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Exploring the Relationship between Chronic Illness and Depression
Laurence Lippsett
Medically reviewed on 11/16/2020 by
Dr. Geoffrey Grammer
Chief Medical Officer
If you've been negotiating a chronic illness day after day, you're bound to feel run down at times. Long-lasting illnesses such as diabetes or Parkinson's disease can cause incessant pain and stress. They can also make it difficult or sometimes impossible to function at your best at work and in your relationships. But those illnesses can also trigger another condition: depression. Chronic illness and depression often go hand in hand, each making the other worse. So, managing your chronic illness and taking care of your mental health is ultimately a double-duty job. According to the Cleveland Clinic, one-third of people with chronic illnesses also experience depression. There's a medical term for this: "comorbidity," the simultaneous presence of two or more distinct conditions in a patient. The symptoms of one condition can often overlap with and mask another. This can make it difficult for people with depression (and sometimes even their doctors) to recognize that two separate ailments—each requiring its own treatment—are occurring at the same time. The list of illnesses that persist or can't be fully cured is unfortunately long. Along with physical pains, chronic conditions like cancer, AIDS/HIV, and multiple sclerosis can bring emotional ones, too, from fear to frustration and loneliness. It's no wonder that the continuous stress of a chronic illness can affect your mental health. Still, it's important to recognize that you are not alone, and that there is hope.
The Connection between Chronic Illness and Depression
A problem can arise when patients and physicians fail to recognize that certain normal and expected feelings have reached the threshold of triggering medical depression. Treating the chronic illness can take so much attention and energy that it's easy to overlook another condition in the midst. To complicate matters, many of the telltale symptoms of depression are the same ones that people with chronic illnesses experience: fatigue, insomnia, stomach troubles, backaches and headaches, weight gain or loss, sexual dysfunction, problems concentrating, and feelings of helplessness, worthlessness, or hopelessness. It can be hard to distinguish whether these symptoms are caused by chronic illness or by depression. The cause could, in fact, be both. Many of the physical symptoms brought about by depression are associated with inflammation in the body, potentially leading to aches and pains, a weakened immune system, and increased stress. All of these can worsen chronic illness, which in turn can heighten depression. Research has shown, for example, that depression is associated with poorer prognoses and faster development of chronic illnesses, such as heart disease and diabetes. Chronic illness and depression have a cyclical, mutually harmful relationship, each one exacerbating the other.
Seeking Treatment for Depression Can Lighten the
Depression is associated with changes in the brain chemicals that regulate signaling and moods. For some people, it can be effectively treated with talk therapy and/or antidepressants and other medications. Yet roughly one in three people don't find relief even after trying two medications. And if you have a chronic condition that already requires medications, you simply may not want to add another pill for depression. You might also be concerned about potential drug interactions between a chronic illness medication and depression medications—or that your chronic illness medication may actually be increasing your risk for or contributing to depression. Especially if you fall into these categories, Transcranial Magnetic Stimulation (TMS) is a depression treatment worth considering. TMS is a non-invasive, drug-free, outpatient treatment in which you sit in a comfortable chair, awake and alert, while a device near your scalp delivers gentle magnetic pulses. These pulses, similar to those in an MRI scan, stimulate changes in brain chemical signaling that can alleviate symptoms of Major Depressive Disorder. To learn more about whether TMS therapy is right for you, schedule a no-cost consultation. If you have a chronic illness, keep in mind that you also have a higher risk of depression. While it can be tough to do, it's important to take care of both your chronic illness and your mental health. You deserve to feel your best, and treatment can help get you there.
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A recent study compared the effects of TMS therapy and Antidepressants. TMS therapy provided more relief from patients depressive symptoms compared to Antidepressants.
You may feel isolated and alone when you have clinical depression, and depression also affects your relationships with family and friends. While the primary focus of your treatment is to improve your mental health, it’s also essential to understand your loved ones may experience their own issues as they try to support you. An understanding of how depression affects relationships can help everyone maintain healthy connections and navigate problems. Here are some of the ways depression may affect the people in your support network.
