Anxiety and Depression with Chronic Illness, part 2
Anxiety or depression with chronic illness is not unusual
Many individuals who suffer from a chronic health condition experience some symptoms of anxiety or depression. There are several different types of both anxiety and depression. Yesterday, we discussed symptoms of some common forms. Please read part 1 if you are trying to identify symptoms of anxiety or depression. Thanks again to Karaleigh for guest posting.
Diagnosis with a chronic illness can trigger many fears as discussed in part 1. While most of our fears may not ever become reality, others could. These thoughts can sometimes lead to anxiety, panic or depression. Remember, if anxiety or depression is persistent and affects your life significantly, you cannot just snap out of it.
Ways to help fight anxiety and depression
Whether we are fighting a disorder or just a nuisance, it is important for us to learn ways of coping with these fears, anxiety and sadness. We must learn to laugh, schedule our time appropriately, sleep enough each night, take time out of our day to relax and recuperate from our activities, and ask for help. We must also remember to care for our physical health, so that we can be emotionally healthy.
Studies show it is important to have a good support system of friends, family, community and spirituality in order to cope with any physical or mental ailment. Simple things like pets can help: Studies also show that fish, cats, dogs, horses and other animals can decrease stress, anxiety and depression. Petting an animal actually will increase the chemicals released in your brain that make you happy! These endorphins are the same chemicals that are also released from eating chocolate or having sexual intercourse.
Needing help with anxiety or depression
It is okay to cry, scream or even ask, “why me?” These are normal – even healthy – reactions. It is when your reactions and emotions consume your life and affect your daily living that it is time to seek help. If you have tried and none of the usual methods help the anxiety or depression to pass, maybe you need outside help.
Treatment for anxiety or depression can include, counseling from a mental health professional and /or a spiritual advisor, group therapy, medications, or talking to a friend or family member. Some people also use alternative methods such as acupuncture, chiropractor, herbs and vitamins, yoga, Pilates, art therapy, exercise or even pet therapy to compliment other forms of treatment.
We can begin to change our focus by keeping a list of things that make us happy or that we can do when we are scared, anxious or depressed. Below is my list, feel free to borrow from it for your own list.
Things to do when I feel anxious or depressed:
- Take slow deep breaths
- Keep my thoughts realistic: Is it really the end of the world or just a bump in the road?
- Call a friend
- Play with my dogs
- Take my dogs for a walk
- Take a hot bubble bath, light candles and listen to soft music
- Take a nap or some chill time
- Watch a funny movie
- Write in my journal
- Sing
- Laugh
- Dance (even if I look silly or am alone in my house)
- Get a massage, facial, manicure, pedicure or hair done
- Go to my place of worship
- Pray
- Meditate
- Visualize myself on a beach relaxing
- Go for a drive
- Surround yourself with positive, supportive, loving people
- Remember that everything happens for a reason, even though we may not know what that reason is today
At this link you will find a self assessment of depression courtesy of Mayo Clinic. To find a counselor, therapist or mental health professional in your area, contact your local hospital, insurance company or doctor’s office for recommendations. You could also ask a friend or spiritual advisor if they can recommend someone.
If you have thoughts of death, dying or suicide, please call the National Suicide Prevention Lifeline at 800-273-8255 to talk to a trained counselor or go to your local emergency room. This number is good for anyone in the United States, is toll-free and is available to you 24 hours a day, 7 days a week, and 365 days a year.
For additional information on the following disorders please follow these links:
Recommended reading:
- Anxiety and Depression with Chronic Illness, part 1
- Losses of Rheumatoid Arthritis: Photos & Other Things
- Rheumatoid Arthritis Anger
- Be Your Own Counselor with Rheumatoid Arthritis
Thank you Karaleigh and Kelly for this important post. Adjusting to the idea of having a chronic disease was a hard pill for me to swallow. At first I was just so relieved and pleased to get a diagnosis and get treatment under way so I could feel better. That is a short lived feeling as reality sinks in and you discover you will never feel normal again. The tricky thing is, depression and anxiety do not usually happen over night. They can slowly creep over you like a fog, coloring your vision, and changing your perceptions. You may not feel extremely sad, or anxious, it may be very subtle. It can happen so slowly you don’t even recognize that you have changed. If you do notice, you may not quite grasp how you feel even though you may know it’s different. This is how it happened to me.
I didn’t act like the people on the depression commercials. I wasn’t lying in bed all day crying, or thinking of suicide. If something doesn’t feel right and keeps going on for weeks, this is the time to access what’s going on and talk to someone. A little help can go a long way and may just be a temporary bridge until you adjust to all the changes.
