Depression and Chronic Illness

Depression is a common illness. It is also common for depression to raise the risk of other health issues like heart disease or diabetes. These problems can raise the risk of depression, too. How do these connections happen? Do they change your ability to heal or be well? The answers are not completely clear but some possible factors are listed below.

When Illness Triggers Depression

Depression is not just feeling really sad. It is caused, in part, by physical changes in the body that affect how you feel. The changes may be caused by:

  • Faulty signals in your brain
  • Changes in hormones or other chemicals
  • Stress
  • Your genes
  • Medicine

Often it is caused by a mix of these things.

Some health problems like thyroid changes can affect how your brain works. These changes can cause symptoms similar to depression. It will often go away once you get treatment for the cause.

Other illnesses can lead to depression because of long term stress and life changes. Depression can be common after illnesses such as:

  • Cancer
  • Lupus
  • Multiple sclerosis (MS)
  • Rheumatoid arthritis
  • HIV
  • Epilepsy

Depression is also common after heart attacks or strokes. These can be scary, life-threatening events. Recovery can be long and lead to major life changes. You may also have intense worry that you will have another event. This long term stress can lead to depression. The depression can continue even when you have recovered from the original illness.

When Depression Leads to Illness

Depression can affect future health in two ways. First, changes that cause depression may also affect other body systems. Depression may play a role in blood vessel health, blood clotting, or the immune system. This is like the effect stress has on our immune system. It may not cause problems right away but the risk of other illnesses gets higher over time.

Second, depression can change how you care for yourself. You may be less likely to choose healthy foods, stay active, or be social. Depression can also make you less likely to see a doctor for any reason. This health problems may not be spotted early, when it may be easier to treat them.

Depression is may raise the risk of:

The Diagnosis Dilemma

Depression can be hard to see in those with long-term illnesses. The symptoms may seem like a natural part of the illness. Your medical team may ask a few questions about your mood, sleep, eating, and activity. This can help screen for depression. Make sure to answer questions truthfully and thoughtfully. It will help to guide your care.

People who are depressed may have a harder time spotting their own symptoms. Family and friends can play an important role in seeing changes or problems. Look out for symptoms of depression such as:

  • Feeling sad, irritable, or anxious
  • Feeling empty, hopeless, guilty, or worthless
  • Loss of pleasure in hobbies or activities, including sex
  • Feeling very tired and low energy
  • Trouble focusing, remembering details, and making decisions
  • Not being able to sleep or sleeping too much. Waking too early
  • Eating too much or too little, weight gain or loss without trying
  • Thoughts of death, suicide or suicide attempts
  • Aches or pains, headaches, cramps, or digestive problems without a clear physical cause and/or that do not get better even with treatment

Depression's Effects

Depression’s effects on chronic illness can be serious:

  • Diabetes —depression may slow or prevent self care. Diet choices and medicine can help to control blood glucose. Depression may make it hard to follow the care plan. This can increase risk of problems.
  • Heart disease —depression can lead to poor diet or lifestyle choices. This itself can increase risk of heart disease. Depression is common after a heart attack. Those that have depression tend to have more heart health problems during recovery.
  • Alzheimer disease —depression causes or is caused by changes in the brain. These changes may also play a role in the development of dementia-related diseases.
  • Healing —depression may slow your body's ability to heal. This can slow recovery after surgery or major injury.

Treatment for Depression

Depression can be treated. You can better cope with other illnesses if the depression is under control. This can also improve your overall health. Medicine and counseling can help most. Sometimes treatment of the related issue will ease depression itself.

The first step is talking to your doctor. Let them know about struggles you may have. "Toughing it out" it through illness can cause harm and slow your healing.

RESOURCES:

American Psychological Association
http://www.apa.org

Mental Health America
http://www.mentalhealthamerica.net

CANADIAN RESOURCES:

Canadian Psychiatric Association
http://www.cpa-apc.org

Canadian Psychological Association
http://www.cpa.ca

REFERENCES:

Chronic illness & mental healh. National Institute of Mental Health website. Available at: https://www.nimh.nih.gov/health/publications/chronic-illness-mental-health/index.shtml. Accessed June 17, 2020.

Co-occurring disorders and depression. National Mental Health Association website. Available at: http://www.mentalhealthamerica.net/conditions/co-occurring-disorders-and-depression. Accessed June 17, 2020.

Gan Y, Gong Y, Tong X. Depression and the risk of coronary heart disease: a meta-analysis of prospective cohort studies. BMC Psychiatry. 2014;14:371.

Major depressive disorder (MDD). EBSCO DynaMed website. Available at:https://www.dynamed.com/condition/major-depressive-disorder-mdd/. Updated April 6, 2020. Accessed June 17, 2020.

Last reviewed June 2020 by EBSCO Medical Review Board  Last Updated: 6/17/2020