The Link Between Situational Depression and Chronic Illness

Learn the differences between situational and clinical depression and how chronic illness plays a role.

I have friends who have dealt with depression for as long as they remember. All are currently on medication, and one has been hospitalized multiple times. When my neurosurgeon suggested I see a therapist before my second major spine surgery, I brushed it off.

I was nothing like my friends. I occasionally felt down but would bounce back in a day or 2. I soon learned that not all depression involves a chemical imbalance. Sometimes, life can put you into a change in mood that affects your whole body.

In my case, my COPD was causing situational depression.

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What are the symptoms of situational depression?

There are definitely differences in the mechanisms of various types of depression. However, the symptoms of situational depression are often the same as clinical depression. They usually include any or all of the following:

• changes in mood, mostly to sadness
• lack of energy to do things
• feelings of hopelessness
• insomnia or sleeping more than usual
• eating too much or too little
• difficulty concentrating or focusing
• loss of interest in social events
• no longer doing activities you used to enjoy
• excessive crying
• avoiding spending time with friends and family
• anxiety about doing things that didn’t bother you before

Most people associate depression with just sadness, but that’s not always true. You may not even have that symptom. It’s easy to say that your lack of energy is just from your COPD, or your difficulty sleeping is from breathing or gastroesophageal reflux disease (GERD). That’s what I did for a long time.

It’s important to recognize that these symptoms are all common for us to have at some point in our lives. The problem occurs when they do not go away. I was lucky enough to have a surgeon who recognized this.

Learning the cause of situational depression

Clinical depression is often caused by a chemical imbalance in the body. My friends with this type of depression often need to take medication.

Situational depression is exactly what it states: What you’re feeling is being caused by your situation. For example, that might mean you experienced a tragedy, an accident, a divorce, or another life-changing event.

It can be caused by a big move in your location or even your career. It’s often called an “adjustment disorder” or “reactive disorder” because your mind and body react and need to adjust.

For me, it was caused by my COPD and other chronic illnesses. The irony was that I did not lose interest in going out or doing things I previously loved. I was no longer able to do many things I enjoyed before.

I didn’t have the energy or could not physically participate, so I became sad and had anxiety.

I already had COPD, lupus, and other autoimmune issues. A long back surgery, with a 10-month recovery, was the last straw for me in dealing with it all. I faced having a second one.

What I did for my depression

I followed my surgeon’s advice and saw a therapist. I actually found one who specializes in dealing with people who have chronic illnesses. She said situational depression is common among her patients.

While my original therapist left her practice, I have continued with another. I really look forward to our conversations. One of the things that’s been an important part of dealing with this is recognizing that I have control over the quality of my life.

I may not be able to make any of my illnesses go away, but it’s up to me to choose what I want to do about it. I can decide what tests, procedures, surgeries, and treatments I will agree to. I discuss these with her to enable me to make the decisions that are best for my life. Taking that control makes it easier to deal with depression.

I am already on a low-dose antidepressant for chronic pain and more than a dozen other medications for my illnesses. That’s why my doctor and I decided not to add anything else. But everyone is different.

Will my situational depression go away?

I would love to answer this question, but I can’t. Situational depression can go away, especially if it’s caused by something that you can deal with and move on with, like a change in a career or an accident you completely recover from. That’s one of the biggest differences between it and one caused by a chemical imbalance.

My COPD and autoimmune illnesses are extremely unlikely to go away completely, so I will probably never get over this.

If you ever feel like you want to harm yourself, please seek immediate help. Mental illness, in any form, is something you should take seriously.