Our bodies are designed to handle stressful situations, particularly immediate stressors that pose a danger to our survival. Unfortunately, the stress of living with chronic kidney disease (CKD), especially end-stage kidney disease (ESKD), can overburden even the genius of our design. For this reason, kidney patients can be more vulnerable to depression than those without serious health issues.*

What are common symptoms of kidney disease and depression?

The rate of depression across racial and gender lines in kidney patients is fairly balanced, meaning that kidney patients, on the whole, are at equal risk. Many of the key symptoms of depression—such as insomnia, loss of appetite, weight loss, and low energy—are also common symptoms of kidney disease. This can pose a challenge when diagnosing depression in kidney patients.

These common symptoms include:

• Fuzzy thinking
• Difficulty making decisions 
• Increasing irritability
• Constant fatigue
• Sleeping more, or less, than usual
• Loss of appetite or wanting to eat more than usual
• Significant weight loss or weight gain in a short amount of time

What symptoms can indicate depression?

To get treatment for depression, it’s important to be able to recognize the symptoms and let your doctor know. It’s natural to feel nervous and angry upon receiving a CKD diagnosis. It’s also normal to feel resentful at a new dependence on caregivers, healthcare providers, and dialysis.

There are other symptoms, however, that you should take seriously if they persist, such as:

• Anxiety about your future
• Ongoing difficulty falling asleep or staying asleep 
• Feelings of powerlessness and/or hopelessness 
• Apathy about your disease and abandoning your care regimen 
• Constant sadness, especially in circumstances  you used to feel happy

What should I do if I’m depressed?

Let your doctor know if you experience any of the symptoms above. Seek help immediately if you have thoughts of suicide or self-injury. 

You can call or turn to:

• A healthcare professional
• Your spouse or significant other
• A trusted friend or family member
• Your religious leader or pastor
• National Suicide Hotline: (800) 273-8255
• 911 for an emergency response

Once I seek help, how is depression treated?

Depression is typically treated with psychotherapy (or “talk therapy”), medication, or a combination of both. These two types of treatment may be provided by different specialists. Psychotherapists are usually licensed mental health counselors (LMHC) or licensed clinical social workers (LCSW). They cannot prescribe medications to treat depression. 

Antidepressant medications can only be prescribed by a qualified medical doctor—most often a psychiatrist—and many psychiatrists don’t also provide talk therapy. Some psychiatrists require that you actively work with a therapist before they will prescribe antidepressants. Nurse practitioners can prescribe some of the milder medications in low dosages. 

Consult with your nephrologist before taking antidepressants, as they can significantly impact your kidney function. 

Self-empowerment and taking charge

Many kidney patients find that they feel less anxious and more hopeful when they advocate for themselves and actively engage in their treatment and care. 

Some ways that you can do this for yourself include:

• Educate yourself about the disease you have
• Ask questions about your treatments and speak up about your experience
• Partner with your doctor and the rest of your healthcare team in decision-making 
• Seek out and join peer communities for support and to support others 
• Become involved in kidney health advocacy at the local, state, and/or national levels

How your support network can help

If you’re a patient, here are some ways that your family members, friends, and caregivers can help support you. Don’t be afraid or hesitate to ask for support. 

If you are a family member, friend, or caregiver of someone living with kidney disease, these are some ways you can support your loved one:

• Listen to them with compassion and free of judgment.
• Encourage them to set small, attainable health goals.
• Go to dialysis appointments with them. 
• Remind them about available resources, such as social workers at dialysis centers; mental health professionals; self-help books and podcasts; and spiritual guidance.
• Participate in your usual activities together, if/when feasible.
• Help them to remain productive, contributing members of the household.

Depression is treatable, and resilience can be developed. Kidney disease may alter your lifestyle, but it doesn’t have to rob you of your quality of life.

Additional information on depression and chronic kidney disease can be found on the DaVita Kidney Care website.

*American Kidney Fund. (2018, July 5). Depression in Kidney Disease Patients. https://www.kidneyfund.org/kidney-today/depression-in-kidney-disease-patients.html