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Depression, Anxiety, and Lupus

Reviewed by: HU Medical Review Board | Last reviewed: January 2020

Most people with lupus report symptoms of depression and anxiety. Some studies report rates of depression and anxiety are twice as high in people with lupus compared to the general population.1

Some depression and anxiety may result from the stresses of living with a chronic condition like lupus and its chronic pain, rashes, and steroid use. In other cases, lupus attacks on the nervous system may cause inflammation that results in depression and anxiety.2

Regardless of the cause, depression, and anxiety are important complications to treat because studies show that other symptoms and outcomes get worse if mood disorders are ignored.2,3

There is also evidence that women with lupus and untreated depression suffer higher rates of obesity and cardiovascular diseases such as arteriosclerosis, heart attack, stroke, and high blood pressure.4

What is depression?

Everyone feels sad or blue at times and it is perfectly normal. However, feelings of sadness, grief, worthlessness, or hopelessness that last every day for two weeks or longer is depression. Other symptoms of depression include:

  • Loss of interest in or pleasure taken in favorite activities
  • Thoughts of death or suicide
  • Too much or too little sleep
  • Trouble concentrating
  • Low energy and fatigue
  • Anger or irritability

Many of these symptoms overlap with other side effects of lupus, making it more complicated to tell what is going on. It is important to talk to a health care professional, a friend or family member if you are experiencing any of these feelings.5

What is anxiety?

Like depression, anxiety is a normal human emotion that everyone feels from time to time. Chronic (long-term) anxiety is described as feelings of tension, worry, or nervousness. Some people also experience physical symptoms of sweating, trembling, voice changes, and increased blood pressure. Anxiety triggers the fight or flight response in the adrenal glands, causing a surge of adrenaline.

Treatments for anxiety and depression

Treating anxiety and depression helps improve a person’s quality of life and makes it easier to adhere to healthy habits that help reduce flares. For example, getting enough exercise, being around other people, and choosing healthy foods are all more likely when you feel mentally strong.

Many treatment options exist for depression and anxiety, including counseling, medicines, self-care methods, and complementary and alternative therapies. Some people with lupus may need better pain control through medication and exercise to improve their mood. Others may need to concentrate on stress management, antidepressants or force themselves to get out more.5

Self-care methods

  • Counseling
  • Healthy diet
  • Exercise
  • Good sleep habits
  • Stress management
  • Hobbies involving art, music, or dance
  • Volunteering5

Medicines for depression

Dozens of antidepressants are available to help ease the symptoms of clinical depression. The main kinds of antidepressant are tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), selective serotonin and norepinephrine reuptake inhibitors (SNRIs), bupropion, mirtazapine, and trazodone.6

Medicines for anxiety

Commonly prescribed anti-anxiety drugs include benzodiazepines, hypnotics, and sedatives. Many antidepressants are also used to treat anxiety.7

Complementary and alternative therapies

  • Yoga or tai chi
  • Acupuncture
  • Mindfulness or meditation practice
  • Cognitive Behavioral Therapy
  • Dietary supplements5,6

There is no one-size-fits-all answer for treating depression or anxiety. Different people respond to different combinations of drugs, self-care, and alternative therapies. You will probably have to experiment over months and years to find what brings relief and improves well-being for you. Regardless of what you try, discuss all potential over-the-counter drugs and supplements, and any new exercise with your health care team. Many supplements can interact poorly with steroids, NSAIDs, antimalarials, and immunosuppressants.5

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