What is a chronic illness?
A chronic illness is one that lasts for a very long time and usually cannot be cured completely. Examples of chronic illnesses include diabetes, heart disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis. Many of these conditions can be improved through diet, exercise, and healthy living, in addition to medication.
What are the symptoms of depression?
Common symptoms of depression include:
- Depressed mood and/or loss of interest or pleasure in daily activities
- Weight loss or weight gain
- Sleep disturbances (sleeping too much or not able to sleep)
- Problems with concentration
- Apathy (lack of feeling or emotion)
- Feelings of worthlessness or guilt
- Fatigue or loss of energy
- Thoughts of death or suicide
Patients and their family members often overlook the symptoms of depression, assuming that feeling depressed is normal for someone struggling with a serious, chronic illness. Symptoms of depression such as fatigue, poor appetite, reduced concentration, and insomnia are also common features of chronic medical conditions. This makes it difficult to decide if these symptoms are due to depression or to the underlying illness.
When a patient has a chronic medical illness and is also depressed, it is extremely important to treat both the depression and the medical illness at the same time.
Why is depression common in people who have a chronic illness?
Depression is one of the most common complications of chronic illness. It is estimated that up to one-third of individuals with a serious medical condition have symptoms of depression.
People who have chronic illnesses must adjust to both the illness and its treatment. The illness may affect a person’s mobility (ability to move) and independence, and change the way a person lives, sees him- or herself, and/or relates to others. These changes can be stressful and cause a certain amount of despair or sadness that is normal.
In some cases, having a chronic illness can trigger what is known as clinically significant depression, a potentially serious but treatable illness itself. The doctor and the patient must decide whether symptoms of depression are just a normal reaction to the stress of having a chronic medical condition, or are so intense or disabling that they require additional treatment with an antidepressant.
Which long-term illnesses lead to depression?
Any chronic condition can trigger depression, but the risk increases if the illness is more severe and causes more disruption in the patient’s life.
Depression caused by chronic illness can aggravate the illness, causing a vicious cycle to develop. Depression is especially likely to occur when the illness causes pain, disability, or social isolation. Depression in turn can intensify pain, fatigue, and the self-doubt that can lead the patient to avoid other people.
The rates for depression that occurs with other medical illnesses is quite high:
- Heart attack: 40%-65%
- Coronary artery disease (without heart attack): 18%-20%
- Parkinson’s disease: 40%
- Multiple sclerosis: 40%
- Stroke: 10% to 27%
- Cancer: 25%
- Diabetes: 25%
How can depression be treated?
Early diagnosis and treatment for depression can reduce distress, as well as any risk of suicide. Patients with a chronic medical condition who get treatment for co-existing depression often have an improvement in their overall medical condition, achieve a better quality of life, and find it easier to follow their treatment plan.
In some cases, improved treatment of the chronic medical condition will relieve the symptoms of depression that it caused. If so, specific treatment for depression may be unnecessary. Some medications can cause depression; in these cases, the best thing to do is reduce or eliminate that particular medication. However, when depression becomes a separate problem, it should be treated on its own.
The success of antidepressant treatment – like any other treatment – cannot be guaranteed, but most people who are treated for depression will recover. Recovery is often more rapid and complete when both antidepressant medication and psychotherapy (“talk therapy”) are combined. Many antidepressant medicines are available to treat depression. How these drugs work is not fully understood, but they affect brain chemicals that are believed to be involved in depression.
Psychotherapy, or “therapy” for short, actually refers to a variety of techniques used to treat depression. Psychotherapy involves talking to a licensed professional who helps the depressed person:
- Focus on the behaviours, emotions, and ideas that contribute to his or her depression.
- Understand and identify the life problems or events–such as a major illness, a death in the family, the loss of a job, or a divorce–that contribute to depression, and help them understand which aspects of those problems they may be able to solve or improve.
- Regain a sense of control and pleasure in life.
Tips for coping with chronic illness
Depression, disability, and chronic illness form a vicious circle. Chronic illness can bring on bouts of depression, which, in turn, can lead to a rundown physical condition that interferes with successful treatment of the chronic condition.
The following are some tips to help you better cope with a chronic illness:
- Learn how to live with the physical effects of the illness.
- Learn how to deal with the treatments.
- Make sure there is clear communication with your doctors.
- Try to maintain emotional balance to cope with negative feelings.
- Try to maintain confidence and a positive self-image.
- Get help as soon as symptoms of depression appear.
Everyone at some point in their lives has been ill. It’s a horrible feeling and depending on the nature of the illness it can leave a person feeling depressed and anxious. Sick people also become more isolated as they may not be able to take part in their usual sporting, social and family commitments. For most people taking prescription medication is a short term act which improves ones health and is then discontinued. For a few though, the pain is so bad and the symptoms of the disease are chronic, especially those fighting life threatening diseases like Cancer. Doctors may either prescribe stronger painkillers or even antidepressants or tranquillisers in addition to the medication used to fight the disease. Take into account there are a number of serious side effects of prescription medication.
Depression triggered by serious illness is common and it leaves the patient in a hopeless state of battling the physical symptoms of the disease as well the effect this has on their psyche. For example, a doctor may prescribe sleeping tablets to be used in combination with the pain medication. But without monitoring the medical situation carefully, this could well lead to prescription medication addiction. Benzodiazepine addiction is serious and can be difficult to spot but it can be just as serious as a heroin addiction.
Who’s at risk:
- People with a previous history of substance abuse
- Over medicating and taking more than the prescribed limit
- People who have suffered from mental illness in the past
What can you do?
- Never be afraid to talk to your doctor.
- If you fell you can’t talk about an escalation in pain, sleeping or anxiety medication, change doctors. They are their to help you.
- Go see either an occupational therapist who will teach you how to adapt to any life changing medical condition like loss of a limb.
- Go see a psychologist. They will also be able to provide your doctor with more information on your mental state to better your treatment.
- Having a team of both medical professionals and mental health professionals will drastically decrease the likelihood of the start of addiction.