Why having a chronic illness increases your risk of depression — and what you can do to feel better

Getting diagnosed with a chronic disease — and learning to live with long-term illnesses — is hard enough. That’s why chronic disease is often accompanied by a range of emotions including anger, fear, and sadness. But, if you can’t shake constant feelings of moodiness, you may also have depression.

Depression — or feeling consistently sad and less interested in activities you used to enjoy — is the second most common mental health disorder in the United States. Getting a diagnosis, and the help you need, will not only help you feel better. It will also help you better manage your chronic illness on a day-to-day basis. 

Recognize the signs of depression

Talk with your health care provider or mental health professional if you’re feeling moodier than usual. These are the signs of depression to look for:

• Sadness
• Irritability
• Anxiousness
• Feelings of emptiness, hopelessness, guilt, or worthlessness
• Not getting pleasure from hobbies or activities you usually enjoy
• Fatigue and feelings of chronic low energy
• Difficulty concentrating and making decisions
• Sleeping too much or not being able to fall asleep or stay asleep
• Eating too much or not wanting to eat

If you’re having thoughts of death or suicide, text or call 988 to get immediate help. 

Why are chronic diseases and depression linked?

Having both depression and chronic disease is common. Researchers believe that there’s a connection — and that chronic inflammation may be the link.

What is inflammation? It's the body’s normal immune response to injury or infection. Inflammation triggers redness, swelling, and pain to recruit healing cells and substances to the area that’s injured or infected. Fevers are also a natural inflammatory response to kill off a virus or bacteria. This is called acute inflammation because it stops when the injury or infection is cleared.

Chronic inflammation, however, is inflammation that never stops. Like a train that has lost its brakes, chronic inflammation stays active in the body, causing damage to cells, tissues, and organs along the way. 

Chronic diseases linked to depression

Arthritis

Approximately 20 percent of people with arthritis and arthritis-related conditions have depression. This category also includes osteoarthritis, rheumatoid arthritis, and psoriatic arthritis.

Those with the most severe pain are at higher risk. That’s because the stress of pain can alter levels of feel-good brain chemicals like serotonin in ways that can trigger mood changes.

Depression can also lower your pain threshold, making the pain that accompanies chronic conditions like arthritis feel even worse, according to the Arthritis Foundation. As a result, people with arthritis and depression have more trouble with day-to-day activities and with taking care of themselves.

Cancer

Nearly 33 percent of people with cancer experience depression and anxiety. The chronic inflammation that accompanies cancer plays a role in depressive thoughts.  

What also contributes: the stress, grief, pain, fatigue, fear, and other emotions — including feeling like your life is no longer in your control. 

Lung conditions

Being diagnosed with chronic obstructive pulmonary disease, or COPD, doubles your risk of depression. Having asthma also raises your chances of developing the mood disorder. And the more severe your breathing problems, the higher your risk.

Not getting enough oxygen into the lungs can also trigger fatigue — as can depression. This combination can become debilitating, interfering with day-to-day activities and relationships with family, friends, and coworkers.

Heart disease

Up to 40 percent of people with heart disease also have depression or anxiety.

Living with depression can make heart disease worse — and may even increase your risk of heart disease-related death. Why? Experts say that depression can make following a healthy lifestyle, such as taking medications prescribed by your doctor and not smoking, more difficult.

Depression may also worsen heart disease by boosting levels of stress hormones, increasing chronic inflammation in the body.

Diabetes

People with diabetes are two to three times more likely to experience depression than those without it, according to the Centers for Disease Control and Prevention. And untreated depression can lead to decreased medication compliance, increased complications and higher chance of hospitalization.

The stress involved in maintaining healthy blood sugar levels every day can contribute, according to the American Diabetes Association. What can also contribute: the constant stress that comes from worries about developing diabetes complications like vision problems and kidney damage.

What’s more, high or low blood sugar levels can often look and feel like depression. They can make you feel anxious or tired during the day and interfere with a good night’s sleep. And not getting enough sleep can also make symptoms of depression worse. 

How to get the help you need

1. Ask about treatment options

Therapy such as cognitive behavioral therapy or antidepressants can ease depression even when you have other health conditions. Talk to your healthcare provider about these treatments.

2. Do your best to make healthy choices

Following a healthy diet, getting regular exercise and enough sleep, and learning a stress-soothing technique such as deep breathing can all support your mental and physical health.  They can also reduce feelings of depression. And think twice about drinking alcohol: It’s a depressant that lowers the amount of feel-good serotonin in your brain.

3. Get social support

Talking with, and spending time with, family and friends can be beneficial by reducing stress. What can also help: joining support groups for people who have been diagnosed with the same condition. These groups can provide a long-lasting network of like-minded people to rely upon.

Between therapy sessions, antidepressants, and just being able to talk with someone about how you’re feeling, you can get the help you need to start feeling better. Getting a handle on your depression may even motivate you to become more involved in your disease management, which can improve your overall prognosis.

Bottom line: Getting started in seeking the help you need can be difficult. But knowing when to reach out for help and taking that first step could make the biggest difference of all.