Why is depression and anxiety so common in people with a chronic illness?

People diagnosed with chronic illnesses must adjust to the demands of the illness itself, as well as to the treatments for their condition. The illness can affect a person’s mobility and independence, and change the way a person lives, sees himself or herself, and/or relates to others. For these reasons, a certain amount of despair and sadness is normal. In some cases, a chronic illness may actually cause depression, which, though treatable, is a serious medical condition by itself.

Depression and anxiety are some of the most common complications of chronic illness. It is estimated that up to one-third of individuals with a serious medical condition experience symptoms of depression. Depression and illness may occur together because the physical changes associated with the illness trigger the depression, the individual has a psychological reaction to the hardships posed by the illness, or simply as a coincidence.

Which long-term illnesses lead to depression?

Any chronic condition can trigger depression, but the risk increases with the severity of the illness and the level of life disruption it causes. The risk of getting depression is generally 10 to 25 percent for women and 5 to 12 percent for men. However, those with chronic illnesses face a much higher risk -- between 25 and 33 percent.

Depression caused by chronic illness often aggravates the illness, especially if the illness causes pain, fatigue, or disrupts your social life. Depression can intensify pain. It causes fatigue and sluggishness that can worsen the loss of energy associated with these conditions. Depression also tends to make people withdraw into social isolation.

The rate for depression occurring with other medical illnesses is quite high:

• Heart attack: 40%-65%
• Coronary artery disease (without heart attack): 18%-20%
• Parkinson's disease: 40%
• Multiple sclerosis: 40%
• Stroke: 10%-27%
• Cancer: 25%
• Diabetes: 25%

Coping with chronic illness

Depression, disability, and chronic illness form a vicious circle. Chronic illness can bring on bouts of depression, which, in turn, can lead to a run-down physical condition that interferes with successful treatment of the chronic condition. Psychotherapy can break this cycle by helping you do the following:

• Learn how to live with the physical effects of the illness.
• Learn how to deal with the treatments.
• Make sure there is clear communication with your doctors.
• Keepinh emotional balance and coping with negative feelings.
• Maintaining confidence and a positive self-image.
• Taking action as soon as symptoms of depression appear.