Autoimmune disorders, such as lupus, rheumatoid arthritis (RA), and inflammatory bowel disease (IBD), are characterized by chronic inflammation and immune system dysfunction. Living with these disorders impacts more than just physical health; it also brings significant psychological challenges. Chronic pain, frequent doctor appointments, and lifestyle changes can disrupt what was once normal, adding to the stress of everyday life. Therefore, it should come as no surprise that people with these disorders often experience symptoms of Major Depressive Disorder (MDD).
The Prevalence of Depression in Autoimmune Disorders
Major Depressive Disorder (MDD) is the third leading cause of disability worldwide, affecting around 21 million people in the US alone. Additionally, one in ten people globally are diagnosed with an autoimmune disorder, and these conditions are projected to become even more common in the coming years.
The Importance of Treating Depression
Adults with autoimmune disorders are more likely to experience MDD due to physical, psychological, and social factors. For instance, individuals with RA are two to three times more likely to be diagnosed with MDD. Therefore, it is important to screen and treat MDD, especially in people with these disorders. Untreated depression can make medications that treat autoimmune disorders less effective, leading to a reduced response to treatments such as biologic medications. Furthermore, untreated depression in these patients has been linked to higher mortality rates, increased suicide risk, poor symptom control, reduced remission rates, and higher levels of pain, fatigue, and physical disability. Overall, they experience a significantly lower quality of life and greater physical, social, and psychological impairment.
Psychiatric Treatments
The best treatment for patients with both an autoimmune disorder and MDD is a combination of psychiatric medications, psychotherapy, and medications to treat the autoimmune condition.
Psychiatric Medications
- SSRIs: Fluoxetine (Prozac), sertraline (Zoloft), escitalopram (Lexapro)
- SNRIs: Venlafaxine (Effexor), duloxetine (Cymbalta)
- Atypical Antipsychotics: Cariprazine (Vraylar), aripiprazole (Abilify)
Psychotherapies
- Cognitive Behavioral Therapy (CBT): Helps patients identify and change negative thought patterns.
- Mindfulness-Based Stress Reduction (MBSR): Incorporates mindfulness meditation and yoga.
- Supportive Psychotherapy: Provides emotional support and practical advice.
- Group Therapy: Offers a sense of community and shared experience.
- Biofeedback: Teaches control of physiological processes to reduce stress.
These, together with the treatments from an autoimmune doctor, can help keep both MDD and autoimmune disorders in check and allow for the best quality of life.
At our clinic, we specialize in psychiatric medication management to provide comprehensive care for the psychological aspects of autoimmune disorders. Together with your autoimmune specialist and therapist, we can find a treatment plan tailored to your specific needs. If you or someone you know is struggling with an autoimmune disorder and depression, reach out to us. We're here to help!
References
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- Bingham, K. S., Rozenbojm, N., Chong-East, M., & Touma, Z. (2021). Exploring the mental health needs of persons with autoimmune diseases during the coronavirus disease 2019 pandemic: A proposed framework for future research and clinical care. ACR Open Rheumatol, 3(1), 25-33. https://doi.org/10.1002/acr2.11205
- Euesden, J., Danese, A., Lewis, C. M., & Maughan, B. (2017). A bidirectional relationship between depression and the autoimmune disorders - New perspectives from the National Child Development Study. PLoS One, 12(3), e0173015. https://doi.org/10.1371/journal.pone.0173015
- Fakra, E., & Marotte, H. (2021). Rheumatoid arthritis and depression. Joint Bone Spine, 88(5), 105200. https://doi.org/10.1016/j.jbspin.2021.105200
- Fangtham, M., Kasturi, S., Bannuru, R. R., Nash, J. L., & Wang, C. (2019). Non-pharmacologic therapies for systemic lupus erythematosus. Lupus, 28(6), 703-712. https://doi.org/10.1177/0961203319841435
- Malhi, G. S., & Mann, J. J. (2018). Depression. Lancet, 392(10161), 2299-2312. https://doi.org/10.1016/s0140-6736(18)31948-2
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- Prendergast, K. L., Gowey, M. A., Barnes, M. J., Keller, C. V., Horne, C., & Young, J. (2022). Treating anxiety and depression in inflammatory bowel disease: a systematic review. Psychology Health, 37(1), 105-130. https://doi.org/10.1080/08870446.2020.1867135
- Read, J. R., Sharpe, L., Modini, M., & Dear, B. F. (2017). Multimorbidity and depression: A systematic review and meta-analysis. Journal of Affective Disorders, 221, 36-46. https://doi.org/10.1016/j.jad.2017.06.009
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