Depression can be difficult to identify in kidney patients because many of the key symptoms, such as insomnia, loss of weight or appetite, and low energy, can also be attributed to kidney disease itself. Despite this, however, people with chronic kidney disease (CKD) and end-stage renal disease (ESRD, or kidney failure) face higher rates of depression as a group. Unlike kidney disease, the rate of depression across gender and racial lines among kidney patients is fairly equal, meaning it can affect anyone. Depression can lead to poorer health outcomes, increased hospitalizations, lower quality of life and more.
The human body is designed to handle the regular day-to-day stress that most people endure. However, having CKD, or especially ESRD, can add many serious stressors on top of the normal day-to-day things our bodies are equipped to handle. These additional stressors can include financial burdens, inability to work because of dialysis, dietary constraints and other recommended treatment guidelines, and the illness itself. Because of these added burdens, kidney patients are at a much higher risk for suffering from depression compared to the general public, and need coping mechanisms to handle these extra stressors in a healthy way.
The first step to addressing depression in patients with kidney disease is recognizing the illness.
Common feelings and experiences of kidney patients with depression include:
- Regular pain and difficulty sleeping.
- Anxiety that their life is in the hands of those who care for them and their disease.
- Unwanted feelings of dependence on health care providers and the dialysis machine.
- Feelings of powerlessness over the disease.
- Feelings of lack of control over their schedule and lives.
- Inability to stand up to societal pressures at the expense of their own health care needs, such as not following a kidney-healthy diet when out with friends.
- Feelings of hopelessness as there is ultimately no cure for kidney disease.
Empowered patients do better physically and mentally
Patients who have experienced the common feelings associated with kidney disease and depression may be able to overcome some of these hardships by advocating for themselves. Patients can be their own advocates by asking questions about their treatments and working closely with their doctors and health care teams. They can express to their health care team that they aim to take an active role in their care, and wish to be part of making decisions. Peer networks and kidney disease advocacy groups can allow patients to advocate for their health at a large-scale level, and interact with others who may be going through the same things.
Family members, friends and caregivers of patients with kidney disease can also become advocates to help kidney patients overcome some of the common feelings associated with depression. Advocates can encourage patients to set small, attainable health goals, like going to all their scheduled dialysis appointments one week, or taking a morning walk. Meeting goals can boost a patient’s feeling of confidence and sense of accomplishment as they check items like these off a to-do list.
Advocates can also encourage patients to take advantage of available resources, such as social workers at dialysis centers, mental health professionals, self-help books, spiritual guidance, or close family members or friends who are willing to listen and help. Family members can encourage patients to find new ways help around the house, so they can still make important contributions even if they are not physically able to do all they have done in the past.
As patients and advocates speak openly about challenges with depression that kidney patients face, and the need to address it, they are actively combating the stigma surrounding the illness. Speaking out may also empower depressed patients personally, or inspire others with similar feelings to take their concerns more seriously and seek professional care.
Questions? Call +254 718 994 368 / 733 994 368 or E-mail: weare@pathwayintl.co.ke
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