When depression occurs with other medical conditions

Many factors can mark the onslaught of depression.  Genetics, as well as a wide range of difficult life circumstances, have been shown to impact brain chemistry and cause depression. Depression can also arise in conjunction with other medical conditions, or as a consequence of those conditions. Some of the most common medical circumstances found to co-occur with depression include:

Depression after surgery

Some anxiety is to be expected before undergoing surgery. But many people are surprised to learn that it is quite common to experience anxiety and/or depression as well.  Immediately following surgery or even months later, patients may develop symptoms of depression as they struggle to cope with endocrine changes, the effects of anesthesia, feelings of loss or mortality, uncertainty about their future health, a sense that those close to them do not understand what they have endured, or the effects of new medicines given to deal with the surgery.

The medical staff charged with helping a patient recover from surgery may not be aware of the appearance of depression.  If you or someone you care about is experiencing any of the symptoms, it’s important to communicate these concerns or feelings with a healthcare provider.

To learn more, and to help prepare yourself to discuss your concerns with a professional, visit these other sections of this website:  Are you depressed? and Talking with your healthcare provider.

Depression and heart disease

Depression can be both a cause and a result of cardiovascular (heart) disease, and vice versa.   The terms “co-occurrence” or “co-morbidity” are commonly used to describe the relationship between the two.

Depression – even mild depression -- is a common and significant risk factor for developing cardiovascular disease. It can also be related to future cardiovascular complications.  Recovery from heart disease has also been shown to be compromised by depression. None of this is surprising, knowing that depression is related to many of the lifestyle factors that contribute to heart disease, such as poor diet, inactivity, drug or alcohol abuse or social isolation.

Many symptoms, such as low energy, sleep problems and irritability, are common to heart disease. Other emotional symptoms, such as feeling sad or losing interest in pleasurable activities, could be assumed “normal” when facing a potentially life-threatening illness and are therefore not adequately addressed.

The good news is that, when depression is recognized in conjunction with heart disease, many of the steps an individual can take to address one of the two illnesses will actually help with both co-occurring diseases:

If the symptoms of depression appear to be present along with heart disease, consult with a healthcare professional. Together, you can develop a self-care program that fits your complete health profile. 

Need advice on starting that conversation?  Visit Talking with your healthcare provider.

Depression and cancer

Depressive disorders arise frequently in conjunction with a cancer diagnosis. As cancer patients, their families and their healthcare providers focus on the wide range of physical effects of the disease and its treatment, it is easy to see how the emotional aspects of cancer might be overlooked.  But increasingly, healthcare providers are realizing that mental health issues associated with a cancer diagnosis must be addressed. 

Potential triggers for depression are present throughout the cancer journey, from the anxiety of hearing the diagnosis to the tremendous physical and psychological toll of grueling treatment regimens to the uncertainty and worry associated with the possibility of the disease returning or spreading.  The brain and body immune systems are both altered.

Cancer treatment itself can also induce emotional difficulties.  Mood changes can occur as a result of some treatments, such as high doses of steroids, or interferon. These compounds are known to contribute to depression, anxiety or even psychosis. Many of the most common symptoms and side effects associated with cancer and cancer treatment, such as poor appetite or fatigue, also occur frequently with depression or anxiety, making it challenging to determine exactly what’s causing the symptoms. 

Finally, it’s important to recognize that the seeds of depression may already be present when a person is diagnosed with cancer.  Patients who have experienced brain problems like depression, substance abuse or anxiety may find that those issues return with cancer.  

The National Comprehensive Cancer Network (NCCN), a coalition of 19 comprehensive cancer centers across the country (including U-M), recently released the following guidelines to help doctors and patients recognize the symptoms of distress associated with cancer treatment:

In addition, events or experiences from the past may make some people more vulnerable to cancer-related depression or distress, including:

If you or someone you care about is living with cancer and experiencing any of these symptoms or concerns, speak with a healthcare provider about making depression treatment part of the cancer recovery program.  Need advice on starting that conversation?  Visit Talking with your healthcare provider.

Depression and diabetes

Individuals suffering from either type I or type II diabetes mellitus (diabetes) are at an increased risk of developing depression.  The anxiety caused by a diagnosis of diabetes can trigger depression, as can the ongoing stress of adhering to a treatment plan and the worry associated with the possible physical consequences of advanced disease.

Although diabetes and depression are two very different illnesses, when it comes to their treatment, they have much in common: 

Research studies have shown that the presence of depression makes living with diabetes even more challenging.  Diabetics with serious, untreated depression are less inclined to adhere to their diabetes treatment plans. They are less likely to stick to their diabetic diets or to get oral medication prescriptions filled promptly.  Diminished physical ability and mental functioning have also been recorded among diabetic patients who suffer from depression. 

If you or someone you care about is living with diabetes and experiencing any of the symptoms of depression, a healthcare provider may be able to help with advice about making depression treatment part of the diabetes management program. Need advice on starting that conversation?  Visit Talking with your healthcare provider.