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A chronic illness is any ongoing illness which evades cure but which can be managed with proper care. These sorts of long-term illnesses can require major adjustments. Those adjustments may be financial or they may be physical. When this happens the person affected may struggle with some negative feelings. Being limited by a chronic health condition can be discouraging and a certain amount of sadness over the imposed lifestyle changes is normal. However, sometimes a chronically ill person never gets past the initial grief and the sadness grows into a more settled depression.

Generally speaking, women are more vulnerable to depression than are men, but both face an increased risk of depression after being diagnosed with a chronic illness such as heart disease, diabetes, lupus, arthritis, or HIV/AIDS. Recognizing and treating depression may not seem like a priority in the face of a long-term illness, but it can make a significant difference in how those illnesses are experienced. For that reason, it deserves the same immediate attention as the physical ailment. Depression, for example, can make a person more sensitized to pain, it can interrupt sleep and can cause the person to withdraw from others just when an active support system would be most valuable.

Concurrent depression and chronic illness is not at all rare. Depression following a heart attack occurs 40 to 65 percent of the time. Forty percent of those with multiple sclerosis or Parkinson’s disease also experience depression. One quarter (25 percent) of those with cancer or diabetes also develop depression. Stroke patients experience depression at a rate of 10 to 27 percent. The likelihood that a patient with chronic illness is also living with depression is notable.

Because loved ones may assume that it is normal to feel sadness over their damaged health and subsequent life changes, they may not even be looking for depression in the chronically ill patient. As stated above, some sadness is normal, but depression is persistent and it keeps the person from developing a healthy new sense of normal. People may miss the depression because other symptoms are covering over them. It may be assumed that medications have made the ill person sleepier or “more blue.” Since the person cannot always join in the full range of physical activities, others may excuse their isolation as accepting their limitations.

Screenings for depression by the medical provider can be helpful in detecting the condition, but it will take some convincing to get patients and families on board with the importance of treatment. Studies have shown that when the chronic illness and depression are diagnosed within the same month, concerns over depression are subsumed by those over the medical illness.  Patients and families may need to be educated about how depression intensifies the hard parts of being ill and how treating it can restore many of the joys that illness cannot steal.

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