Could a Health Condition Be Causing Depression?

With a condition such as diabetes, chronic obstructive pulmonary disease (COPD), arthritis, high blood pressure, or others there are typically a set of symptoms you can expect, or at least be aware of, like weight gain or loss, inflammation, or fatigue.

Although depression doesn't just "come along" with having a health issue, it's critical to acknowledge that having chronic health ailments like these can directly contribute to feelings of sadness. A 2018 Epidemiology and Psychiatric Sciences study found that certain depressive episodes were associated with having a chronic condition—especially those that involve inflammation and pain.

While there's not a direct link between having a condition and depression, it's important to talk to your doctor. Here’s how to tell if your condition might be causing feelings of sadness, and what you can do to feel better soon—mentally and physically.

The Connection Between Conditions and Depression

The stress and anxiety of coping with a chronic condition—whether you’ve just received a cancer diagnosis, are living with joint pain, or are trying to keep your blood sugar or blood pressure under control every day—can raise the risk of having depression. But recent studies also suggest that inflammation plays an important role in depression, too. And it may explain why depression itself can boost the risk of some health conditions or make them worse.

In a 2016 study published in The Journal of Clinical Psychiatry, researchers found that people with depression had 31 percent higher levels of an inflammatory compound called C-reactive protein than that of people without depression. Meanwhile, depression can boost inflammation levels and may contribute to the development or worsening of health problems, according to a 2013 review from Meharry Medical College. Researchers have also found that depression can disrupt the human stress response and change levels of brain chemicals, such as serotonin and norepinephrine, in ways that may cause blood clots, high cholesterol, obesity, high blood pressure, and high blood sugar.

Conditions Most Likely to Contribute to Feelings of Sadness

Although medical experts know more than ever about the links between physical health conditions and depression, many people who are coping with both are not getting the help they need. Health conditions that have been linked to a higher risk of depression include Alzheimer’s disease, arthritis, asthma, cancer, COPD, diabetes, heart disease, and stroke. Here are the details about some of the most common ones:

• Arthritis: Rates of depression are two to ten times higher in people with arthritis and arthritis-related conditions, than in those without one of these painful conditions (this category also includes osteoarthritis, rheumatoid arthritis, psoriatic arthritis, lupus, fibromyalgia, and others). Those with the most severe pain are at a higher risk. That’s because the stress of pain can alter the levels of brain chemicals such as serotonin, cortisol, and epinephrine in ways that can lead to depression. And it’s a vicious circle: Depression can lower your pain threshold, making your arthritis feel even worse, according to the Arthritis Foundation. As a result, people with arthritis and depression have more trouble with day-to-day activities and taking care of themselves.
• Cancer: Up to 40 percent of people with cancer experience depression. Stress, grief, pain, fatigue, fear, and other emotions—including feeling like your life is no longer under your control—can all contribute to that.
• Lung conditions: Having COPD doubles your risk of having depression, and asthma raises it by about 60 percent, researchers report. Having more severe breathing problems may raise the risk even more. For COPD, smoking likely plays a role, perhaps by boosting levels of anxiety. Depression can increase fatigue, interfere with day-to-day activities, and affect relationships with family, friends, and coworkers.
• Coronary heart disease: Up to 30 percent of people with heart disease have depression. Living with both can worsen your heart disease and even increase your risk of a heart disease-related death. Experts say that’s because depression can make following a healthy lifestyle, taking medications prescribed by your doctor, and not smoking more difficult. However, depression may also worsen heart disease by boosting levels of stress hormones, increasing inflammation, and affecting your nervous system.
• Diabetes: One in four people with diabetes will experience major depression, according to the Centers for Disease Control and Prevention. The stress of maintaining healthy blood sugar levels every day (by eating healthy meals, exercising, and taking your medications), along with worries about diabetes complications, can increase the chance of depression, according to the American Diabetes Association. In addition, high or low blood sugar levels can look and feel like depression, which can make you feel anxious or tired during the day and interfere with a good night’s sleep.

How to Get Help

Step 1: Recognize the signs of depression. Talk with your doctor if you notice any of these symptoms:

• Fatigue and low energy
• Not getting pleasure from hobbies or activities you usually enjoy (this is a major sign of depression)
• Sadness
• Irritability
• Anxiousness
• Feelings of emptiness, hopelessness, guilt, or worthlessness
• Difficulty concentrating and making decisions
• Sleeping too much or not being able to fall asleep or stay asleep
• Eating too much or not wanting to eat

Get help immediately if you have thoughts of death or suicide, or if you have attempted suicide in the past. (If you’re having suicidal thoughts, call the 24/7 National Suicide Prevention Lifeline at 1-800-273-8255.)

Step 2: Ask about treatment options. Treatments can ease depression even when you have other health conditions. Your doctor may recommend talk therapy, such as cognitive behavioral therapy, or antidepressants.

Step 3: Do your best to make healthy choices. Following a healthy diet, getting regular exercise and enough sleep, and learning a stress-soothing technique such as deep breathing can all support your mental and physical health and alleviate feelings of depression. Also, think twice about drinking alcohol: It’s a depressant that lowers the amount of feel-good serotonin in your brain.

Step 4: Get social support. Talking with a close friend or trusted family member about your feelings can help ease stress when you’re coping with the challenges of a medical condition.

For any questions regarding mental health coverage, benefits, or providers, please call the Mental Health/Substance Abuse phone number on the back of your member ID card.