Anxiety, which involves a feeling of worry, nervousness, or unease, is common in people who have been diagnosed with chronic kidney disease (CKD). Understanding your CKD diagnosis and how to manage the disease can be anxiety-inducing. For some, without the right coping techniques, the anxiety can become debilitating. Learn how to recognize the signs of anxiety and how to manage it.*

Risk factors and anxiety triggers

There are several different reasons as to why you may develop newfound feelings of anxiety, including:

• Dealing with a life-changing event
• Being diagnosed with generalized anxiety disorder (GAD) or panic disorder
• Not having practiced coping skills or not having outlets for stress management
• Expecting or not expecting kidney disease to lead to dialysis
• Not being well informed on your treatment options or CKD in general

Several factors may also trigger your anxiety as you navigate your diagnosis, such as:

• Health/disease status (e.g., if a transplant or dialysis could be in the future)
• Fear of the unknown (e.g., insurance or finance worries)
• Loss of control (e.g., feeling stuck)
• Stress
• Overbearing loved ones
• Poor sleep
• Lack of knowledge/information
• Phobias 
• Poor relationships with medical personnel
• Sadness and depression
• Certain medications (e.g., steroids)

What symptoms to look for

While your doctor needs to rule out any related medical causes that could exhibit similar symptoms, some signs of anxiety include:

• Shortness of breath
• Trembling of hands
• Excessive sweating
• Increased heart rate
• Chest pain
• Changes in blood pressure
• Dizziness
• Abdominal pain
• Feeling disconnected from reality 

Other symptoms may include:

• Fear of dying
• Irritability
• Anger
• Desire to isolate from friends and family
• Muscle tension
• Avoidance of everyday activities
• Depression
• Worrisome or obsessive thoughts
• Poor concentration

It’s important to consider the duration of these symptoms and the level at which these symptoms are disrupting your participation in your day-to-day. Make sure to give your doctor as many details as possible so they can recommend the most appropriate treatment plan for you.

Getting the help you need

If you’re experiencing anxiety for longer than two weeks, you should let your dialysis team know that it’s become a recurrent issue. In a webinar on anxiety presented by the American Kidney Fund (AKF), Chasity Shugart, LCSW-S, shares ways in which CKD patients can reduce anxiety, particularly for anyone between the pre-dialysis stage and transplant stage.

These tips include:

• Get as much information as you can pre-dialysis.
• Get involved with your local ESRD (end-stage renal disease) network.
• Find a support group.
• Talk to your doctor about exercise.
• Talk to your doctor or social worker about talk therapy and/or supplements/medications.
• Attend all doctor’s appointments and come with questions.
• Engage with your facility representative.
• Participate in patient care conferences or request one with your dialysis team.

Incorporating some additional self-care techniques into your daily regimen may also lead to stronger mental health, such as:

• Finding new hobbies
• Engaging in mindful thinking
• Meditating or doing breathing exercises
• Limiting or cutting out caffeine
• Journaling
• Doing physical exercise
• Practicing proper sleep hygiene (e.g., avoiding exercising or using technology close to bedtime)

If at any point your anxiety becomes too much to handle and the above tips aren’t helping, be sure to lean on the resources available to you, such as your friends and family, the National Alliance on Mental Illness (NAMI), and the Anxiety and Depression Association of America (ADAA) for telemental health or mental health apps.

*American Kidney Fund [kidneyfund]. (2019, Jan. 2). Webinar: Anxiety and kidney disease [Video file]. Retrieved from https://www.youtube.com/watch?v=a0_VIl2k9k4