Chronic Physical Illness and Depression - Essay Example

Chronic Physical Illness and Depression Introduction Physical illness and depression are closely linked. When an individual is in a depressed mood, it is likely to contribute to the progression and development of some illnesses, whereas physical illness can, on the other hand, increase the likelihood of getting depressed. Patients who have physical illnesses are more likely to get depressed as compared to those patients without, with approximately 33.3% of medical in-patients reporting moderate or mild signs of depression. Certain medical conditions have a higher correlation with psychiatric illnesses as compared to other medical conditions, for instance the frequency of depressive disorders in patients with neurological, diabetes or cardiac disease is higher, as compared to patients suffering from illnesses such as hypertension. It is also common to find that medical in-patients are more susceptible to depression as compared with out-patients. According to statistics, one in eight men and one in five women will undergo some depression in their natural life. In spite of these statistics, there has been prevalent disregard of depression in patients suffering from illnesses; this has led to the increased poor outcomes. It is common to find that in psychiatric patients that physical problems might not be properly diagnosed. Patients suffering from depression and physical illness have higher morbidity and mortality levels, and lower functioning levels in comparison to patients suffering from identical illnesses, but not having depression. This paper aims at discussing the connection between chronic physical illnesses and depression, the causes and symptoms of depression in individuals with chronic physical illness, and the forms of treatments that are available for patients. The connection between chronic physical illnesses and depression In understanding the link between chronic physical illnesses and depression, it is crucial to define both a chronic physical illness and depression. Depression is defined as a severe health problem that affects the well-being and biological functioning of a person for a period exceeding 2 weeks. Depression severely affects the mental and physical health of a person, and this makes it hard for such a person to perform his or her normal daily activities. Persons who are depressed have negative feelings and thoughts, lack appetite, experience disturbance of sleep, tiredness, decreased interest in activities, and uncharacteristic and prolonged duration of low mood (Thomas 2005). A chronic physical illness refers to a persistent health problem that one cannot overcome easily such as stroke, heart disease, cancer, arthritis, asthma, or diabetes. These illnesses can be controlled, but they cannot be fully cured. Such chronic illnesses have a higher chance of becoming stressed as compared to those without. Nevertheless, chronic physical illnesses that are less common can also be linked to depression; they include chronic fatigue syndrome, Parkinson’s disease, and chronic pain. Many studies have been conducted about these illnesses, and how they are related to depression. These illnesses can be classified as follows: Vascular diseases Stroke: research has indicated that, for people who have suffered a stroke, there are increased chances of developing depression. This is increased in individuals who have suffered mini strokes. Moreover, people who suffer depression are likely to have prolonged and severe illness as compared to those without depression. Heart disease: for individuals suffering from heart diseases, depression is more frequent. This is amplified in people suffering from angina, and is higher in individuals who have suffered a heart attack. In these circumstances, depression can lead to difficulties for individuals who are recuperating from heart attacks, making them more vulnerable to more heart attacks. Additionally, it might be hard for such people to go back to work. High blood pressure: research has indicated that hypertension also results to increased depression rates. (Braun et al 2007, p. 720) Nervous system diseases Parkinson’s disease: it is approximated that over 40% of people with Parkinson’s disease are likely to suffer from depression. Often, depression is not identified because it has similar symptoms to Parkinson’s disease. Researchers have proposed that the increased prevalence of depression for patients with Parkinson’s disease is as a result of the direct impact on the brain or the effect of the condition of the daily life of the sufferer. Dementia: individuals suffering from dementia, tend to display more depressive illnesses and symptoms as compared to any other people. Such individuals have difficulties in communicating; this makes it hard for their depression to be treated. However, symptoms such as gloominess, lack of interest in others, and loss of interaction, can indicate that an individual is suffering from depression. Multiple sclerosis: under this condition, it is unclear how much depression emerges from the impact of this disease on the brain. In addition, it is unclear the extent of depression is caused by the outcome of multiple sclerosis. Infections Certain infections such as influenza and glandular fever can prompt depression in individuals who are vulnerable. According to research, there are strong connections between chronic physical illness and depression. Statistics have shown that one in eight men and one in five women will undergo some depression in their natural life. This figure is much higher for people having a chronic physical illness. Statistics indicate that nearly 28% of individuals with chronic physical problems also suffer from mental disorders (Slade et al 2009, p. 286). People with chronic physical illnesses are likely to develop depression. Some treatments and symptoms of a chronic physical illness can lead to drastic changes in lifestyle that may result in serious interferences to work, or social life of a person and generate financial problems. This is because of the direct biological mechanism, particularly where the disease affects the central nervous and endocrine systems. Drugs that might result in depressive side-effects include; Interferon, isotretinoin, Metoclopradimine, Cimetidine, and steroids. The physical illness can also cause depression through a psychological response, particularly if the illness is potentially fatal, disabling or disfiguring. Factors such as having a history of psychiatric illnesses, lack of social help, treatments or illnesses such as stroke, disfiguring illnesses and chronic pain, and other life-threatening conditions, will increase the possibility of patients developing depression. On the other hand, depression increases the risk of getting a chronic physical illness, especially diabetes, stroke, and heart disease. Depression hardens the life of individuals having chronic physical illnesses. Depression makes it difficult for such people to take medications, to exercise, and eat healthily. Depression is even more incapacitating as compared to feelings of disappointment or frustration due to a chronic health condition. This is because there is the lack of enjoyment in the life of such people. In addition, a chronic physical illness makes it hard to relate well with friends and family members. This is because the patient might feel isolated making it more difficult for him/her to recover from depression (Currie & Clarke 2009, p.58). Finally, chronic