Best Way to Understand the Relationship between Depression and Chronic Illnesses

Diabetes

Nearly one-third of people with diabetes experience some level of depression, ranging from mild to serious. Depres­sion and diabetes are related on several different levels. Depression appears to have a direct effect on control of blood sugar. Depression and stress can lead to hormonal changes that increase blood sugar and reduce the effect of natural insulin. Depression also makes it more difficult to manage diabetes effectively.

Taking steps like changing your diet, exercising more, and losing weight are difficult even when you’re feeling good and may seem overwhelm­ing when you’re depressed. Symptoms of diabetes can also contribute to depression. Changes in blood sugar level may cause fatigue and interfere with your concentration. Eye damage or nerve damage from diabetes may prevent you from doing some of the things you’ve always enjoyed.

Heart Disease

As many as 25 percent of people with heart disease may also experience depression. Depression is especially com­mon after heart attack or bypass surgery. Some of the rela­tionship between heart disease and depression is biolog­ical. Depression may affect stress hormones and blood clotting, leading to increased risk of heart disease. Psy­chological changes can play a major role as well. Heart disease often changes the way you think about yourself, and you may find yourself withdrawing from people and activities you’ve enjoyed. You may be fearful that “over­doing it” (even in a positive way) might be dangerous. Feeling depressed also makes it much more difficult to quit smoking or start an exercise program. It’s also easy to feel fatalistic or hopeless, thinking that the damage is already done so there’s not much point in making changes.

Arthritis

The central symptoms of arthritis are persistent pain and immobility, and it’s hard to imagine a more discouraging combination. Chronic or recurrent pain certainly con­tributes to depression, and feeling depressed makes any pain problem much harder to bear. Pain often interferes with sleep, another important influence on your mood and energy. Limits on your activities can contribute to the vicious cycle of depression: the less you do the worse you feel, and the worse you feel the less you do. For some peo­ple, arthritis medications (like prednisone) can also have a big effect on mood.

Stroke

A stroke is a brain injury, so it’s not surprising that depres­sion is common after stroke. Sometimes one or more small strokes (too small to cause obvious weakness or numbness in your body) can trigger depression. Major strokes are a devastating event and may severely limit your mobility, communication, and independence. Those major limitations may contribute to the vicious cycle of depression.