good sleep patterns, a healthy diet and exercise. This is beneficial for chronic health conditions and mental health challenges that may arise.

Treatment

Recovery from depression takes time, but treatment can improve the quality of life even if you have a long-term medical illness.

Treatments include:

  • Antidepressant medications, including, but not limited to, selective serotonin reuptake inhibitors (SSRIs) and serotonin and noradrenalin reuptake inhibitors (SNRIs).
  • Talk therapies mentioned above are also effective, while interpersonal and other types of time-limited psychotherapy have also been proven effective (in some cases combined with antidepressants).

 

In the interest of our patients, in accordance with SA law and our commitment to expertise, Mediclinic cannot subscribe to the practice of online diagnosis. Please consult a medical professional for specific medical advice. If you have any major concerns, please see your doctor for an assessment. If you have any cause for concern, your GP will be able to direct you to the appropriate specialists.