Depression can be a common manifestation in people with lupus. It is often difficult to determine whether depression is an integral part of lupus (as it is in some patients), where management of the lupus itself often lifts the depression, or whether the depression has arisen in response to having a chronic and painful illness, or if it is an unrelated psychological condition.
Symptoms of clinical depression
People are considered depressed when they have any of the symptoms listed below that last for more than a few weeks and disrupt daily life.
· 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 or regret
· Lowered self-esteem or feelings of worthlessness
· Inability to concentrate or difficulty thinking
· Diminished memory and recall
· Indecisiveness
· Lack of interest in things formerly enjoyed
· Lack or energy
· General slowing and clouding or mental functions
· Diminished sexual interest and/ or performance
· Recurrent thoughts of death or suicide
Clinical depression may not be recognised in people with lupus because its symptoms and the symptoms of active lupus can be so similar. For example, lack of energy, trouble sleeping and diminished sexual interest can be attributed to lupus itself, although they are also symptoms of clinical depression.
What can you do?
The management of depression in lupus rests on a combination of treating the underlying symptoms in addition to other therapies such as;
Counselling and Psychological Therapies
Clinical depression generally improves with a combination of therapy and medication. If you feel that you have the symptoms of clinical depression then please discuss this with your consultant who can refer you to a psychologist or therapist. This type of talking therapy can help you understand your feelings and your illness, and to cope more effectively with stress.
Antidepressant medicine
There are several types of antidepressant medications available which help to ease the effects of clinical depression. In some people, improvements can occur in a matter of weeks once medication is started.
Strategies to reduce pain
Chronic pain from lupus can be a factor in the development of depression. In addition to other treatments, some people find that activities such as yoga, Tai Chi, Pilates and meditation help to ease their pain which in turn decreases the symptoms associated with clinical depression.
Exercise
If you are physically able to then take part in some sort of physical activity every day. Exercising releases endorphins which reduce your perception of pain and trigger a positive feeling in the body. This could be as simple as going for a walk, doing the house work or gardening.
Improve sleep habits
Disturbed or reduced sleep can lead to symptoms of clinical depression. To improve your sleep aim to get 7 to 8 hours per night and avoid caffeine, nicotine and alcohol several hours before bedtime. Make sure that you are comfortable when you go to bed, consider your mattress, bed linens, room temperature and lighting. If you need to then take opportunities to rest throughout the day, ensuring that this does not disrupt your sleep at night.
Build a support network
Family, friends and colleagues all form part of your network. Make sure that those around you understand your condition to reduce feelings of uneasiness, anxiety and guilt. Your consultant forms part of your network too, which is why it is important that they understand if you are feeling depressed so they can take action and give you the support you need.
Strive to accept the new “you”
It is not your fault that you have lupus. It can be difficult to adapt but you need to focus on what you have and what you can do about it rather than what you cannot do. This sounds easier said than done, which is why it is important to ask for help from your support network and accept help graciously.
Conquering clinical depression is a gradual process. With the right help and resources most people with lupus find that, in time, their overall attitude and sense of well-being improves.
This article is intended to inform and give insight but not treat, diagnose or replace the advice of a doctor. Always seek medical advice with any questions regarding a medical condition.
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