By Dr. Lara Stepleman, Psychologist
MCG Health System

When you’re dealing with a chronic illness, feeling depressed and sad may seem natural. You may not even think about getting treatment.

Unfortunately, ongoing depression related to chronic disease remains undertreated. Some estimates find that up to half of all patients with chronic illnesses such as diabetes and heart disease suffer from ongoing depression, compared to 2 to 15 percent of the general population. Recognizing the signs, and getting treatment early, are the most important things you can do to help you cope successfully with your illness and get on with the business of living life.

If You Have a Chronic Illness

Ongoing depression doesn’t mean occasional feelings of fear, anger, anxiety, numbness or sadness. Ongoing depression has persistent symptoms that last for longer than two weeks. These include:

• Depressed mood. This can look like sadness, numbness, emptiness, even irritability.
• Decreased interest and pleasure in doing things that used to be important and fun.
• Weight changes of five percent or more in a month.
• Sleep changes, including sleeping all the time, or difficulty sleeping.
• Feelings of agitation or restlessness, or of being slowed down.
• Fatigue or loss of energy.
• Worthlessness and guilt. Patients with chronic illness often blame themselves for what they did or didn’t do to cause their illness. They may feel guilty for not being able to do activities like playing with children.
• Cognitive changes, such as difficulty making decisions or remembering things.
• Thoughts of death or suicide

If you think you need help, let your health care provider know what’s going on. The key is to get treatment early and learn appropriate coping strategies. Social support is also helpful and can include:

• Talking about your illness
• Keeping the lines of communication open with your partner
• Staying focused on the future and positive aspects of life
• Not allowing the illness to define you
• Finding things you can do, enjoy, and find meaningful
• Joining a support group
• Coping spiritually through prayer and talking to a spiritual advisor

If You’re a Friend or Family Member

Know that allowing your loved ones to express their frustrations and other feelings is often helpful. But sometimes people may also just want to be with friends and family and do activities that do not focus on illness. This provides a sense of normalcy in their lives. Going out to dinner or a movie and talking about the latest entertainment news, politics or hometown gossip can offer a welcome distraction.

You should also know that those affected also sometimes push people away, especially when they feel physically and emotionally worse. You can respect that and give them some time, but continue to keep in touch and offer support. While the desire for social activity and support will fluctuate, most eventually seek out friends and family, especially those who continue to make themselves available.

If You’re a Caregiver

Depression is not just limited to those with chronic illness. It’s estimated that up to 20 percent of caregivers also experience depression, which is two to three times greater than the general population. The stress of so many responsibilities and watching a family member deteriorate are the most common causes. If you’re suffering from caregiver-related depression, you should:

• Seek treatment.
• Schedule respite time. Don’t be the only caregiver. Hire a professional caregiver or ask other family members to help.
• Take care of yourself. It’s important that you spend time with others, doing things that you enjoy.
• Give yourself permission to rest.  As a caregiver, you need your time to rejuvenate. And don’t feel guilty about needing this time for yourself. You’ll come back and be a better caregiver for it.

Whether you suffer from depression, or you are the friend, family member or caregiver of one who does, a mental health professional can provide help, treating not only depression, but also offering guidance on issues such as: how to talk to friends and family about illness, thinking through important decisions, strategies to help you follow through on difficult or uncomfortable medication or treatment regimes, sleep hygiene, pain management and lifestyle changes such as smoking cessation.

The goal of successful therapy for those with chronic disease is to create the highest quality of life possible given the constraints of the illness. What life was like before illness could be considered the old yardstick. As long as you measure your new life to the old yardstick, you’ll be disappointed. But with therapy and support, you can make the new yardstick the best one it can be.

MCG Health System is composed of three organizations - MCG Health Inc. and the clinical services offered by the faculty of the Medical College of Georgia and the members of the MCG Physicians Practice Group.  MCG Health, Inc. is a not-for-profit corporation operating the MCG Medical Center, MCG Children’s Medical Center, the MCG Sports Medicine Center, MCG Ambulatory Care Center, the Georgia Radiation Therapy Center and related clinical facilities and services.  MCG Health, Inc. was formed to support the research and education mission of the Medical College of Georgia, and to build the economic growth of the CSRA, the state of Georgia and the Southeast by providing an environment for delivering the highest level of primary and specialty health care.  For more information, please visit www.MCGHealth.org.