Coping With the Coexistence of Depression and Chronic Illness

Coping with chronic illness is one of the most difficult paths anyone can walk. It is lonely; it is arduous, and it is exhaustingly, excruciatingly constant. Part of this, of course, due to the illness itself. However, another part of this is the grief associated with loss of our life as we previously lived it.

Any experience of grief, but particularly the unrelenting grief of chronic illness can be a trigger for depression and many studies have documented the coexistence of depression with chronic illness. One such study in 2001 stated, “Chronic medical illness is consistently associated with an increased prevalence of depressive symptoms and disorders.”

So aside from having to manage the myriad of day-to-day physical symptoms related to the chronic illness, management of the hurricane of emotion is essential. It is so because that same study stated, “recognition and treatment [of depression] are crucial; depression worsens the course of a chronic illness.”

But while it is well documented that many people with chronic illness also struggle with some degree of depression, it is often the forgotten piece of the chronic illness patient’s healthcare puzzle. What is worrisome is that the symptoms of depression are often overlooked, whether it presents as a mild dissatisfaction with the current status quo or whether it is a profound sense of helplessness and hopelessness that requires intensive treatment.

I think it is forgotten because the physical symptoms of the chronic illness take precedence. It is forgotten because the doctors that treat those symptoms are specialists who focus on those symptoms alone. It is forgotten because the symptoms of depression such as fatigue, changes in appetite, difficulty sleeping or poor concentration often overlap the symptoms caused by the chronic illness itself. It is forgotten because unpacking these emotions takes time, which the current healthcare climate has precious little to offer a patient. And it is forgotten because even our doctors might believe that being depressed during our chronic health battle is simply a natural consequence.

So how do those of us with chronic illness cope?

I believe the first and most essential part of coping is acknowledging and managing the emotional storm that accompanies chronic illness — the storm of fear, guilt, loss, anger, frustration, deep sadness and grief. All of these emotions can become toxic and lead to serious depression and further health complications if not expressed in a healthy manner. Even if you are not comfortable discussing your feelings, I think it is vital to acknowledge and convey them when you are coping with chronic illness.

Though you may already feel guilty for leaning on those close to us to physically assist you, sharing your emotional challenges can make those struggles easier to withstand. Connecting to others and remaining engaged in activities that bring you pleasure may help you manage both your physical and emotional health.

So I think it is important to continue to:

• Turn to family and friends. Now is when you need to lean on the people who care about you, even if you take pride in being strong and self-sufficient. Do not avoid loved ones, and accept the assistance that’s offered. Those who love you likely want to help, but often don’t know how to help. So you have to tell people what you need, whether it is simply a shoulder to cry on or help with the groceries. Knowing that you are well taken care of will help ease the worry of those who love you, improve your comfort, and will provide the kind of support that we all need.

• Draw on your faith if it helps you. If you follow a religious tradition, embrace the comfort its community can offer. Spiritual activities such as praying or meditating can provide solace for the pain, fear and anger we face, while going to group meetings and services can help prevent isolation.

• Express your emotions in a tangible or creative way. Write about your journey in a journal or a blog or find a different medium into which you can channel your feelings. Try creating a digital photo journal with photographs, or perhaps you would rather create a scrapbook. Take a free online course on your favorite hobby or learn something new. Each of these can help you manage the storm of emotion which in turn can make managing your illness.

• Of course, look after your physical health. Your mind is absolutely connected to your body. When you are emotionally stressed, anxious or uneasy, you may see those emotions manifest in physical symptoms. That is something we all have enough of without adding to them. Try to get sufficient sleep to combat stress and fatigue, maintain a healthy diet, and remain as physically active as possible. Each of these can boost your mood, which in turn could help ease some of your symptoms.

• Never let anyone tell you how you should feel. Your journey is your own, and no one else can tell you to “get over it.” Give yourself permission feel whatever you feel without embarrassment or fear of judgment. It’s OK to be angry, to yell at the universe and to cry. I think it’s also OK to joke and laugh, to find moments of happiness on your good days, and to build a new vision for the way your life is now and will be when you’re ready.

Even doing all of these things, you may still reach a point where everything is just too much to handle. Your illness may be causing a particularly bad episode, or some of your friends may not be understanding and make you feel guilty when you have to cancel plans. Perhaps you have come to the realization that you can no longer continue employment, or are utterly exhausted and facing another night of “painsomnia” is that final straw that you just cannot bear.

These all can be triggers for acute depression which requires attention from your doctors. Only you know where you are in your journey and what symptoms are “normal” or “abnormal” for you.

And while some doctors overlook depression or perhaps believe depression is a normal consequence of living and coping with chronic illness, it does not have to be your normal. Your battle with your chronic illness is more than enough for one person to fight, and you should not be forced to add to that struggle by not treating a condition that can be treated.

There is no reason for shame, no weakness in your capacity to cope, no inherent flaw of character that caused your need for help. You are stronger than most simply by virtue of battling your illness each and every day. Your illness has not gotten the better of you; it has simply given you a new curveball to manage. And you have done that before. In fact, you’re an expert at it!

So don’t ever be anxious or uneasy to reach out to qualified mental health professionals for help. You are valued and appreciated by those who love you, and you deserve to live the best life possible. That means acknowledging the dark and scary reaches of your mind and managing what you find there. And if you find depression there, you deserve to receive the necessary treatment to improve condition both physically, and emotionally.

Editor’s note: Any medical information included is based on a personal experience. For questions or concerns regarding health, please consult a doctor or medical professional.