Woman dealing with depression because of her chronic illness

Coping With Depression and Chronic Illness

March 28, 2023

8 min.

The relationship between chronic illness and mental health is often overlooked. Learn more about the relationship between the two and about coping strategies for common mental health challenges that may arise with chronic illness.

By: Amanda Lundberg

Clinically Reviewed By: Dr. Don Gasparini

Learn more about our Clinical Review Process


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Table of Contents

What is the connection between chronic illness and depression?

Several medical and physical conditions can mimic depressive symptoms. For example, vitamin D is required for your brain to function properly, and according to the National Institutes of Health, one out of every four persons has blood levels that are too low or inadequate.

Other chronic physical conditions that affect mood and can mimic depression are hypothyroidism, hormonal imbalances, anemia, vitamin B12 deficiency, and diabetes. According to the Mayo Clinic, nearly twice as many women as men will be diagnosed with depression. In some instances, the gender gap is related to hormonal changes that have a significant effect on mental health. 

These changes  are influenced by premenstrual problems, pregnancy, postpartum, perimenopause, and menopause. However other life circumstances and cultural stressors also play a role in an imbalance between men and women, such as sexual or physical abuse, and the higher likelihood that women live in poverty and have reduced access to healthcare.

Several chronic physical conditions have a high association with mental illness, including depression. Some experts estimate that up to one-third of persons with a serious medical condition have symptoms of depression. 

The necessity to adjust to the illness and treatment, as well as the way a chronic illness affects an individual’s mobility, independence, and ability to relate to themselves and others can increase the risk for poor mental health. Chronic diseases that have a higher rate of depression than others include:

  • Heart attack
  • Stroke
  • Cancer
  • Diabetes
  • Coronary artery disease
  • Parkinson’s disease
  • Multiple sclerosis
  • Substance use disorder

Why is depression common in people who have a chronic illness?

In addition to persons with chronic diseases having a higher risk of developing anxiety and depression, researchers have also found women and younger men who have anxiety and depression are more likely to develop certain types of chronic illness. 

One retrospective study gathered data from 40,360 adults living in Minnesota and found an increased risk for congestive heart failure, stroke, arthritis, asthma, and diabetes in those who reported mental health conditions like depression and anxiety.

Studies have also found persons with depression and anxiety have an increased risk of general medical illnesses. This suggests that mental health conditions can increase the risk of chronic illnesses beyond that which is associated with each illness individually. In other words, comorbid depression increases the risk of chronic illness and chronic illness increases the risk of depression.

While everyone experiences occasional feelings of sadness, depression is a serious medical illness that can affect the way a person thinks and acts. There is a strong link between depression and different types of heart disease, including high blood pressure. That risk can double when a person also has Type 2 diabetes or obesity, both of which are associated with heart disease.

According to the National Institute of Mental Health, depression is one of the most common mental illnesses in the U.S. and affects adult women (10.5%) more than men (6.2%). The highest prevalence is in individuals aged 18 to 25. There are an estimated 21 million adults who have reported at least one major depressive episode, which represents 8.4% of all U.S. adults.

Behavioral health treatment options for treating depression are effective in helping people to overcome challenges, manage their illnesses, and be productive. Chronic illnesses often create chronic stress in people’s lives, which in turn contributes to mental health conditions like anxiety and depression. 

Primary care mental health is about providing mental health services as close as possible to where the patient lives or works. The growth of online mental health resources has expanded mental health depression treatment options well beyond the immediate community and can provide care for persons who live in areas where mental health providers are not easily accessible.

Coping with a chronic illness can feel like a never-ending battle. It’s okay to feel frustrated, angry, and overwhelmed. But sometimes those feelings are consuming and trigger devastating depression. You may feel like you’re in over your head, but when you work with a skilled and experienced mental health professional, they will help you find a brighter future. 

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How do you deal with chronic illness emotionally?

Most people with chronic conditions sometimes find it difficult to handle their emotions. These emotions can spiral out of control, leading to worry, fear, and frustration. Prolonged anger, frustration, and stress have negative effects on social, physical, and emotional health.

Chronic disease and illness also present unique mental health challenges. Among the chronic illnesses that increase the risk for depression are chronic fatigue syndrome and chronic pain, which is often secondary to an underlying disease. Living with daily pain is physically stressful and can change neurochemicals that affect your mood, thinking, and behavior.

Chronic pain conditions that can affect your mental health include arthritis, fibromyalgia, multiple sclerosis, chronic migraines, menstruation-related pain, and back and neck pain. You can develop effective strategies that facilitate coping with chronic pain while working with a skilled mental health professional.

Pain may also be a common symptom in people with an anxiety disorder. According to the American Psychiatric Association, functional imaging studies have suggested that chronic pain and mental illness share biological pathways that contribute to the connection. 

