Depression Caused By Chronic Illness

Chronic illness causes depression in some people. A chronic illness is an illness that lasts for a very long time and usually cannot be cured completely. However, chronic illnesses can often be controlled through diet, exercise, and certain medicines. Examples of chronic illnesses include diabetes, heart disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis (MS).

Why is Depression Common in People With a Chronic Illness?

People diagnosed with chronic illnesses must adjust to the demands of the illness itself, as well as to the treatments for their condition. The illness may affect a person's mobility and independence, and change the way a person lives, sees him or herself, and/or relates to others. For these reasons, a certain amount of despair and sadness is normal. In some cases, a chronic illness may actually cause depression.

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 experience symptoms of depression. Depression and illness may occur together because the physical changes associated with the illness trigger the depression, the individual has a psychological reaction to the hardships posed by the illness, or simply as a coincidence.

Which Long-Term Illnesses Can Lead to Depression?

Any chronic condition can trigger depression, but the risk increases with the severity of the illness and the level of life disruption it causes. The risk of getting depression is generally 10-25% for women and 5-12% for men. However, those with chronic illnesses face a much higher risk -- between 25-33%.

Depression caused by chronic illness often aggravates the illness, especially if the illness causes pain, fatigue, or disrupts your social life. Depression can intensify pain. It causes fatigue and sluggishness that can worsen the loss of energy associated with these conditions. Depression also tends to make people withdraw into social isolation.

The rate for depression occurring with other medical illnesses is quite high:

• Heart attack: 40-65% experience depression
• Coronary artery disease (without heart attack): 18-20% experience depression
• Parkinson's disease: 40% experience depression
• Multiple sclerosis: 40% experience depression
• Stroke: 10-27% experience depression
• Cancer: 25% experience depression
• Diabetes: 25% experience depression

What Are the Symptoms of Depression in People with Chronic Illness?

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 are also frequently masked by the other medical conditions, resulting in treatment for the symptoms -- but not the underlying cause of the symptoms -- the depression. It is extremely important to treat both forms of illness at the same time.

What Can Be Done to Treat Depression in People With Chronic Disease?

Treatment of depression in people with chronic disease is similar to that offered to other people with depression. Early diagnosis and treatment for depression can reduce distress, as well as the risk of complications and suicide. People who get treatment for depression that occurs at the same time as a chronic disease often experience an improvement in their overall medical condition, a better quality of life, and are more easily able to stick to their treatment plans.

If the depressive symptoms are related to the physical illness or side effects of medicine, treatment may just need to be adjusted or changed. If the depression is a separate problem, it can be treated on its own. More than 80% of people with depression can be treated successfully with medicine, psychotherapy, or a combination of both. Treatment with antidepressant drugs can start to work within a few weeks.

Tips For Coping With Chronic Illness

Depression, disability, and chronic illness form a vicious cycle. Chronic illness can bring on bouts of depression, which, in turn, can lead to a run-down physical condition that interferes with successful treatment of the chronic condition.

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.

Reviewed by the doctors at The Cleveland Clinic Department of Psychiatry and Psychology.

WebMD Medical Reference provided in collaboration with the Cleveland Clinic

Edited by David H. Fram, MD on December 01, 2006

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