Depression and Chronic Illness: Which Comes First?

IMAGE Which comes first—depression or chronic illness? While the connection works both ways, one thing's for sure: treatment can make a difference. Jennifer was 26 years old when her doctor diagnosed her with high blood pressure. It wasn't until she learned that she also suffered from polycystic ovary syndrome that she began her slide into depression. Like many other people with chronic illnesses, she hid her depression from her doctor, even as she underwent fertility treatments and a high-risk pregnancy. "It's so hard to deal with a chronic illness," says Jennifer, now 29. "Many people are afraid to admit that they need help."After the birth of her son, she broke down and told her doctor of her depressive symptoms—her self-imposed isolation from others, withdrawal from relationships, sleeplessness, and feelings of hopelessness. He helped her understand that like her other chronic conditions, her depression was not her fault. She began taking an antidepressant, and her outlook improved."It has helped tremendously," she explains. "I needed it to keep things in perspective for me, which it did."

When Illness Triggers Depression

When faced with a potentially life-changing diagnosis of a chronic condition, it can be easy for depression to set in.When someone is diagnosed with an illness, it is not uncommon to feel helpless or alone. Depression is easy to overlook in part because some of its symptoms, like fatigue or change in energy levels, mimic those of some chronic illnesses.

When Depression Leads to Illness

In cases like Jennifer's, it's pretty clear that the illness led to depression. But for scores of others with conditions like heart disease and diabetes, the connection can be the reverse. People with a history of depression are at least 3 times more likely to suffer from heart attacks than their non-depressed peers, making depression as important a risk factor as high cholesterol or family history of heart disease. Depression is also associated with type 2 diabetes. Links between depression and these illnesses likely work on different levels. Depression could have a behavioral component, such as having different eating or exercising habits. It can also affect the body in how the immune system works or how the blood clots.

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