People with other chronic medical conditions are at higher risk of depression.

The same factors that increase the risk of depression in otherwise healthy people also raise the risk in people with other medical illnesses, particularly if those illnesses are chronic (long-lasting or persistent). These risk factors include a personal or family history of depression or family members who have died by suicide.

However, some risk factors for depression are directly related to having another illness. For example, conditions such as Parkinson’s disease and stroke cause changes in the brain. In some cases, these changes may have a direct role in depression. Illness-related anxiety and stress also can trigger symptoms of depression.

Depression is common among people who have chronic illnesses such as:

• Alzheimer’s disease
• Autoimmune diseases, including systemic lupus erythematosus, rheumatoid arthritis, and psoriasis
• Cancer
• Coronary heart disease
• Diabetes
• Epilepsy
• HIV/AIDS
• Hypothyroidism
• Multiple sclerosis
• Parkinson’s disease
• Stroke

Some people may experience symptoms of depression after being diagnosed with a medical illness. Those symptoms may decrease as they adjust to or treat the other condition. Certain medications used to treat the illness also can trigger depression.

Research suggests that people who have depression and another medical illness tend to have more severe symptoms of both illnesses. They may have more difficulty adapting to their medical condition, and they may have higher medical costs than those who do not have both depression and a medical illness. Symptoms of depression may continue even as a person’s physical health improves.

A collaborative care approach that includes both mental and physical health care can improve overall health. Research has shown that treating depression and chronic illness together can help people better manage both their depression and their chronic disease.

Children and Adolescents With Chronic Illnesses

Children and adolescents with chronic illnesses often face more challenges than their healthy peers in navigating adolescence. Chronic illnesses can affect physical, cognitive, social, and emotional development, and they can take a toll on parents and siblings. These limitations put children and adolescents at higher risk than their healthy peers of developing a mental illness.

Children and adolescents with chronic illnesses experience many forms of stress. Parents and health care providers should be on the lookout for signs of depression, anxiety, and adjustment disorders (a group of conditions that can occur when someone has difficulty coping with a stressful life event) in young people and their families.

People with depression are at higher risk for other medical conditions.

It may come as no surprise that adults with a medical illness are more likely to experience depression. The reverse is also true: People of all ages with depression are at higher risk of developing certain physical illnesses.

People with depression have an increased risk of cardiovascular disease, diabetes, stroke, pain, and Alzheimer’s disease, for example. Research also suggests that people with depression may be at higher risk for osteoporosis. The reasons are not yet clear. One factor with some of these illnesses is that many people with depression may have less access to good medical care. They may have a more challenging time caring for their health—for example, seeking care, taking prescribed medication, eating well, and exercising.

Scientists also are exploring whether physiological changes seen in depression may play a role in increasing the risk of physical illness. In people with depression, scientists have found changes in the way several different systems in the body function that could have an impact on physical health, including:

• Increased inflammation
• Changes in the control of heart rate and blood circulation
• Abnormalities in stress hormones
• Metabolic changes such as those seen in people at risk for diabetes

Depression is treatable even when another illness is present.

Depression is a common complication of chronic illness, but it does not have to be a normal part of having a chronic illness. Effective treatment for depression is available and can help even if you have another medical illness or condition.

If you or a loved one think you have depression, it is important to tell your health care provider and explore treatment options. You also should inform your health care provider about all your current treatments or medications for your chronic illness or depression (including prescribed medications and dietary supplements). Sharing information can help avoid problems with multiple medicines interfering with each other. It also helps your health care provider stay informed about your overall health and treatment issues.

Treating depression with medication, psychotherapy (also called “talk therapy”), or a combination of the two also may help improve the physical symptoms of a chronic illness or reduce the risk of future problems. Likewise, treating the chronic illness and getting symptoms under control can help improve symptoms of depression.

Depression affects each individual differently. There is no “one-size-fits-all” for treatment. It may take some trial and error to find the treatment that works best. You can learn more about the different types of depression treatment—including psychotherapy, medication, and brain stimulation therapies—on NIMH’s depression webpage. Visit the Food and Drug Administration (FDA) website for the latest information on medication approvals, warnings, and patient information guides.
 

Participating in Clinical Research

Clinical trials are research studies that look at new ways to prevent, detect, or treat diseases and conditions. Although individuals may benefit from being part of a clinical trial, participants should be aware that the primary purpose of a clinical trial is to gain new scientific knowledge so others may receive better help in the future.

Researchers at NIMH and around the country conduct many studies with patients and healthy volunteers. Talk to your health care provider about clinical trials, their benefits and risks, and whether one is right for you. For more information, visit NIMH’s clinical trials webpage.

Finding Help

Behavioral Health Treatment Services Locator

The Substance Abuse and Mental Health Services Administration (SAMHSA) provides the Behavioral Health Treatment Services Locator, an online resource for locating mental health treatment facilities and programs in your state. For additional resources, visit NIMH’s Help for Mental Illnesses webpage.

Talking to Your Health Care Provider About Your Mental Health

Communicating well with your doctor or health care provider can improve your care and help you both make good choices about your health. Read NIMH’s Tips for Talking With Your Health Care Provider to help prepare for and get the most out of your visit. For additional resources, including questions to ask your doctor, visit the Agency for Healthcare Research and Quality website.