What is a chronic illness?
A chronic illness is one that lasts for a very long time and usually cannot
be cured completely. Examples of chronic illnesses include diabetes, heart
disease, arthritis, kidney disease, HIV/AIDS, lupus, and multiple sclerosis.
Many of these conditions can be improved through diet, exercise, and healthy
living, in addition to medication.
Why is depression common in people who have a chronic illness?
Depression is one 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. People diagnosed with chronic illnesses must
adjust to the demands of the illness as well as to its treatment. The illness
may affect a person’s mobility and independence, and change the way a person
lives, sees him- or herself, and/or relates to others. These requirements can be
stressful and cause a certain amount of despair or sadness that is normal.
In some cases, having a chronic illness can trigger clinically significant
depression, a potentially serious but treatable illness itself. The challenge
for the doctor and the patient is to decide whether symptoms of depression are
just a normal reaction to the stress of having a chronic medical condition, or
so intense or disabling that they require additional specific antidepressant
Which long-term illnesses lead to depression?
Any chronic condition can trigger depression, but the risk increases with
the severity of the illness and how much disruption it causes in one’s life.
Depression caused by chronic illness can in turn aggravate the illness,
causing a vicious cycle to develop. Depression is especially likely to occur
when the illness is associated with pain, disability, or social isolation.
Depression in turn can intensify pain, fatigue, and the self-doubt that can lead
to avoidance of others.
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%
What are the symptoms of depression?
Patients and their family members often overlook the symptoms of depression,
assuming that feeling depressed is normal for someone struggling with a serious,
chronic illness. Symptoms of depression such as fatigue, poor appetite, impaired
concentration, and insomnia are also common features of chronic medical
conditions, adding to the difficulty of deciding whether they are due to
depression or to the underlying illness. When depression is present, it is
extremely important to treat both the depression and the chronic medical illness
at the same time.