It’s very difficult to admit to being depressed and by that I don’t mean just feeling a bit sad for a day or two. You may feel guilty and think you should ‘pull yourself together’, especially if there’s nothing that you can think of that accounts for why you feel this way.
Men in particular often have a hard time admitting they’re depressed, they may have been brought up to believe to believe that vulnerability is weakness and struggle to share their feelings, thinking it’s not ‘manly’ to admit to being depressed.
I have previously admitted to a period of depression which occurred before my diagnosis of lupus, I think it was an actual symptom of lupus as it came on very suddenly and there was no other reason for it. When I finally told the doctor I was feeling extremely depressed they tried to find a reason - I was happy at work, single (and happy about it) and had nothing else that was causing me any particular stress, certainly not to the extent that I would become depressed. Under normal circumstances I was (and still am) a very upbeat, glass half full kind of person so this was very alien to me.
I actually got to a very dark place quite quickly. I was standing at the edge of a tube station platform when the thought ‘one step forward and this would be all over’ came into my head. This was my wake up call and made me go to my GP for help. Ending it all is not something that I would have ever considered and I certainly wouldn’t do it in a way that would traumatise other people in such a public setting. There was obviously something very seriously wrong.
In the end the GP resorted to anti depressants which was probably the correct thing to do as no amount of counselling would have helped as there was nothing in my life at the time that could have caused it. After a few months I began to feel much better and was weaned off the anti depressants. Since then I haven’t had a recurrence of this for which I am very thankful.
With lupus depression is a bit like a chicken and egg situation. Are you depressed because you have lupus or is depression a symptom of your lupus. In my case I hadn’t had a diagnosis of lupus so I’d be pretty sure it was a symptom. Just the fact you have lupus can obviously cause depression as it’s a lot to cope with.
Also certain lupus medications, particularly corticosteroids like prednisone, can contribute to depression as a side effect, especially when taken at higher doses (20mg) or more. NHS prednisolone side effect information.
In a piece of research we helped fund (link at the bottom of this article), patients who reported that their autoimmune disease was misdiagnosed as psychosomatic or a mental health condition were more likely to experience higher levels of depression and anxiety, and lower mental wellbeing. So misdiagnosis and doctors not being believing that you are physically sick can also be a factor in causing depression.
When to seek help
It’s now known that psychological manifestations such as depression and anxiety are very common in lupus patients. Major depression is present in approximately 25% of patients and major anxiety in 37%.
It’s normal to have the odd day when you feel down, but when you are overwhelmed by the feeling it may be time to seek help. Please don’t do what I did and try to cope alone. These days things are much better, there’s more awareness, more understanding, not the stigma there was years ago and different/better treatment options. As with all lupus symptoms it can remit as mine did, there is light at the end of the dark tunnel.
The following information has come from MIND where you can also seek advice.
How you might feel
down, upset or tearful
Decreased energy
restless, agitated or irritable
guilty, worthless and down on yourself
empty and numb
isolated and unable to relate to other people
finding no pleasure in life or things you usually enjoy
a sense of unreality
no self-confidence or self-esteem
hopeless and despairing
suicidal
How you might behave
avoiding social events and activities you usually enjoy
self-harming or suicidal behaviour
difficulty speaking, thinking clearly or making decisions
losing interest in sex
difficulty remembering or concentrating on things
using more tobacco, alcohol or other drugs than usual
difficulty sleeping, or sleeping too much
feeling tired all the time (more than is ‘usual’ for you
no appetite and losing weight, or eating too much and gaining weight
physical aches and pains with no obvious physical cause
moving very slowly, or being restless and agitated
Further reading:
Systemic Lupus Erythematosus (SLE) and Depression.
Prevalence of depression and anxiety in systemic lupus erythematosus.
Impact of depression on quality of life in SLE patients.
I believe you, the words patients want to hear from doctors. Research funded by the Lupus Trust.
Angie Davidson
The content on this blog should not be seen as a substitute for medical advice. If you have, or think you may have lupus, always seek advice on a qualified physician. Find out more in our Terms of Use.
