Chronic Illness, Clinical Depression, and Suicide…

Anyone who knows me really well, knows that I suffer from chronic illness – specifically, Ankylosing Spondylitis (A.S.) and Hereditary Hemochromatosis. Several months ago, I joined an online support group for A.S. and have found it to be incredibly helpful in making me feel more “normal”.

Last week, I became one of the admins for that group which consists of over 9,800 people, all of whom are suffering in various stages of this terrible illness. As I’ve participated in the group, I’ve noticed that almost everyone  has suffered from depression at some time or another… some clinical depression for years (like me) and others situational depression that comes and goes. Anyway, I tend to look for similarities and patterns among the people in that group and there are a couple of things I’ve noticed:

  1. Autoimmune diseases tend to have a high incidence of comorbidity, which is the simultaneous presence of two chronic diseases or conditions. In fact, I would even say “multiple comorbidities” seem to be prevalent. Many people with autoimmune disease have so many other health issues simultaneously that it’s no wonder there is such a high incidence of depression… which leads me to my next observation.

  2. Many people who suffer from illnesses with chronic pain also suffer from depression. I’m not just talking about sadness every now and then, I mean sustained, overwhelming sadness that doesn’t go away.  Clinical depression is the more severe form of depression, also known as major depression or major depressive disorder. It isn’t the same as depression caused by a loss, such as the death of a loved one or the loss of a job. Symptoms of clinical depression include:
    • Depressed mood, such as feeling sad, empty or tearful (in children and teens, depressed mood can appear as constant irritability)
    • Significantly reduced interest or feeling no pleasure in all or most activities
    • Significant weight loss when not dieting, weight gain, or decrease or increase in appetite
    • Insomnia or increased desire to sleep
    • Either restlessness or slowed behavior that can be observed by others
    • Fatigue or loss of energy
    • Feelings of worthlessness, or excessive or inappropriate guilt
    • Trouble making decisions, or trouble thinking or concentrating
    • Recurrent thoughts of death or suicide, or a suicide attempt

      So this isn’t something you can tell people to “cheer up” and they’ll get over it. It isn’t a choice and it isn’t brought on by a lack of effort on  one’s part to “be cheerful”. Imagine being in a wheelchair and people constantly telling you to “get up and walk”, that’s all you need to do to get better. Or, similarly, imagine being blind and someone telling you that you aren’t trying hard enough to see; if you would just force your eyes to see, then you could. Sounds ridiculous, doesn’t it?! But the exact same thing happens with depression… people don’t understand so they go about issuing platitudes or solutions as if one magic little thing would fix it. “Cheer up!”, they say, or “What do you have to be sad about? You have a great life!”… as if you have no right to be depressed. How horrible would it be to suggest to an amputee that they had no right to lose that limb, or a to any person with a visible, physical disability that they are less of a person because they choose to be that way or they must’ve done something to be in that position. This condemnation of the condition of depression leads to piling on more of the feelings of worthlessness and certainly does more harm than good. The lack of understanding leads to a more drastic feeling of isolation and so the downward spiral goes.

  3. This brings me to my final observation: suicide. Ever since I was a child, the word “suicide” has always been taboo. People almost cringe at the mention of the word and, therefore, don’t want to even think about it, much less talk about it. It is offensive to people when they think that something, or anything, can be worse than death. I’ve come to understand that there are some things in life that are actually worse than death. Things like constant pain, depression, feelings of worthlessness, anxiety, medical problems, isolation and extreme loneliness that comes from chronic illness which others cannot possibly understand – all piled one on top of another on a single person. I can tell you that being a part of a group of people who all share the same problems, I see the recurring theme of suicidal thoughts. People suffering from chronic illness are prone, not only to clinical depression, but the inevitable side effect and it’s constant companion – suicidal thoughts. “They’d be better off without me.” or “I can’t take it anymore… I’ve reached the limit of what I can handle.” or “I’m alone and suffering in constant pain. Nobody cares about me; they all think I’m a burden.”

If you know someone who is chronically ill, chances are they are suffering from depression, as well. If you care about them, let them know you care… for real! In tangible ways, you can let people know you care and are thinking about them with a simple phone call, an invitation to do something like go to dinner or to do something they enjoy. A warm hug, a friendly smile, a sincere, unrushed conversation, a handwritten note in their mailbox can all be encouragement maybe in one of the darkest hours of their lives.

Chronic illness is sometimes “invisible” and so is depression, but they go hand-in-hand and I can assure you that the suffering is very real… probably more than you could ever imagine. Take the time to let someone you know you care. You may be the person who makes a significant difference in someone’s ability to live for another day. Just don’t try to “fix it for them” by playing it down, or trivializing it. Don’t try to offer simple solutions that makes them feel even worse, and do not tell them that everybody is sad sometimes, but they get over it. Nobody would choose depression over happiness. Nobody.

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