By Lana Barhum
Chronic illness and pain are generally associated with increased risk for depression, and depression is a common complication of being sick and in pain. In fact, the Cleveland Clinic reports that at least one-third of people living with a serious health condition will experience symptoms of depression.
Serious illnesses will bring out incredible challenges and hardships and complicate the ability to take pleasure in and pursue activities once enjoyed. It is no wonder that chronically ill people experience sadness and despondency. So often, the physical effects of the illness and/or medication side effects may trigger depressed feelings.
Conditions that trigger depression
Many chronic illnesses may trigger depression, including the following:
Up to 15% of people with heart disease experience depression, this according to the Cleveland Clinic. Further, as noted by a study published in the Archives of General Psychiatry, heart disease patients with depression have increased platelet reactivity, decreased heart variability, and increased pro-inflammation markers, which lead to increased risks, including heart attack.
Depression may increase blood pressure, affect heart rhythm, and alter blood clotting - all things that worsen heart disease or may trigger a heart attack.
People with Rheumatoid Arthritis (RA) are twice as likely to suffer from depression compared to others in the general population. Studies show many people with RA go undiagnosed and untreated for depression and RA treatments are less effective when depression is not managed.
Studies find that people with diabetes have a greater risk for depression than those without. The stress of living with diabetes day in and day out is stressful and the chances of getting depressed increase as diabetes complications worsen.
Depression can lead to poor physical and mental function and leave patients less likely to follow required diet and medication plans. Treating depression, however, can help improve quality of life and ability to manage diabetes.
Around 20% of people who live with fibromyalgia also have anxiety and/or depression, as reported by the Anxiety and Depression Association of America. The stress of living with fibromyalgia pain and unrelenting fatigue can cause anxiety and depressed feelings.
It is also possible anxiety and depression are part of fibromyalgia, just as pain is. Nonetheless, managing anxiety and depressed feelings will also improve patients' quality of life with fibromyalgia.
Pain and depression are closely linked. Depression causes and worsens pain and pain causes and worsens depression. It can be vicious cycle. And more than three quarters of people in pain report feeling depressed, this according to the American Academy of Pain Medicine.
Researchers at the Department of Clinical and Biomedical Sciences: Barwon Health, The University of Melbourne, Victoria, Australia report that approximately 65% of depressed people are in pain.
Overlapping symptoms
The symptoms of depression in people with chronic illness are often missed by patients, loved ones, and even medical providers. The assumption is that feelings of continued sadness, anger and grief are normal for chronically ill people. And because symptoms overlap, doctors and patients might believe depressed symptoms are attributable to the chronic illness, and not an emotional disorder.
The physical symptoms of depression – including, sleep issues, appetite changes, fatigue, and lack of energy – are difficult to associate with depression because they are also symptoms of chronic medical conditions. And when chronic disease and depression co-exist, it is important to manage both, so that disease symptoms don’t worsen.
Treating depressed symptoms
For most chronically ill people, successful treatment of depression helps with pain and symptom management, improved quality of life, and allows for a greater chance of following prescribed treatments. And early diagnosis and treatment is key to managing and reducing depressed feelings and the risk for disease complications and suicide.
Treating depression in chronically ill people is no different than treating it in others. But when considering appropriate treatments for depression caused by a chronic illness, doctors will first look to better treat the chronic disease and/or change medications to alleviate symptoms.
A mental health professional can help patients to effectively treat and manage depressive symptoms and challenges associated with illness. More than 80% of depressed people can successfully be treated with medication, talk therapy or both, this according to the American Psychological Association. Anti-depressant medications start to work in a matter of weeks and talk therapy is a great way to release painful emotions about the challenges of chronic illness and pain.
Resources
- http://my.clevelandclinic.org/health/articles/chronic-illness-depression
- http://psychologydictionary.org/article/how-to-cope-with-heart-conditions-and-depression/
- http://my.clevelandclinic.org/health/articles/depression-heart-disease-heart-health
- https://www.ncbi.nlm.nih.gov/pubmed/11343523
- https://academic.oup.com/rheumatology/article/40/12/1327/1787867/The-burden-of-depression-in-patients-with
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3247620/
- https://diabetes.org/
- https://www.adaa.org/understanding-anxiety/related-illnesses/other-related-conditions/fibromyalgia
- https://painmed.org/
- https://www.ncbi.nlm.nih.gov/pubmed/26989796
- http://www.apa.org/about/gr/issues/health-care/chronic.aspx
- https://www.dbsalliance.org/
Further Reading
Depression linked to chronic pain: Variability shown across patient characteristics