Some chronic diseases, such as heart disease, COPD and diabetes have all been linked to depression. This probably doesn’t surprise you. After all, these diseases are frightening, they are difficult to manage and can cause significant suffering and eventual death. It is for this reason that the symptoms of depression are sometimes ignored.
Research on COPD and depression has found that some medical providers don’t pay attention to the diagnosis of depression and only focus on the disease. They may believe that if the symptoms of the disease improve, then the depression will lift on its own. Similarly, patients sometimes neglect to tell their medical provider about their symptoms of depression, believing that they are logical and maybe even expected given their state of health. The problem with both assumptions is that they are not necessarily correct.
Research has not found a cause and effect relationship between COPD and depression. In other words, just because you have COPD doesn’t mean that you will automatically develop a clinical depression. Your risk of depression may be increased, but that doesn’t mean that you must accept it.
People who have COPD and clinical depression actually have higher mortality rates than those who have COPD alone. This is because depression may affect the person’s motivation to do the things that will help their medical condition. For example, they are less likely to agree to quit smoking, less likely to be proactive with pulmonary rehabilitation, and less likely to do other pro-health behaviors. Because of these outcomes, it is very important that the depression be treated and not ignored.
Now, does this mean that people who have a chronic disease like COPD won’t experience any kind of emotional pain or sadness? No, they very likely will. As indicated before, these are not fun conditions to have. But it’s important to remember that there are significant degrees of difference between sadness and clinical depression. One is normal and something everyone experiences in different degrees depending on what we are facing, and one is not normal and something that should be treated aggressively.
As mentioned at the beginning of the article, heart disease and diabetes have also been linked to depression. In fact, some studies show that up to 33% of people who have experienced a heart attack will develop depression at some level, and another study found that having diabetes as an adult literally doubles your chances of developing depression. But again, even though there is a strong link between these diseases and depression, it doesn’t mean that you will definitely develop it or that it should be left untreated.
Not only does the existence of depression make the treatment of a chronic disease more challenging, but it can also have a strong negative impact on the person’s quality of life — something that people want to hold on to for as long as they can.
Here is your takeaway: If you have one or more of these chronic diseases, you absolutely do not have to just “accept” clinical depression as part of it. Talk to your medical provider about your symptoms. If you have depression, then insist on some type of treatment. That could mean taking medication, receiving counseling, or both.
You may also want to consider support groups, and finding useful resources online from organizations like the American Heart Association, American Diabetes Association and the American Lung Association. All of these sites discuss depression, how it can impact your condition and what you can do about it.
If you choose to engage in counseling, you may want to ask your counselor if they also help people meet certain health behavior goals while also addressing the depression. For example, if you are a patient with heart disease who is having difficulty staying motivated to exercise, this very well may be something a counselor can help you with. Doing positive health behaviors may not only help your chronic disease condition, but also your depression symptoms, as well.
American Heart Association. (2014). Depression after a cardiac event or diagnosis. Retrieved from http://www.heart.org/HEARTORG/Conditions/More/MyHeartandStrokeNews/Depression-and-Heart-Health_UCM_440444_Article.jsp#.V50rOvkrLIU
Anderson, R.J., Freedland, K.E., Clouse, R.E., & Lustman, P.J. (2001). The prevalence of com;orbid depression in adults with diabetes. Retrieved from http://care.diabetesjournals.org/content/24/6/1069
Cafarella, P.A., Effing, T.W., Zafar-Ahmad, U., & Frith, P.A, (2012). Treatments for anxiety and depression in patients with chronic obstructive pulmonary disease. A literature review. Respirology, 17, 627-638.
Janssen, D.J.A., Spruit, M.A., Leue, C., Gijsen, C., Hameleers, H., Schols, J. MGA, & Wouters, E.F.M. (2010). Symptoms of anxiety and depression in COPD patients entering pulmonary rehabilitation. Chronic Respiratory Disease, 7(3), 147-157.
Yohannes, A.M., Hann, M., & Sibbald, B. (2011). The management of depressive symptoms in patients with COPD: A postal survey of general practitioners. Primary Health Care Research & Development, 12, 237-244.