Depression and other medical conditions

Immediately following surgery or even months later, patients may develop symptoms of depression as they struggle to cope with the effects of anesthesia, uncertainty about their future health, a sense that friends and family don’t understand what they have gone through, or the effects of new medicines given to deal with the surgery.

The medical staff helping a patient recover from surgery may not be aware of the appearance of depression. If you or someone you care about is experiencing any depression symptoms, it is important to communicate these concerns or feelings with a healthcare provider.

Depression is a common and significant risk factor for developing cardiovascular disease and may be connected with future cardiovascular complications. Recovery from heart disease may also be more challenging in someone with depression. This makes sense, knowing that depression is related to many of the lifestyle factors that contribute to heart disease, such as poor diet, inactivity, drug or alcohol abuse or social isolation.

Treatment for depression and heart disease

When someone has heart disease, common symptoms of depression may seem normal and may therefore go unrecognized. However, when depression is accurately recognized as occurring with heart disease, you can address both illnesses at once by:

• Getting regular exercise
• Getting enough sleep
• Developing a social support network
• Reducing or stopping the use of alcohol or drugs

If symptoms of depression appear to be present along with heart disease, consult with a healthcare professional. Together, you can develop a self-care program that fits your complete health profile.

Potential triggers for depression are present throughout the cancer journey, from the anxiety of hearing the diagnosis, to the tremendous physical and psychological toll of exhausting treatment regimens, to the uncertainty and worry associated with the possibility of the disease returning or spreading.

Some cancer treatments, such as high doses of steroids, are known to contribute to depression, anxiety or even psychosis. Many of the most common symptoms and side effects associated with cancer and cancer treatment, such as poor appetite or fatigue, also occur frequently with depression or anxiety, making it challenging to determine exactly what is causing the symptoms.

Finally, patients who have previously experienced issues like depression, substance abuse or anxiety may find that they return with cancer.

In addition, events or experiences from the past may make some people more vulnerable to cancer-related depression or distress, including:

• A relative who died from cancer
• Recent loss of a close friend or relative
• History of depression or suicidal thoughts

Treatment for depression and cancer

If you or someone you care about is living with cancer and experiencing any of these symptoms or concerns, speak with a healthcare provider about making depression treatment part of the cancer recovery program.

Individuals suffering from either type I or type II diabetes are at an increased risk of developing depression. The anxiety caused by a diagnosis of diabetes can trigger depression, as can the ongoing stress of following a treatment plan and the worry associated with the possible physical consequences of advanced disease.

Research studies have shown that the presence of depression makes living with diabetes even more challenging. Diabetics with serious, untreated depression are less likely to stick with their diabetes treatment plans. Reduced physical ability and mental functioning are also more common in diabetic patients who suffer from depression.

Although diabetes and depression are two very different illnesses, when it comes to their treatment, they have much in common:

• Both are chronic illnesses requiring ongoing care to manage symptoms over time
• Both illnesses are most successfully managed by a combination of professional medical care (including medication) and self care (including diet, exercise, and stress management).

Treatment for depression and diabetes

If you or someone you care about is living with diabetes and experiencing any of the symptoms of depression, a healthcare provider may be able to help make depression treatment part of your diabetes management program.

There is a clear connection between depression and pain. Stomach problems, headache, and other less specific aches and pains are common features of depression. In addition, depression frequently sets in when someone is dealing with ongoing pain and can make the pain even more intense.

Paying attention to pain

Pain can serve as an early indicator of many things – including depression. When pain persists after depression has been treated, it can indicate that someone is at risk for a recurrence of depression. Persistent pain can also signal another physical problem that needs further medical evaluation.

What is chronic pain?

Chronic pain is pain that lasts much longer than would be expected from a specific injury or physical problem. Chronic pain can affect our thoughts, mood, and behavior and can lead to isolation, immobility, and drug dependence. In this way, depression and chronic pain are very similar.

Chronic pain can lead to decreased energy, muscle pain or weakness. It can also bring about neurochemical changes in the body, which can make you more sensitive to pain. Life with ongoing pain can be extremely challenging, leading to feelings of irritability and even hopelessness when it seems there is no relief in sight.

Because depression in people with chronic pain frequently goes undiagnosed, it often goes untreated.

Treatment for depression and pain

Because chronic pain and depression are so intertwined, they are best treated together. The good news is that effective tools and lifestyle changes exist to both relieve the symptoms of depression and help manage chronic pain.

Specifically, medication is commonly prescribed to fight both depression and pain, since they share some of the same neurotransmitters. Antidepressants have been shown to be effective in reducing an individual’s sensitivity to pain, as well as improving sleep and overall quality of life. Psychotherapy and a number of different self-care strategies including relaxation techniques are also beneficial. In pain rehabilitation centers, specialists treat both problems together, often with the same techniques, including progressive muscle relaxation, hypnosis, and meditation.

If you are facing both depression and chronic pain, it is important that your treatment plan addresses every aspect of your life impacted by depression and/or pain.

Depression may cause sleep problems and sleep problems may cause or contribute to depressive disorders. Patients with depression tend to experience sleep disruption, poor sleep quality, and insomnia (problems falling and staying asleep). This can have a cascading effect because an increase in sleep disruption can lead to a decrease in effective treatment response for depression. It can also mean an increase in depression-related episodes and greater time spent ill during those episodes. Even more concerning, those with chronic sleep disturbance are more likely to develop treatment resistant or difficult to treat depression.

Can poor sleep cause depression?

It’s possible to develop depression without ever having had a sleep disturbance, although 90% of depressed patients report a sleep problem. The longer the history of sleep disturbances, the greater the risk of depression. While not everyone whose sleep is chronically disturbed will develop depression, the risk is estimated to be three to ten times greater than for those who sleep well.

Treatment for depression and sleep problems

It is important to intervene early to improve sleep and reduce the risk of depression. Sleep problems and depression share some of the same risk factors and biological features, meaning the two conditions may respond to some of the same treatment strategies.

If you or someone you care about is living with sleep problems and depression, speak with a healthcare provider about addressing both depression and sleep problems.

Doering, L. V., Chen, B., Cross, R., Magsarili, M. C., Nyamathi, A., & Irwin, M. R. (2013). Early cognitive behavioral therapy for depression after cardiac surgery. The Journal of cardiovascular nursing, 28(4), 370.

Farooqi, A., Gillies, C., Sathanapally, H., Abner, S., Seidu, S., Davies, M. J., ... & Khunti, K. (2022). A systematic review and meta-analysis to compare the prevalence of depression between people with and without type 1 and type 2 diabetes. Primary Care Diabetes, 16(1), 1-1. 

Harshfield, E. L., Pennells, L., Schwartz, J. E., Willeit, P., Kaptoge, S., Bell, S., ... & Emerging Risk Factors Collaboration. (2020). Association between depressive symptoms and incident cardiovascular diseases. JAMA, 324(23), 2396-2405.

IsHak, W. W., Wen, R. Y., Naghdechi, L., Vanle, B., Dang, J., Knosp, M., ... & Louy, C. (2018). Pain and depression: a systematic review. Harvard review of psychiatry, 26(6), 352-363.

Riedl, D., & Schüßler, G. (2022). Factors associated with and risk factors for depression in cancer patients–A systematic literature review. Translational oncology, 16, 101328.