The Connection Between Lupus and Depression
Depression, anxiety and lupus can, unfortunately, go hand in hand. There is some evidence that lupus itself can cause these distressing disorders, whilst other times, the medication used to treat the illness can cause lupus patients to feel down in the dumps or anxious. On top of that, add the uncertainty of lupus, especially in the middle of a flare, and you’ve got the perfect recipe for situational depression.
Up to 60 percent of people with lupus experience clinical depression. Lupus is closely associated with depression for several reasons:
- Lupus and its symptoms often bring about feelings of helplessness and hopelessness.
- Research indicates some medications used to treat lupus, like corticosteroids, have been associated with depression.
- Lupus symptoms may be confused for anxiety, coming with fatigue and tightness in chest.
- Loss of function from lupus can bring about feelings of loss and the grief.
For me, my struggle with anxiety and depression began way before my lupus symptoms began to present themselves. I began to experience clinical depression as young as 13 and then began to have full-blown panic attacks after witnessing a particularly distressing event in college. I have been able to control a lot of the symptoms with medicine, but that doesn’t solve everything.
My anxiety manifests in the form of what is termed “health anxiety," which is a horrible thing to mix with a chronic illness. This means that I am prone to worrying excessively or even working myself into a panic attack over feeling ill, seeing the doctor, or having procedures done.
Not long ago, I had a minor operation and awoke from surgery with a panic attack. Of course, since an elevated heartbeat can be a symptom of a major complication, the doctors and nurses took it pretty seriously, which made me even more nervous.
Likewise, depression can strike when you’re at your worst, making you feel even worse physically. Although I suffer back and forth from depression even when I’m not ill, having to lie in bed all day due to fatigue or ill health makes my self-esteem plummet.
I often feel like I’m a failure, or that I’m never going to be able to support myself in a job, even though I am attempting to carve out a niche for myself that allows me to work with my symptoms.
And the depression and anxiety can get scary. Like, really scary. Some days, I have had anxiety so badly that I thought I was actually going to die. Other days, the fog of the depression got so bad that I wanted to die.
At times, it feels like I mentally can’t go on, which isn’t something that is often talked in regards to those of us who are chronically ill. We are supposed to be heroes and inspirations to those around us, but in reality, there is no other choice but to carry on. And that only choice is a tough road.
Anger Turned Inward
With chronic illness, sometimes our depression is anger turned inward. At times when you’re feeling low, it is often a natural progression for your self-esteem to eventually plummet and feel as though you’re a burden to all of those around you.
I often feel as though I am “ruining people’s lives" just by being in them, but I have to constantly remind myself that the people in my life love me despite my illness, otherwise they would have abandoned me a long time ago.
In the past, my depression has gotten so bad that I have had to be hospitalized, which isn’t something I am very proud of because of the stigma surrounding it. In fact, it is something I am downright ashamed to admit. However, knowing the consequences of serious depression (having had a close friend of mine commit suicide), I know I did the right thing.
Seeking professional help when dealing with severe anxiety and depression related to lupus is extremely important. And it is important that you see a doctor or a counselor who understands (like, actually understands) that you have a chronic illness.
I have had depression since I was virtually a child, so I have had doctors ask if antidepressants have helped my lupus symptoms, assuming all of my problems were related to depression. Sometimes depression can cause physical symptoms like headaches and fatigue, and it is important that you are seeing a professional who understands that while that is true, you do have a chronic physical illness as well.
It is also important to see a counselor or therapist who is educated in helping you accept both your illness and the depressive feelings that either come and go or that are lingering for a long time. Although it can hard to cope with, remember that depressive feelings are quite normal when you’re dealing with an illness that cannot be predicted from one day to the next.
This isn’t like the flu where you know what the symptoms are going to be and know you’ll feel miserable for a few days and then feel better. Lupus is the unknown, and that is scary.
Uncertainty and Anxiety
The sheer uncertainty can also translate to anxiety as not knowing what is going on with your own body can be very scary. Many people with lupus have symptoms that are ultra-frightening, such as swelling around the heart or in the chest that is quite benign, but feels life-or-death in the moment. Additionally, hearing stories about people with lupus who have either died or had to spend weeks in the ICU can tap into your fears about your health.
These fears can then be translated to fears and phobias that have nothing to do with health and can cause symptoms that are equally as crippling as lupus. If untreated, sometimes the anxiety can develop into the inability to leave the house for fear of infection, or any other phobia.
Dealing with anxiety is also tricky, but seeing a counselor specially trained in it is also ideal. Luckily, many counselors are trained in both depression and anxiety and the two disorders are closely related. A counselor or professional can really help you begin to identify thought patterns that spiral out of control and lead to bouts of anxiety or depression, and coping mechanisms that relate to your specific issues.
They may even be able to help you cope with nervousness and depression that goes with long hospital stays and help you find strategies to stay both calm and positive. If your anxiety is severe, you may be referred to someone who can prescribe you medication to “get you over" the hardest portion.
Keeping on Top
Anxiety and depression that is fleeting or very mild may not need to be treated with medicine or prolonged visits to a counselor, but it is important to be on top of it. Journaling your feelings in your lupus journal so you can see patterns and develop different thought patterns is helpful, as is gentle exercise.
The latter can be difficult when also trying to cope with lupus, but if you can, simple things like doing a meditative yoga DVD (or following along with a video on YouTube) or taking your dog out for a walk can help ease your mind.
Take care of your body. How are you sleeping? Sleeping eight hours each night gives your body an opportunity to recharge from the previous day. What about your diet? The foods you eat have a direct impact on how you feel. Ask your doctor or consult a professional to find the diet that is best for your symptoms.
Stay social. Isolation may feel like a good idea. You are tired, and your energy is low, but people with lupus benefit from social interaction, just like everyone else. Make plans with friends, chat online, join a support group and use the phone. Consider a pet! A companion can make your bad days feel brighter.
Take care of your mind. Be kind to yourself. With depression comes low self-esteem and negativity. Treating yourself as if you would a friend can change this mindset.
Although you may feel as though you are leaning on your family and friends too much, it is important to identify people who will listen to you and support you through your dark times. This may be a friend, family member, or it may help to join a support group for either lupus or anxiety and depression.
If you are not feeling physically ill with lupus symptoms during a bout of anxiety or depression, it is also important not to allow yourself to lie in bed excessively and to continue doing the activities you enjoy. While it may be difficult, it is worth it in the end. If your anxiety and depression is interfering with your everyday life, talk to your general practitioner or rheumatologist about strategies or referrals.
If you ever feel your anxiety or depression is truly out of control and you are in a crisis situation, do not hesitate to go to your nearest emergency room or call your local suicide hotline.