Depression with physical illness

Every year Bimal Sen led his family through the Durga Puja pandals in Old Dhaka, late into the night. This autumn, three months after his bypass surgery, he stayed at home. The surgeon is pleased; the scar has healed. Bimal has stopped walking, skips his diabetes tablets, and tells his wife there is no point.

An illustration drawn from common experience. The person is invented; the pattern is not.

Understanding depression with physical illness

Living with a long illness, such as diabetes, heart disease, cancer, kidney disease, arthritis or chronic pain, is hard on the mind as well as the body. Depression is common after heart attacks, strokes and major surgery, and alongside long-term conditions. It is a treatable illness, and when it is left untreated, people often stop looking after their physical health.

The finding worth knowing

WHO’s World Health Surveys, analysed in The Lancet in 2007, found that depression worsened health more than angina, arthritis, asthma or diabetes did, and that having depression together with one of those illnesses was worse than any of them alone.

Signs and symptoms of depression with physical illness

• Low mood or hopelessness after a diagnosis, surgery or hospital stay
• Stopping medicines, exercise or appointments
• Withdrawing from family and from celebrations
• Sleep and appetite changes beyond what the illness explains

Treatment for depression with physical illness

Depression can be treated alongside physical illness, with careful attention to other medicines, such as blood thinners. Psychotherapy helps people adjust to illness and regain a sense of control, and working with the physician or surgeon keeps care joined up.

What getting better can look like

Bimal Sen might start with a short evening walk in the lane, then a longer one, and next Puja, at least one pandal, with a grandchild holding his hand.

Common questions about depression with physical illness

Is depression common after heart surgery?

Depression is common after heart attacks, strokes and major surgery, and alongside long-term conditions such as diabetes. It is a treatable illness, not a normal part of recovery. Left untreated, it often leads people to stop their medicines, exercise and appointments.

Can depression be treated if I already take medicines for diabetes or my heart?

Yes. Depression can be treated alongside physical illness, with careful attention to other medicines, such as blood thinners. Tell the psychiatrist about every medicine you take, and keep your physician involved so that care stays joined up.

When to see a psychiatrist

If you or someone you love has become low, hopeless or withdrawn during a long illness, please mention it to a doctor. Treating depression may help people keep up with their medicines, exercise and appointments.

Care here is personal: built around your history, your health and what you want to change, and reviewed with you as it goes.

If you or someone else is in immediate danger, call 999 or go to the nearest hospital emergency department.

Sources

• Moussavi et al., The Lancet, 2007