The facts about chronic illness and depression

Managing a chronic health condition is no small task. The doctor visits, medications, and required changes to your routine can be overwhelming — and exhausting. No matter what your treatment plan is, it can be hard to adapt to a new reality and continue to cope with these changes over the long haul.

This stress can weigh on you. While it’s only natural to feel sad or discouraged from time to time, the burden can also put you at a greater risk of depression, according to the National Institute of Mental Health (NIMH).

Depression is a prolonged feeling of sadness that can make it difficult to carry on with daily life and find joy in the activities and people you love most. It can also impact your ability to take care of yourself, such as taking your medication, eating well, being active, and even seeking support when you need it most.

The good news: Depression is very treatable, even if you’re living with a chronic condition. The tough part is recognizing the signs and symptoms so that you can get help and start feeling like yourself again.

Here’s how to tell if your condition might be causing ongoing feelings of sadness, and what you can do to feel better, both mentally and physically.

Know the symptoms of depression

Depression is a medical condition, just like diabetes or heart disease, that can greatly impact your health. And there’s a lot more to it than just feeling down occasionally. According to NIMH, symptoms of depression can include:

• Fatigue and low energy
• Inability to enjoy your favorite hobbies or activities (this is a major sign of depression)
• Sadness
• Irritability
• Anxiousness
• Feelings of emptiness, hopelessness, guilt, or worthlessness
• Difficulty concentrating and making decisions
• Sleeping too much or inability to fall asleep or stay asleep
• Eating too much or not wanting to eat

If you notice any of these signs, talk to your doctor. Opening up about your mental health can be tough, but it’s the first step toward getting the help you need. Make it easier by coming to your appointment with a list of questions — and consider bringing a loved one along to support you.

How chronic conditions put you at risk for depression

Undergoing a major life change, experiencing trauma, and having a family history of depression or suicide are top risk factors of depression. When you’re living with a chronic condition — dealing with joint pain or trying to manage your blood sugar or blood pressure daily — the stress and anxiety that can come with it can also increase your likelihood of depression. The side effects of certain medications can also make symptoms worse, so tell your doctor what prescriptions and supplements you’re taking.

On the flip side, having depression can also increase your chances of developing a chronic condition. It can make it harder to care for yourself and disrupt hormones that play a role in regulating cholesterol and blood clots, blood pressure, blood sugar, and even your weight.

Specific chronic health conditions that have been linked to a higher risk of depression include Parkinson’s disease, arthritis, asthma, cancer, chronic obstructive pulmonary disease (COPD), diabetes, heart disease, and stroke. Here are details about the three most common ones:

• Arthritis: Depression rates are 2 to 10 times higher in people with arthritis and similar pain disorders, such as fibromyalgia, than in those without one of these conditions. That’s because the stress of pain can alter the levels of brain chemicals such as serotonin, cortisol, and epinephrine in ways that can lead to depression. And it’s a vicious circle: Depression can lower your pain threshold, making you feel even worse, according to the Arthritis Foundation. As a result, people with both arthritis and depression have more trouble with day-to-day activities and self-care.
• Heart disease: Up to 30 percent of people with heart disease have depression. When untreated, living with both can worsen your heart disease and even increase your risk of heart disease-related death. Experts say that’s because depression can make it more difficult to follow a healthy lifestyle, take medications as prescribed by your doctor, and break unhealthy habits. However, depression may also worsen heart disease by boosting levels of stress hormones, increasing inflammation, and affecting your nervous system.
• Diabetes: One in four people with diabetes will experience major depression, according to the Centers for Disease Control and Prevention. The stress of maintaining healthy blood sugar levels every day, along with worries about diabetes complications, can increase the chance of depression, according to the American Diabetes Association. In addition, high or low blood sugar levels can look and feel like depression, which can make you feel anxious or tired during the day and interfere with a good night’s sleep.

You can treat depression

There’s no one-size-fits-all treatment approach. If you think you have depression, talk to your doctor, who may recommend talk therapy, lifestyle changes, medication, or a combination of the three.

In talk therapy, such as cognitive behavioral therapy, a therapist will help you become aware of negative thought patterns and develop the skills to respond in a healthier way.

Your doctor may also talk to you about your overall wellness. Following a healthy diet, getting regular exercise and enough sleep, and learning a stress-soothing technique like deep breathing can all support your mental and physical health and alleviate feelings of depression. Also, think twice about drinking alcohol: It’s a depressant that lowers the amount of feel-good serotonin in your brain.

Antidepressants are medications that help treat depression by improving the way your brain handles certain moods and stress. There are many different prescription options, so it may take trial and error before you find the right fit. Keep in mind that antidepressants can take up to four weeks to work.

When in doubt, reach out. Talking with a close friend, a trusted family member, or a mental health professional about your feelings can help ease stress when you’re coping with the challenges of a medical condition.

For any questions regarding mental health coverage, benefits, or providers, please call the Mental Health/Substance Abuse phone number on the back of your member ID card.

You can also get help 24/7 via the National Suicide Prevention Lifeline. If you or a loved one are having thoughts of death, suicide, or harming yourself, don’t hesitate to call their hotline at 988. You can also text their Crisis Text Line (Text HOME to 741741).