physical illnesses and depression might have the same cause, for instance stress or bereavement that might trigger depression and stroke. Cause of depression in individuals with chronic physical illness Similar to the factors that result in depression in individuals without any physical illness, the causes of depression for individuals with chronic illness is still not clear. There is substantial evidence that proposes that chronic physical illnesses have an effect on the chemical systems, and parts of the brain that manage our behavior and mood. For instance, Parkinson’s disease and vascular diseases destroy the vital parts of the brain; this makes individuals susceptible to depression. Endocrine problems interrelate directly with the crucial chemical systems that manage the mood of an individual and other characteristic of depression. Nevertheless, the social and psychological effects of depression are also extremely significant. Trying to move after a heart attack, or losing the ability to move a limb following a stroke can result in numerous consequences socially. Depressive illness can be triggered by the inability to go back to work, or giving up on some hobbies. Furthermore, these losses have an impact on the self esteem of the patient and leads to the change of roles at work and home. Such factors will add to the increase in depression (Thomas 2005). Symptoms of depression in individuals with chronic physical illnesses It is essential for people to recognize the likelihood of depression, particularly in a case where one is suffering from chronic physical illnesses. However, problems arise from the fact that depression symptoms are almost the same as those experienced by people with chronic physical illnesses such as tiredness, loss of appetite, and disturbed sleep. This fact makes such symptoms less useful for doctors in diagnosing an illness because the patient might accept his or her condition, but frequent weeping and low moods will indicate that an individual is depressed. An individual with a chronic physical illness will portray some of the following symptoms if he or she is depressed. There is constant sadness, which is reduced by happy experiences, loss of interest in pastimes and activities that were appealing before, lack of interest in sex, feelings of self-blame and guilt, lack of interest in family and friends, suicidal thoughts, and loss of pessimism about the future. Treatments for depression in individuals with chronic physical illnesses There are numerous treatments that can be administered for individuals with a chronic physical illness and depression. This treatment ranges from medication to psychological treatments. Psychological treatments Interpersonal therapy This form of therapy has been established to be efficient in treating depression. Research indicates that this form of therapy enables individuals to find new means of solving conflicts, losses and changes in relationships and getting along with people. Cognitive behavior therapy Studies have established that this form of psychological therapies is amongst the most effective ways of treating individuals with anxiety disorders and depression. This therapy teaches individuals to think about their hardships realistically, assisting them to change their patterns of thinking and how such individuals should react to given conditions. Behavioral therapy has been proved to be extremely useful for many anxiety disorders and depression (White 2001, p. 88). Medication The use of antidepressant medication can be effective in cases where the other forms of treatments have failed in treating anxiety disorders and depression, or when someone becomes seriously depressed. Making a decision as to which antidepressants are suited for an individual can be complicated. There is a variety of factors that should be put into consideration by a doctor before antidepressants are administered, such as medication interactions (Hammersley et al 2001, p. 668). Medication for depression can take approximately two to three weeks before positive results can be witnessed. From the beginning, the differences in side-effects and effects of medications should first of all be discussed with the health professional that is prescribing the medications. In addition, stopping medication should be done in a gradual manner, under the supervision, and on the recommendation of a doctor. It is crucial that a health professional reviews the current medication that the patient might be taking for the chronic physical illness, including natural or herbal remedies and over-the-counter drugs, before an individual begins taking medication for depression. Moreover, a majority of individuals taking antidepressants will gain from psychological therapies. These therapies will decrease the chances of a relapse when an individual has ceased taking the medication. The commonly prescribed antidepressants include calcium channel blockers such as Verapamil, beta-blockers such as Metoprolol, corticosteroids such as hydrocortisone, and Levodopa. In cases where the development of depressive symptoms arises after consuming a new type of medicine, then the patient should seek the advice of a doctor on whether to look for an alternative. Manufactures of antidepressants and the regulatory agency for medical drugs in Australia, recommend that antidepressants should only be administered for patients who are over 18 years old. Conclusion It is evident from this paper that chronic physical illnesses and depression are closely related to each other. Depressive illnesses and mood changes are higher among individuals with physical illnesses as compared to those without any physical illness. Even though, an individual can be depressed due to nearly any physical illness, some illnesses that are chronic are likely to result to depression as compared to other illnesses. Depression in such instances can be anticipated to react to similar treatments as with other forms of depression. Therefore, patients should seek treatment for the form of depression that they are experiencing, regardless of the cause it. Since most patients with chronic physical illness suffer from depression, it is important that all psychiatrists have the proper skills of managing this form of depression. Recent developments in psychiatric treatments, such as selective medications and psychological developments, are giving health professionals the chance to make a considerable impact on the life and health of a patient that was neglected previously. References Braun, U, Kunik, M, Stanley, M., et al, 2001, One session cognitive behavioral therapy for elderly patients with chronic obstructive pulmonary disease. Psychological Medicine, vol. 31, pp. 717–723. Currie, C, & Clarke, M, 2009, Depression, anxiety and their relationship with chronic diseases; a review of the epidemiology, risk and treatment evidence. MJA supplement, Vol. 190, pp.55-59. Hammersley, V, Pringle, M, Hippisley-Cox, J., et al, 2001, Antidepressants as a risk factor for ischemic heart disease: case-control study in primary care. BMJ, Vol. 323, 667–670. Slade, T, et al, 2009, The mental health of Australians 2; Report on the 2007 National Survey of Mental Health and wellbeing. Department of Health and ageing, Canberra. Thomas, A 2005, Depression and physical illness, Netdoctor, viewed 21 June 2010, White, C, A, 2001, Cognitive Behavior Therapy for Chronic Medical Problems: A Guide to Assessment and Treatment in Practice. John Wiley & Sons Ltd., West Sussex. Read More