We’ve all heard the common health-related misconceptions or myths-- chocolate causes acne, carrots will improve your night vision, and cracking your knuckles gives you arthritis. Subscribing to these particular myths is relatively harmless, but other health-related misconceptions can have far more serious consequences. This is the case for depression—the myths surrounding it can prevent people from getting the help they need. This is the case for depression—the myths surrounding it can prevent people from getting the help they need. Because untreated depression can have a serious physical and psychological impact, it’s imperative to have the right information in order to make the best decisions for yourself and for your health. Here are 5 common misconceptions about depression, and the facts behind them:
Starting any medical treatment for the first time can leave you with questions, especially if you’re looking forward to the benefits it may bring. It’s no different when you’re preparing for your nasal esketamine treatment. Your previous mental health treatments may have consisted solely of taking antidepressants at home or visiting a therapist’s office for cognitive behavioral therapy (CBT), so nasal esketamine is probably a new treatment experience for you. If you're wondering what it's like to start nasal esketamine and get ready for your first session, keep reading. Getting Started with the Nasal Esketamine Treatment As with any new treatment, you’ll first talk to your primary care provider or psychiatrist about whether nasal esketamine is a good fit for you. Alternatively, you can schedule your esketamine nasal spray consultation with a treatment center (such as Greenbrook) that has certification by the FDA’s Risk Evaluation and Mitigation Strategy (REMS). At Greenbrook's REMS-certified nasal esketamine treatment centers, our Greenbrook-affiliated psychiatrists and psychiatric nurse practitioners will review your medical history and also conduct our own assessment to help determine whether nasal esketamine treatment is right for you. Certain conditions, including blood vessel disease and a history of psychosis, may make treatment a risk for you. Make sure you discuss all previous and present conditions with your doctor or nasal esketamine provider before beginning treatment. If the medication is deemed a good fit, you’ll receive your prescription from the Greenbrook-affiliated provider. Your Greenbrook Care Team will put together a personalized care plan for the weeks and months to follow. Keep in mind that you will need to take a standard (oral) antidepressant along with your nasal esketamine treatment. There are two important regulations to note when it comes to preparing for treatment: Each treatment is followed by a mandatory two-hour observation period. This means you will need to plan to stay at the center for at least two hours following your self-administration of the esketamine nasal spray. You cannot drive during the rest of the day after treatment and must arrange for transportation. These regulations are mandatory. It may be helpful to sit down and plan out several weeks’ worth of transportation once you know your treatment schedule. In addition, if you’re wondering what to bring for the treatment, we recommend entertainment such as an audiobook or playlist of favorite songs and a pair of headphones. You may want them during the two-hour observation period. What to Expect During Nasal Esketamine Treatment On the day of treatment, you’ll need to stop eating any food two hours before your appointment and stop drinking all fluids 30 minutes before you come in. Your Greenbrook Care Team will confirm that you are prepared for the two-hour observation period and that you have a ride home. You’ll get the opportunity to practice using a “trainer sprayer” that mimics the real nasal esketamine sprayer but does not release any medication. The Care Team will encourage you to use the restroom and set up your preferred environment in your private treatment bay or room. Some patients like reduced lighting, for example, while others don’t request light adjustments. You’ll complete a depression scale before each treatment session. Your Greenbrook provider will confirm that the dose kit is yours, show you how to administer it, and then hand it to you. Each sprayer contained 28mg of Spravato esketamine nasal spray. Patients usually start with two sprayers (56mg) and soon increase to 84mg (three sprayers) per treatment. But, your dosage maybe vary. Should you be left with a metallic taste by the spray, the Care Team will offer suckers to help make the flavor dissipate. After your dose, you’ll be encouraged to lie back in your comfortable recliner. While most patients enjoy a quiet setting, Greenbrook is prepared to accommodate patients with a more animated reaction to the medication. You may feel sleepy, dizzy, mildly dissociated, and/or nauseated during treatment. Greenbrook's Care Team is readily available if you need assistance. How to Prepare for after your Nasal Esketamine Treatment Most side effects begin to wane in the second hour of observation, but if you’re wondering, “Is it safe to drive immediately after nasal esketamine treatment?” the answer is a resounding no. In addition to the mandatory ride home, you will need to block off time to rest and let side effects fully dissipate. This extended rest period is especially important in the first weeks of treatment when you’ll have treatment twice a week. Do not drive or operate machinery of any kind until the day after treatment. Just take it easy, relax, and take care of yourself. If you’re unsure what activities you can do or should avoid during this time, talk to your Care Team for more information. While side effects tend to dissipate completely after a good night’s sleep, many nasal esketamine patients begin feeling relief from depression symptoms within hours of their treatment. Other Tips in Preparing for Your Nasal Esketamine Treatment At Greenbrook, we make every effort to schedule your treatment in the afternoons or whenever it is most convenient for you. We encourage you to see each treatment session as an opportunity to relax and take care of your mental health. If you have any questions or concerns, talk to your doctor or the Greenbrook Care Team. At Greenbrook, we’ll help you feel at ease when preparing for each treatment session. Schedule A Free Consultation To get started with nasal esketamine, schedule your free consultation today.
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