One day you woke up not knowing that after that day, things were going to be different in your life. Something that you suspected to be true or something that came out of nowhere took a prominent role in your life. That was the day that you were diagnosed with a chronic health condition.
A doctor probably discussed your specific information and told you what your treatment options were. Whether it felt like a kick in the stomach, a tidal wave of fear, or just total numbness, there was probably some emotional reaction going on. This may or may not get addressed at that time.
Since that day, life has been filled with doctor appointments, tests, treatment options, and lots of questions that don’t necessarily have answers. Is it any wonder that a person may be dealing with anxiety or depression on top of all that? Unfortunately, the medical community has not always given the emotional impact enough attention when addressing initial treatment plans after a medical diagnosis. It’s been expected that a person will address the medical treatments, yet there is minimal regard to the emotional and life impact after a diagnosis. Luckily, things are changing.
In this day and age of healthcare, we encourage people to be active parts of their treatment team. This means more than just taking the provider’s suggestions. This includes implementing the treatments, keeping track of symptoms, managing side effects, and exploring complimentary treatment options that best fit for you. This requires a lot of insight, understanding, involvement, monitoring, and juggling, all while not feeling your best. However difficult, it is worth it for your health and care management in the long run.
Depression and Chronic Health Issues
Depression and/or anxiety often accompany a chronic health condition, and the causes for this are varied and still being researched. No one reason will fit all. Along with the adjustment and any major life transition comes a grieving process, during which many people ask “what could have been?” or “what should have been?”
Some individuals may be genetically predisposed to the condition you or a loved one have been diagnosed with. It should be of note that many medications used to treat chronic illness may have a potential side effect of depression or anxiety. Research is currently being conducted to see if inflammation in the body plays a role by impacting the other body systems.
Some major medical issues co-occurring with depression or anxiety include:
- Seizures: 30-50% of those with a seizure conditions have psychiatric symptoms at some point during the course of their illness.
- Parkinson’s disease: Major depression in patients with Parkinson’s is estimated to be 40%; anxiety occurs in 25% of people with Parkinson’s.
- Multiple sclerosis (MS): 25-50% of people with MS experience symptoms of major depression after onset of the disease.
- Diabetes: Depression is estimated to occur in 12% to 18% of people with diabetes.
- Coronary heart disease (CHD): Depression affects between 15% and 23% of people with CHD.
- Depression also may occur with other serious medical illnesses such as stroke, cancer, and HIV/AIDS.
People who have depression along with a medical illness tend to have more severe symptoms of both depression and the health condition, making it more difficult to adapt to their medical condition, and raising more medical costs than for those who do not have co-existing depression. Treating the depression can help improve the outcome of treating the co-occurring illness. Just because statistics may point to co-occurring depression does not mean that it depression inevitable or that you can’t do anything about its occurrence to manage it. One thing is clear: this is not caused by a weakness in character or a personal failure.
Talking to Medical Professionals
So what can one do in order to improve the quality of care and odds of being physically and mentally healthy despite a disease? Learning how to effectively discuss how you feel with your health care providers goes a long way. Doctors tend to speak the language of symptoms, location of occurrence, and frequency of such. Learning how to speak to them in their language with less vagueness can help to address problems early on. Stating “I’m in pain” is only telling the start of what they need to know. Let them know what the pain feels like—shooting? throbbing? radiating?—how frequently it occurs, and if there are any triggers. This will help them evaluate your situation with greater accuracy.
Rather than stating “I’m depressed,” try to communicate specifically what you’re feeling—whether you’re sad, lacking motivation or appetite, or having a difficult time falling and staying asleep. This will compile a more thorough picture for them to evaluate, and they can make referrals more easily. It can feel very rushed when you’re face to face with the doctor. You may forget what it was you wanted to address if you leave it to memory, so be prepared and write it out beforehand.
If a provider doesn’t ask you directly about your mood or how you are handling the impact of being diagnosed with a chronic illness, bring it up to them. If it is having an impact on your mental health or daily functioning it is important enough to address, especially early on. This advise goes for any physical or mental health issue, no matter how embarrassed you may feel. If it is impacting your quality of life then it is important to discuss. There is a lot of crossover between the various systems in the body; their emotional impact and origin may be rooted in a metabolic change or something else. Standard practice is to examine the medical or physiological nature of symptoms in addition to addressing the psychological. The majority of things are best addressed in the earlier rather than the later stages.
Lastly, being open to addressing your mental health can also go a long way. Many people see therapists or psychiatrists for what are considered major mental health issues, but others seek out and are open to treatment in order to gain understanding about how to best cope with situations, gain support for issues they are dealing with, and prevent further progression of what is currently manageable. Gaining an awareness of how your mental health and physical health have an interplay and addressing both can help you be your own best health manager, as well as help you live a life not totally consumed by health issues.
- Linda Chuang, MD. Mental Disorders Secondary to Medical Conditions. Medscape Reference Drugs, Diseases, and Procedures. Updated March 15, 2012 http://emedline.medscape.com/article/294131-overview
- Katon, W. State of the Art: Epidemiology and treatment of depression in patients with chronic medical illness. Dialogues in Clinical Neuroscience. Vol 13 . No. 1 . 2011 http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181964/pdf/DialoguesClinNeurosci-13-7.pdf
- Cassano, P., Fava, M. Depression and public health, an overview. Journal of Psychosomatic Research, 2002; 53:849–857.
- Katon, W., Ciechanowski, P. Impact of major depression on chronic medical illness. Journal of Psychosomatic Research, 2002; 53:859–863.
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