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What is a chronic illness?
A chronic illness is an illness that lasts for a very long time and usually
cannot be cured completely. However, chronic illnesses often can 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.
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 himself 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, which, though treatable, is a serious
medical condition by itself.
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 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 to 25 percent for women and 5 to 12
percent for men.
However, those with chronic illnesses face a much higher risk -- between
25 and 33 percent.
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%
- Coronary artery disease (without heart attack): 18%-20%
- Parkinson’s disease: 40%
- Multiple sclerosis: 40%
- Stroke: 10%-27%
- Cancer: 25%
- Diabetes: 25%
What are the symptoms of depression?
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 depression. It is extremely important to treat both
forms of illness at the same time.
Common symptoms of depression include:
- Depressed mood or loss of interest or pleasure in daily
activities
- Significant 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
- Recurrent thoughts of death or suicide
What can be done to treat 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
percent 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.
Many antidepressant medicines are available to treat depression. These drugs
work by altering the level of certain chemicals in the brain, which are
responsible for transferring messages between brain cells.
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 behaviors, 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, a 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 run-down
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.
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