Living with chronic illness is tough. And it would be difficult to find someone who hasn’t encountered periods of extreme sadness, frustration and grief related to their condition.
Sometimes, however, those feelings can progress to the level of clinical depression. This is also not uncommon among those of us who face chronic illness symptoms day in and day out.
It’s often a complicated process for us to figure out whether we are clinically depressed or not. One reason is that some of the symptoms of depression may also be symptoms of our illness. Fatigue, lack of participation in once-loved activities, withdrawal from socialization, difficulty concentrating, changes in sleeping and eating patterns — all of these can be symptoms and responses related to our chronic illness diagnosis itself.
Many medications we take for our illnesses can cause effects such as inability to sleep (or excessive fatigue), loss of appetite (or extreme hunger), and difficulty concentrating. So how can we tell if we are suffering from depression or not?
One of the first things to do in this situation is to speak with the physician who treats you regularly. That way, the doctor can assess all of your symptoms and sort through which ones are normal for your condition or could be side effects of the medications you are taking.
It’s also very common to have deep emotional reactions to our physical illnesses. We may face feelings of worthlessness if a diagnosis has changed our lifestyle or career dramatically. We may encounter periods of hopelessness when we realize that our pain or other symptoms could last for a lifetime.
While those feelings are expected periodically, if they exist consistently for weeks or months on end, please advise your doctor. Serious and persistent feelings such as those can signal that your mental health has declined.
Many people who become depressed secondary to chronic illness feel guilty for not being in better control of their emotions. But just as we cannot fully control our chronic illness, we also may not be able to change the cascade of events that lead to depression. The combination of physical discomfort and reactions to medications can place us on that path, and we may not realize it until we’ve reached the point of no return.
But there are some interventions that can help if we make note of our progression toward depression early enough.
Locus of control is our perspective as to whether our life experiences are controlled by internal or external forces. The more empowered we feel to change our situation, the more internal our locus of control. And while we cannot necessarily “think” ourselves to the point of a cure, we can make some choices that may affect how we feel on a day to day basis.
Socialization plays an important role in our lives — particularly when we are ill. Bonding with others and feeling a sense of camaraderie can provide us with a sense of well-being. And it doesn’t have to be socialization in person. I am a firm believer that we can experience those same feelings via virtual relationships, which is excellent for people who are more home-bound due to illness.
Guilt is another factor that can push us closer toward depression. While an internal locus of control can help empower us when we feel we can positively affect our situation, feeling responsible for having our illness in the first place can cause the opposite effect. We may also experience guilt due to perceptions that we are somehow “failing” others by being chronically ill.
How can we address these three areas in ways that give us the best possible chance for not developing a clinical level of depression?
Control what we can control. Will avoiding dairy help GI symptoms? Will gentle stretching help with chronic pain? There are always some specific ways we can help ourselves. Take advantage of what you can control, be your biggest and best advocate, and do everything within your ability to increase your quality of life. If you need suggestions for what you can control, ask your doctor or other health provider.
Engage with other human beings. If you have friends you enjoy spending time with, then you know how good you feel afterward. Even if you aren’t healthy enough for an evening out on the town, you can still find ways to connect. Perhaps a good friend would come over to watch a movie or bring some delicious take-out. And if you don’t have good friends who are located nearby, developing and nurturing online friendships can help in similar ways. The feeling that someone cares about you and understands what you are going through can lead to a more positive frame of mind.
Let go of what you can’t control. Your illness is not your fault. You did not cause it. Despite your best efforts, you will experience some unpleasant effects from it. Give up the guilt over these things and be logical about what you do and do not have control over. Be as kind and considerate toward yourself as you would be toward others in a similar situation.
These strategies may not always prevent an episode of depression. But, they will help tremendously as you recover and can help you to maintain some hope even in the midst of depression.
It’s a shame that chronic illness can present us with this double whammy of physical and emotional distress, and it hardly seems fair that the two often go hand in hand. Being aware of the likelihood of depression making an appearance can help you to realize early on when your symptoms are progressing down that path. And like with any illness, early diagnosis leads to a reduction of those symptoms in a more timely manner.
And please remember that if you believe you could be depressed, you should share this information with your physician or other healthcare provider so you can be properly evaluated and treated.
Have you experienced full-blown depression along with chronic illness? Please feel free to share your story below in the comments section. I’ll be sharing mine.