Thanks again Karaleigh for sharing your expertise with us.
Dear Ronda, you always leave the most thoughtful & helpful comments. I’m sure someone else will be helped reading this excellent description. I’m so lucky to have such smart readers.
I don’t know why we seem to need permission to get help with the RA monster, do you? maybe it’s that “lack of RA awareness demon” again?
Personally, as I shared in my comments on part 1, I did need help to deal with the grief & shock of it all – & I’d need a lot more of that help if it were not for friends like you who understand & try to help me feel understood. Thank you Ronda. :heart:
Thank you for this, Karaleigh, Kelly, and for your comment Ronda. As someone who had been dx with a manic depression before being dx with RA, this is a very important topic for me. I’ve been almost obsessive about learning how the two diseases interact lately – there aren’t really many people or sources that know about/deal with this topic.
Ronda, I experienced something very similar to your experience I think. My RA dx didn’t hit me at first, I was just happy to have one. I thought there would be treatments that would take care of it, and I thought I’d be able to get whatever help I needed to get those treatments (living in US). I continued to get reassurances from my RA doc that I would return to a state of normal, in which I could do anything I used to do. Well, over a period of 3 years, I’ve learned reality of it, and the depression/anxiety has worked it’s way into my life even more so than it had with just having manic depression. And it’s like you say, I didn’t wake up one day and not get out of bed, or cry all day – like the flip of a switch. Of course I’ve been getting help for some time b/c of “pre-existing depression”, but I definitely recommend for other RA’ers to not hesitate to seek out help… it’s helped me in a lot of ways. I think just forming the sentences with specific words and expressing them to another person can be very very beneficial.
This is a very important yet taboo subject. There’s all kinds of research that shows that chronic illness is associated with struggles with depression.
It is extremely difficult to tease out what is “an appropriate” level of grief in letting go of an old life that was fulfilling with accompanying concerns about an uncertain future after diagnosis of chronic illness. There is also a huge adjustment to being limited physically and to feeling unwell a lot of the time. The lines between having a disease such as RA, having depression, and simply adjusting to chronic illness are very blurry.
The questions from the BECK Inventory to evaluate depression is a case in point. Many of the questions, if answered honestly, have relevance to changes that occur with illness. For example, answering that I’m feeling old and unattractive when one’s face is puffed up from steroids and inflammation isn’t a distorted perception. So, if I answer that honestly then my score is increased lending weight to a diagnosis of depression. Being worried about physical illness is another question with potentially the same result. So, the diagnosis of depression is really muddied by changes that occur with chronic illness.
When I was a research assistant at a university, the research I was working on was about resilience. What are the factors that are associated with people adapting to potentially stressful life events? I think this focus is far more relevant to coping with chronic illness then trying to just label someone with another disease and throwing some medication at the problem. Counseling to help build resilience resources and/or awareness of resilience factors might help all of us focus on things we can do to improve the quality of our lives. Some of the factors that I discovered in the research about resilience include many of the points that Kelly made about this topic:
FACTORS LEADING TO RESILIENCE
developing or having a strong social network of support
certain personality characteristics such as efficacy or believing in one’s ability, a positive outlook, friendliness, intelligence, organizational skills
being involved in community activities
community supports – availability of appropriate services and access
financial resources
spiritual beliefs that are nourishing
feeling valued by others
I struggle with what might be labeled as depression a lot of the time and receive ongoing therapy. Adapting to such a drastic change in how my life has changed, what the future might or might not hold, social isolation, reduced energy and unrelenting physical symptoms, as well as dealing with a disease that is not well understood are all realistic challenges.
One of the resources I’ve found very helpful is:
http://www.alpineguild.com/COPING%20WITH%20CHRONIC%20ILLNESS.html
Also, cognitive behavior therapy techniques are very valuable to challenge one’s thoughts that often fuel depression. There are a lot of free resources about cognitive behavior therapy online and many counselors are now trained in CBT. Anti-depressant medications might or might not be appropriate in helping people adapt to chronic illness and low mood.
Certain philosophies such as Buddhism, Christianity, or A Course in Miracles have principles that help foster emotional well-being and challenge negative thoughts, feelings, and beliefs.
All-in-all, I think a focus on factors that will enhance our quality of life and well-being are far more important then trying to pathologize people who are struggling to cope with chronic illness. I appreciate writing this post, it is helping to lift my mood already : )