Managing your mental health with lupus

Day-to-day life with lupus can be challenging and can take a toll on your mental health. Whether you are newly diagnosed or have been living with lupus for years, it's important to pay attention to changes in your mental health and emotional well-being. When negative feelings become overwhelming and long-lasting, it may be time to seek professional help. 

For reasons that are not entirely understood, people with chronic disease often experience depression, anxiety and other mental health disorders. For people with lupus, depression may be brought about by lupus, by some medications used to treat lupus, and/or by factors and forces in a person's life that are not related to lupus. When you are coping with economic, social, workplace, family and other concerns as well as your lupus, it can be more difficult to cope with challenging or negative feelings.

Multiple studies have shown people with lupus are more likely to experience depression and anxiety¹. In one study, researchers also found that Black patients with lupus experience moderate or high anxiety compared to Whites².

Symptoms of depression and anxiety 

Sometimes symptoms of anxiety and depression cross over, and can be difficult to tell if you're experiencing one or the other, or both.

One of the single markers for depression is a loss of interest in activities and responsibilities that used to be important. For those who experience anxiety, many may find it difficult to breathe or have an increased heart rate. It's important to note that anxiety is a common and an early symptom of the disease for people who have lupus³. 

These are among the most common psychological and physical symptoms of depression:

• Feelings of helplessness or hopelessness
• Sadness, or crying often without reason
• Restless sleep, or sleeping too much
• Changes in appetite (weight loss or weight gain)
• Lack of energy
• Lowered self-esteem, inability to concentrate, diminished memory 
• Indecisiveness
• Thoughts of death or suicide, or intrusive thoughts 

Symptoms of anxiety

• Feeling nervous, restless or tense
• Increased heart rate, and/or heart palpitations
• Fast breathing, or faster than normal  
• Trembling
• Feeling a sense of impending doom, worry
• Change in body temperature, sweating or feeling cold

If recognized and properly treated, symptoms of depression and anxiety can improve.

When and how to get help

Seek therapy.  

For most people, their mental health generally improves with a combination of therapy and sometimes medication. You should not feel embarrassed or hesitant about asking your doctor for a referral to a psychiatrist, psychologist, or therapist.

• Psychotherapy. Under the guidance of a trained professional, can help you learn to understand your feelings, your illness, and your relationships, and to cope more effectively with stress
• Cognitive behavioral therapy. Sometimes referred to as CBT is a type of therapy done in a group setting with a lead counselor or therapist.
• Therapist. Someone to talk to, who doesn't prescribe medication 
• Psychiatrist. Someone who prescribes medication to help manage your mental health. 

Take antidepressant medications.

Several types of prescribed drugs can help ease the effects of depression. Anti-anxiety medicines are also available to reduce worry and fearful feelings. In some people, improvements can occur in a matter of weeks once medication is started.

Find ways to reduce pain.

Chronic pain can be a factor in the development of depression. Besides medication, experts often recommend non-medication ways to conquer—or at least reduce—chronic pain, such as yoga, Tai Chi, Pilates, acupuncture, meditation, play therapy, and chiropractic care. It is important to discuss all herbs and supplements with your rheumatologist or primary care provider before trying them as certain ingredients can cause reactions with your prescribed medications.

Get more exercise.

If you are 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 window shopping at the mall.

Improve your sleep habits.

Not getting enough  restful sleep can cause many health problems, including symptoms of clinical depression. 

Build a support system.

Stay in touch with family members, former work buddies, or long-time friends. Make phone calls, connect with family and friends through social media, or consider adding an animal companion to your family.

Change your self-talk.

Feelings of anger and self-pity can bring on unproductive thoughts. Replace negative, self-defeating inner language with truthful, productive thoughts.

You can also list the people and things in your life for which you are grateful. Try to add to this list every day!

More facts about clinical depression and lupus

• Between 15 and 60 percent of people with a chronic illness will experience clinical depression.
• Clinical depression may be a result of the ways in which lupus physically affects your body.
• Some of the medicines to treat lupus—especially corticosteroids such as prednisone (and at higher doses of 20 mg or more)—play a role in causing clinical depression.
• Clinical depression may be a result of the continuous series of emotional and psychological stressors associated with living with a chronic illness.
• Clinical depression may be a result of neurologic problems or experiences unrelated to lupus.
• Clinical depression also produces anxiety, which may aggravate physical symptoms (headache, stomach pain, etc.).
• Two common feelings associated with clinical depression are hopelessness and helplessness. 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.

If you need someone to talk to, or if you're considering harming yourself, call the National Suicide Prevention Lifeline at 1-800-273-8255 or 988. Another resource to use is Mental Health America's Center for Peer Support or Resources for Immediate Response.

While there is no concrete number on how many people with lupus experience depression, anxiety, and other mental illnesses, it's important to remember you're not alone. Talk with your rheumatologist to help guide you in the right direction to receive treatment. Those who seek treatment find that, in time, their overall attitude and sense of well-being are greatly improved.