Regaining Control: Chronic Disease-Related Depression

04/15/2015 12:37 pm ET | Updated Jun 15, 2015

Depression and chronic illness walk hand in hand, and it makes sense why: Painful, long-term illnesses like diabetes, heart disease, or MS (to name a few) can cause a devastating impact on your life, in large part, by stealing your control. Here's how.

When you're healthy, you're in control. To get stronger, you exercise. To boost your energy, you eat healthy. To prevent a cold, you wash your hands. But when chronic disease sets in, that control slips away. Even eating more carefully or exercising harder, you might still feel pain, sluggishness, or fatigue.

"Maybe I can't control this," you might think, followed by the hopeful, "But that's what doctors are for." So you hand them control. They comfort and reassure, giving you hope. "Take this," they say; but there may still be the emotional pain. "Try that," they say, and it gets better! Then worse. Then better! Then worse. One medication or procedure leads to the next -- one specialist to another. It's like a roller coaster ride. The costs add up and the side-effects take a toll -- often exacerbating the emotional distress.

A few years later, you're sitting in your doctor's office. She's explaining the latest "cutting edge treatment." You see her lips moving but you've given up listening. She could have just a few more years of school than you. It's beyond her control, you realize. It's the disease that's in control.

Occasionally, there's a "good day." You feel energetic, strong, pain-free, happy. But then the pain returns. It makes you confused -- frustrated. You decide there will never all be "good days." You realize you might never go back to how you felt before the disease.

Despair sets in and, with it, depression. Some days, you just want to be alone. Nobody knows what it's like to walk in your shoes. One so-called friend has the nerve to say, "Have you tried a psychiatrist?" Some days, you just feel like sleeping. But other days, it's too painful to sleep.

One night, you toss and turn, then try a sleeping pill. But the pain keeps you up. You take another one, eying that bottle a little longer. Maybe that's how you end it, you think. Maybe that's the only way left to take back control.


It's a frightening tale, all too real. An estimated one-third of people with a serious medical condition suffer symptoms of depression. I often see it in patients with Keratoconus, a degenerative eye disease, which left untreated typically slowly steals away vision.

One notable case was one of the Olympic athletes I treated. This athlete was at the height of the career when the world started getting blurry. Various specialists recommended thick glasses, then soft contact lenses, then hard contacts. But nothing worked after a while.

Previously outgoing and exuberant, this athlete became quiet and withdrawn as depression sank its claws. When it became too dangerous to continue competing, this athlete decided it was time to quit -- to give up the dream. One night shortly afterwards, the athlete tried to end it all with a suicide attempt.

The next morning, the athlete woke up and decided to make the most of this second chance at life. The search began for alternative treatments and cures -- which eventually brought the athlete to my door. Fortunately there was a non-invasive procedure to correct vision (called "Holcomb C3-R"). It stabilized the Keratoconus along with other implants to improve vision and the symptoms of depression began to improve -- as I frequently notice after successful treatments.


This athlete is fortunate as are most people with Keratoconus who come to us. It's rare for chronic diseases to have such a "quick fix." Often, people live with the symptoms for years, decades, even a lifetime. And when depression sets in, which it so often does, many figure, "Maybe this is here to stay too." But that's where they're wrong. Depression can be treated, mitigated, and controlled, even when the disease itself cannot. I've developed an acronym -- CONTROL -- to explain a few ways how:

Community: When you're depressed, you feel the urge to retreat from the world and isolate yourself from your community. Resist that urge. Reach out to family and friends or ask your doctor about support groups and other resources. You might feel alone in your struggle, but you never have to be.

Open Channel: Keep an open channel of communication with medical experts you trust. Speak frequently with them about your concerns and questions. Share what's working and what's not. If the depression intensifies, alert them immediately.

Nutrition & Exercise: Healthy diet and exercise are an age-old remedy for depression. Try subbing out sugary foods for whole foods like grains, vegetables, beans, fruits, lean meats, and food items high in vitamins and nutrition. Try exercising at least three times a week, if and when you're able. Exercise releases endorphins, a hormone which can reduce pain and can alleviate depression.

Personal note: I lived in Edinburgh, Scotland for a year which is an incredible city. The weather on the other hand is not so fabulous -- it's rainy and often overcast. I regularly exercised and never got the common "seasonal affective disorder."

Treatment: If depression intensifies, seek professional help from a psychologist, therapist, psychiatrist, or psychiatric nurse. Ask your doctor for a recommendation or get in touch with organizations like NAMI (the National Alliance for the Mentally Ill), which can recommend a professional in your area.

Routine: Develop a routine. Often, when you're depressed, one day seems to slip into the next. So set up a daily schedule and fill it, as often as possible, with activities you enjoy. Even a small daily chore, like watering the flowers every morning, can give you a sense of accomplishment and improve your mood.

Objectives: When you're depressed, you feel terrible about yourself. "I can't accomplish anything," you might tell yourself, so you shirk your responsibilities and give up on former goals. Don't. Keep up your day-to-day objectives and responsibilities. Keep working toward your goals, whether little daily ones or larger life ones.

Learn: An important way to battle depression is to learn everything you can about your disease (as my Olympian patient did). Study up on it. Read everything you can. Not only might it lead to a treatment option, it will give you a sense of independence and restore that all-important sense of CONTROL.


If you -- or someone you know -- need help, please call 1-800-273-8255 for the National Suicide Prevention Lifeline. If you are outside of the U.S., please visit the International Association for Suicide Prevention for a database of international resources.