Lupus and Depression

In part 1 of our lupus blog series, we provided a basic understanding of what lupus is, and how it is diagnosed and treated. We focused on the various types of lupus in part 2. In part 3, we discussed how women with lupus can prepare for a safe pregnancy. As we continue our lupus blog series, we now turn our attention to a particular psychological aspect of lupus. Although the link between lupus and depression is controversial, we know that negative life events, lupus symptoms, and side effects from lupus treatments may be capable of contributing to clinical depression.

Life with Lupus can be challenging. While it is very apparent to note the physical signs and symptoms that Lupus produces, often times, we do not see the clandestine consequences that a patient suffers from within. It is natural for a person to become depressed. Causes of depression due to Lupus include the emotional drain from the stress of coping with the complications of physical illness. Furthermore, there are numerous economic, social, and workplace concerns. Quality of life is something that can never be overlooked. What type of life will a person have? Can she/he be able to maintain a sense of normalcy like those of an average person? Moreover, various medications used to treat Lupus—especially corticosteroids—may cause depression as their side effect. A Lupus flare also can trigger depression because one feels unwell, and because it may seem dealing with it is going to be an unending struggle. People who feel hopeless believe that their distressing symptoms may never improve. People who feel helpless believe they are beyond help—that no one cares enough to help them or could succeed in helping, even if they tried.

However, there is a difference between transient negative feelings, and feelings becoming so overwhelming and persistent that they signal a serious but treatable illness called clinical depression. Clinical depression is much greater than just feeling sad; it is a disorder of thoughts, feelings and behavior. These are among the most common psychological and physical symptoms of clinical depression:

• Feelings of helplessness or hopelessness
• Sadness
• Crying (often without reason)
• Insomnia or restless sleep, or sleeping too much
• Changes in appetite leading to weight loss or weight gain
• Feelings of uneasiness, anxiety, or irritability
• Feelings of guilt
• Lowered self-esteem or feelings of worthlessness
• Inability to concentrate or difficulty thinking
• Diminished memory and recall
• Lack of interest in things formerly enjoyed
• Lack of energy
• General slowing and clouding of mental functions
• Diminished sexual interest and/or performance
• Recurrent thoughts of death or suicide

Helpful Tips:

1. Seek psychotherapy. One should not be shy or hesitate to ask a doctor for a referral to a psychiatrist, psychologist, or therapist. Psychotherapy can assist one to have an understanding of all feelings, the illness, and relationships, and to cope more effectively with stress. Cognitive behavioral therapy, a special type of psychotherapy, can be very helpful. Support groups are another option that can be instrumental in helping with combating symptoms of depression.

2. Take antidepressant medications. Several types of drugs within this class can help ease the effects of depression. Anti-anxiety medicines are also available to reduce worry and fearful feelings. Talking with one’s primary care provider about such medications would determine if they are suitable to take them. In some people, improvements can occur in a matter of weeks once a medication is started.

3. Get more exercise. If a patient is physically able, take part in some sort of physical activity every day. This can be as simple as walking the dog, yard work or gardening, or strolling through the mall.

4. Keep self-talk positive, avoid negative self-talk. Whether we realize it or not, most of us talk to ourselves as we go about our day. What is said can have a big effect on one’s mood. For example, if you can’t do something because your symptoms are acting up, do not to blame yourself. Instead, remind yourself that you’re doing the best you can. Furthermore, tell yourself that you’ll do the activity another day when you’re feeling better.

5. Keep a list of ways to feel better. Create a list of things that make you feel happy and good. Some examples may include taking a bubble bath, calling a friend, watching a show or movie that you enjoy, reading, taking a walk or petting your pet. Keep this list handy and do one of these things if you start to feel down.

6. Be active living with Lupus. Staying active can also help your mood. If one is in pain or discomfort, even a little bit of activity can be meaningful. Some people with lupus also benefit from taking up an activity such as Tai Chi, elementary yoga or meditation. These can not only ease depression but also enhance physical health.

7. Diet and sleep are keys. Try to eat a well-balanced diet and aim for at least 6-8 hours of sleep each night. Additionally, it is key to curb tendencies to smoke and consume alcohol. Making strides in both these paths will foster a better attitude of one’s self.

Just as clinical depression develops over a long period of time, conquering it is a gradual process; it requires maximal sustained effort. However, most people with Lupus find that their overall attitude and sense of well-being are greatly improved.

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