An important tool for dealing with difficult emotions is effective communication. Yet, while this is a valuable tool, it does not come naturally to many people. However, it is a skill that nearly anyone can learn and use when they work with a qualified mental health therapist.

Without help, you may find your thoughts and emotions uncontrollable. These intense emotions can worsen your physical health and increase your pain. This sets up a vicious cycle in which your mental health worsens your physical health, and as your physical health declines, so does your mental health.

Male dealing with the emotional toll of his chronic illness

What is depression?

People who have experienced deep sadness may think they understand depression, but this isn't usually the case. Symptoms of clinical depression can vary from very mild to severe, must last at least two weeks, and cause a change in your ability to function to meet the diagnostic criteria for depression. Some symptoms of depression include:

  • Feeling empty or hopeless
  • Feeling irritable, restless, or easily frustrated
  • Feeling worthless or helpless
  • Loss of energy or fatigue
  • Difficulty concentrating, mental fog
  • Insomnia or oversleeping
  • Change in appetite
  • Physical pain, digestive issues, or headache
  • Thoughts of death or suicide

People have described clinical depression as:

  • “Like the worst day of your life. Every day.”
  • “Like someone else having the remote control and constantly switching channels.”
  • “Torture … hell inside your mind.”
  • “Like dragging around massive stones.”
  • “It's an iron fist pushing you down, into a tunnel, gasping for breath.”

Although most people who experience depression are unable to see how the feelings can end, there are effective depression treatments that allow a person to live a satisfying and productive life while coping with a chronic disease.

It is crucial that you treat depression as a serious medical condition and you do not try to diagnose or treat yourself. The four major diagnostic forms of depression are seasonal affective disorder, bipolar disorder, major depression, and persistent depressive disorder

In some cases, clinical depression can develop due to a specific circumstance, such as postpartum depression or seasonal affective disorder (SAD). In the case of seasonal affective disorder people may begin feeling depressed as the days get shorter in the fall and winter. This is the result of altered body rhythms or declining exposure to sunlight.

There are two common forms of depression: persistent depressive disorder and major depressive disorder. People who experience major depressive disorder or severe depression have at least one major depressive episode with five or more symptoms that last at least two weeks. The symptoms cause intense emotions and can be debilitating.

Persistent depressive disorder was once called "dysthymia," which refers to mood changes that last for at least two years. People with persistent depressive disorder feel low or joyless much of the time but are able to function day to day.

What are examples of chronic illnesses?

According to the National Institute of Mental Health, cancer, heart disease, and diabetes increase the risk of a mental health illness such as depression or anxiety. Suddenly facing new limits and treatment outcomes can raise stress levels and make it hard to cope and adapt to life changes. 

In other circumstances, the risk of depression is directly related to the illness. For example, a stroke or Parkinson's disease causes changes in the brain that can play a direct role in triggering symptoms of depression. Researchers have suggested that people with depression and other medical illnesses tend to experience more severe symptoms, have more difficulty adapting, and may have higher medical costs. 

Even when other illnesses are present, depression is treatable and by reducing symptoms of depression you can positively impact other chronic health conditions. According to the Centers for Disease Control and Prevention, six out of every 10 adults have a chronic disease and four out of every 10 adults have two or more. 

Chronic disease is broadly defined as a condition that lasts at least one year and requires ongoing medical attention. It can limit activities of daily living and increase your risk of premature death. Examples of chronic diseases include heart disease, cancer, stroke, chronic respiratory diseases, diabetes, Alzheimer's disease, and chronic kidney disease. 

The rise in chronic disease is a public health concern as the conditions lower productivity in the workplace and increase medical health costs for the community. Chronic health conditions like cardiovascular disease are the focus of health promotion programs aimed at education and lifestyle changes.

Lack of accessibility can make rural health chronic disease prevention and treatment programs more challenging. Yet the growth of telehealth diagnosis and treatment programs has leveled the playing field in areas where skilled mental health professionals may not have been available.

Do you need more support with
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How Charlie Health can help

It’s vital to prioritize mental health since it is intimately related to physical health, quality of life, and productivity. With proper treatment from mental health experts at Charlie Health, individuals can develop healthy coping strategies and reduce the negative effects of overwhelming stress.

Charlie Health’s virtual Intensive Outpatient Program (IOP) integrates personalized facilitated groups, individual therapy, and family therapy to comprehensively address the underlying triggers for depression and anxiety. It doesn't happen all at once, but small changes lead to big improvements and that's what Charlie Health is here to do - to help you make those changes and support you along the way. Together our skilled therapists help you find a way to improve your quality of life. There is a connection between chronic illness and depression and that connection typically responds to supported groups, individual therapy, and family therapy.

Effective care is available at home to support healing and growth. Our Admissions Team is available now, 24 hours a day, 7 days a week, to discuss your needs. Contact us today.

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