Depression and Physical Illness
Triggers & Treatment of Low Mood in People with Physical Conditions
Jun 25, 2008
Although becoming physically unwell can affect people emotionally, depression is not a normal reaction to physical illness. Depression describes an illness of persistent sadness that significantly impacts on an individual’s ability to function. Fortunately, it can be treated.
Physical Illness and Diagnosing Depression
It may be difficult to recognize depression when a physical illness is present. This may be attributable to some of the following:
- Symptoms of depression may appear to be an understandable reaction to the physical illness.
- People with acute physical conditions will often experience adjustment issues, which may present similarly to depression.
- Physical symptoms of depression, such as fatigue, may be attributable to an existing physical condition.
- People experiencing symptoms of depression may not share their concerns.
The severity and duration of symptoms are key factors in making an appropriate diagnosis. In the US, the Diagnostic and Statistical Manual of Mental Disorders lists the criteria for making a diagnosis of depression.
People with physical illnesses may express non-persistent concerns regarding their condition, but this does not necessarily lead to depression. They may describe feeling out of control, angry and hopeless about the future.
Causes of Depression in People with a Physical Illness
The causes of depression are unknown, though biological and genetic factors may be relevant. In cases of depression where a physical illness is present, it may be caused or triggered by the following:
- The stress of coping with a serious and/or disabling physical illness and its treatment.
- As a direct result of physical illnesses or medications that cause symptoms of depression.
Around one third of people with physical illnesses are depressed, according to UK studies. It is a common illness and its occurrence may not necessarily be related to a present physical illness. There are risk factors that make some people more vulnerable, such as a history of depression, lack of support, substance misuse and other life stressors (e.g. divorce).
Treating Depression in People with a Physical Illness
Sometimes mild depressive symptoms do not require treatment and may be managed through self-help and reassurance from friends, family and health professionals. However, it is worthwhile visiting a doctor in order to seek a proper diagnosis and advice.
Depression can also be serious, requiring more specific intervention. People with physical conditions such as cancer, chronic pain, HIV and AIDS may be at increased risk of suicide. This should therefore be a consideration when treating people in this group.
Antidepressants are not always a straightforward option where physical illness is concerned. There are risks of adverse or unpleasant side-effects, and there is also the possibility of interactions with other medications. The available research, albeit limited, supports the use of antidepressants as a treatment for depression in people with physical illnesses.
Psychological treatments may also be an option for treating depression, especially when antidepressants are not appropriate. Such treatments may help people with physical illnesses developing coping mechanisms and may make them less vulnerable to more episodes of depression.
For more information, read Depression and Physical Illness, edited by Andrew Steptoe. This book is aimed at health professionals, exploring in detail the relationship between depression and medical disorders. People experiencing symptoms of depression should seek advice from a qualified health practitioner.
Sources
Depression in physical illness, Clinical Medicine, published: November 2006, authors: Rutley, A and Reid, S
Physical Illness and Mental Health, The Royal College of Psychiatrists, accessed: June 24th 2008, no author specified
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