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Lupus and Mental Health: What You Need to Know

May is National Lupus Awareness Month. It’s an opportunity for the lupus community to join together across the country to raise funds and awareness of the physical, emotional and economic impact of lupus. Lupus is a long-term autoimmune disease in which the body’s immune system cannot distinguish healthy body tissue from foreign particles such as bacteria or viruses. When the immune system attacks healthy tissue, the resulting inflammation and swelling can have damaging effects on joints, skin, kidneys, heart and lungs.

In addition to its physical symptoms, lupus can also impact mental and emotional health which in turn, can impact on your behavior. The unpredictability of lupus flares, the pain and fatigue can all have a compounding effect on emotions. Additionally, medications taken to manage lupus may have side effects that cause mood swings or emotions that are significantly different from those that you normally feel or want to express. Not to mention, coping with an illness, especially an unpredictable one, is stressful. People with lupus are at higher risk of depression and anxiety because of all the stressors a chronic condition can bring on. Here’s how to cope:

Lupus, Pain and Mental Health

Pain, fatigue and other symptoms of lupus can make everyday tasks feel uncomfortable, difficult and frustrating. In fact, 65% of people living with lupus say that chronic pain is the most difficult part of the disease. Living with chronic pain can make it difficult to do things you once enjoyed which can have physical and emotional repercussions as well as take a significant toll on daily life.

Lupus pain and fatigue can also lead to social isolation and may disrupt your work and social life. You may face new challenges at work, discover that you don’t have the energy for socializing, or find it difficult to continue a relationship with a romantic partner or start a new one after being diagnosed with Lupus. When chronic illness effects your ability to work and socialize, it can impact your sense of purpose and increase financial stress. You may find that while your friends are building careers, romantic partnerships, and families, you’re busy managing a chronic illness instead. Physical limitations and a decreased quality of life can play roles in depression and other mental health conditions.

Lupus, Medications and Mental Health Effects

Many people diagnosed with lupus face a higher risk of depression. Lupus can affect your nervous system and cause symptoms such as memory problems, difficulty concentrating, mood swings, and confusion. These symptoms, sometimes referred to as “lupus fog,” can impact mood and strain your mental health. If you’ve received a lupus diagnosis, there is also the chance that some of the medications you take could contribute to this increased risk.

Corticosteroids, like prednisone, are commonly used to treat lupus. These medications play a role in clinical depression as they lower the body’s serotonin levels. This can increase the risk of depression, even in those who are not ordinarily prone to depression. Withdrawal from the medication can also increase the risk of depression.

The uncertainty associated with chronic illnesses, like lupus, can increase stress and anxiety. Not knowing if you will be able stay independent or if you will be able to manage the physical and financial repercussions can be emotionally draining.

Unpredictable changes in mood and personality are also common with lupus. As a result of the disease process or, in some cases, the use of corticosteroid medications, individuals living with lupus can experience unpredictable mood and personality changes, including anger and irritability.

The effects on outward appearance from the disease can also have an effect on your mental health. Visible effects of the disease such as a facial rash or weight gain from medication can result in lower self-esteem. Concerns about changes in appearance can be another reason why someone living with lupus may have an increased risk of social isolation. 

What can you do?

If you have been diagnosed with lupus and are experiencing mental health symptoms or side effects, you are not alone and you have treatment options.

Seek mental health treatment. Ask your doctor for a referral to a psychiatrist, psychologist, or therapist. Psychotherapy, under the guidance of a trained professional, can help you learn to understand your feelings, your illness, and your relationships, and to cope more effectively with stress. You can also ask your mental health provider about antidepressants and other treatment options for depression and anxiety, like transcranial magnetic stimulation (TMS), a non-invasive, drug-free treatment for depression that’s covered by most insurance.

Find ways to reduce pain. Chronic pain can be a factor in the development of clinical depression. Ketamine is a dissociative anesthetic that can help relieve symptoms of depression and anxiety, particularly when resulting from chronic pain. Besides medication, experts often recommend non-medication ways to conquer—or at least reduce—chronic pain, such as yoga, Tai Chi, Pilates, acupuncture, meditation, behavioral changes, play therapy, and chiropractic care.

Reduce inflammation with nutrition. An anti-inflammatory diet can reduce the risk of depression & improve quality of life. Plant foods fight inflammation whereas red meats & processed foods are strongly inflammatory. Maintaining a diet rich in whole, unprocessed foods is the best way to get nutrients and fight inflammation. However, when stress, travel or poor food choices deplete the body’s vitamin supplies, IV nutrition, especially NAD+ infusions, can help nourish, replenish and hydrate.

Improve your sleep habits. High quality sleep improves both physical and mental health including the ability to exercise, eat well, handle stress, pay attention, build new memories, deal with tough emotions and interact with others. To improve your sleep, and, in turn, your mental well-being, try to:

  • Get seven to eight hours of sleep in a 24-hour period.
  • Aim to fall asleep and wake up at the same time Monday through Sunday.
  • Avoid caffeine, nicotine, alcohol and blue light emitted from electronic screen at least one hour before bedtime.
  • Optimize your sleep environment with a good mattress, comfortable bed linens, the right room temperature, and the right amount of darkness.
  • Develop a calming pre-bedtime routine like listening to a calming playlist or podcast, reading, taking a hot bath or shower, meditating or deep breathing.

Build a support system. People who maintain a positive social support network and feel a genuine sense of belonging experience improved health outcomes and lower rates of depression and anxiety. Stay in touch with family members, former work buddies, or long-time friends. Make phone calls, join Facebook, try videoconferencing, or consider adding an animal companion to your family.

Educate yourself — and others. Learn as much as you can about the disease and its treatment options. Share information with friends and family members so they will better understand the disease and how it affects you. Their support is important to success in managing the illness.

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