Patients First: HCV and Depression —Alan Franciscus, Editor-in-Chief

People with hepatitis C face many challenges after being diagnosed.  These challenges can occur on a daily basis and seem to last from diagnosis until being cured.  These challenges can lead to increased anxiety and depression.  This article is about the many difficulties that people with hepatitis C face that can lead to depression, how to identify depression and some steps to deal with it. 

HCV and Depression
There are certain times during the hepatitis C journey that people may experience depression:

Diagnosis:  After a diagnosis of HCV, people are in shock, and many feelings may surface.  Some of the fears may include, but are not limited to:
The list is endless.   An additional issue is that now people are being denied access to treatment.  All of these matters can lead to anxiety and depression.  This time of year is even more difficult because some people experience additional holiday loneliness, isolation, and depression. 

Depression
Depression is a serious disease that affects about 1 in 4 American adults.  It can lead to death.  More importantly, it is a treatable illness.  It is not something that you can just snap out of in spite of what some people think.   Like hepatitis C, it is a silent disease and very stigmatized.  It is finally coming out of the shadows, and it can be successfully treated with counseling and medication.   

Warning Signs:  If you have thoughts of hurting yourself or others, this is an emergency that needs to be taken care of right away.  Call your doctor or nurse or one of the phone numbers listed at the end of this article.  People who work at crisis hotlines have been trained to help people who are in crisis mode. 

Signs and Symptoms of Depression
Getting Help
There is help out there.  Think about talking to a professional.  Ask for help from your family, friends, and medical team.  If you cannot talk to family or friends, start with a support group.  This can be particularly useful if you are dealing with any issue related to hepatitis C. 

There are some general things that people can do to help conquer depression, but with severe depression, nothing replaces professional help.

Alcohol
Everyone with hepatitis C should stay away from alcohol, but if you are suffering from depression it is even more important.  Alcohol can also cause depression. 

Stress
Stress is a killer—that is a no-brainer.  There are many tips to reduce stress—exercise, finding balance, keeping a positive attitude, finding help, meditating, prayer, laughing, watching movies or any other pastime you find pleasurable.  Personally, when I get stressed out, I like to listen to one of my favorite comedians.  It always puts a smile on my face and sends me on my way to enjoy the rest of my day—at least when I have a light case of the blues.   

Realism
Try to get a realistic picture of your life and problems.  It sounds easier than it is but don’t dwell on the negative.  Find things that you enjoy and when you find yourself dwelling on the negative try turning it around and remember what it is positive about your life. 

Exercise
Walking, swimming, Qigong, running or almost any exercise can help to elevate the mood.  Think about joining a gym or a group exercise program.  Go slowly and if you have any physical problems get cleared by your medical provider.  Personally, I exercise every day to chase away the stress and blues. 

Balance
We live in a stressful world and trying to do everything can lead to stress, exhaustion, unrealistic expectations and depression.  Try to find balance – plan activities, build in down time and get plenty of rest. 

Keeping a Positive Attitude
A positive attitude will not cure depression, but it does offer hope for the future.  Remember, the way you feel now will not last forever. However, it is important to get a realistic picture of your physical and mental health.

These are all useful tips for less severe types of depression, but if you feel that you need more help, consider professional help. 

Medications
There are many medications—anti-anxiety and antidepressants—that can help.  Talk to a psychiatrist or your medical provider to find out if this would be a good fit for you.  Everyone is different, and every antidepressant works differently.  You and your medical provider may have to try more than one medication to find the one that works for you.  Most medicines have side effects, and all antidepressants have some side effects.  The most common side effects of antidepressants include headaches, nausea, jitters, nervousness and sexual side effects.  Some of the side effects may diminish over time.  Talk to your medical provider to make sure that the antidepressant is safe for the liver.

One of the best ways to fight depression is through knowledge and actions.  Learn as much about hepatitis C to reduce the fear of the unknown.  If you are depressed because you cannot get approved for a new treatment—check out Lucinda’s HealthWise article for tips to fight back and get approved for the new therapies.    We don’t want to harp on it too much, but get help for depression if you need it. 

Resources:
http://hcvadvocate.org/news/newsLetter/2015/advocate0115.html#3

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