By Megan Prescot, MSW, LCSW, FMC-NA

A diagnosis of chronic kidney disease (CKD) can be overwhelming. Individuals respond to the diagnosis in different ways, but it is common to have strong emotions when faced with the reality of needing to start dialysis. You may feel anger, guilt, and shock. You may notice changes in your ability to work, your role in your family or your social life – all of these add to the confusion and upset that most people report feeling as they learn to cope with CKD.

For some, both physical and emotional treatment and rehabilitation is necessary.

Most people are able to adjust and return to many of the activities that were present in their lives before CKD, including family, travel, leisure and work. To live well with kidney disease, it is important to care for both the physical and emotional changes that you may experience. Talking with someone about these changes and how they affect you can help you manage your feelings and lower your chances of becoming depressed or anxious, while increasing your chances of making a positive adjustment to living with CKD.

When to Get Help

Statistics show that up to 40 percent of people with CKD experience depression at some time (1) (2). Signs of depression include trouble enjoying things that used to be fun, staying away from social situations such as time with family and friends, having a hard time concentrating and feeling sad or down most of the time. If you have one or more of these symptoms it does not always mean that you are suffering from depression, but it is important to discuss your symptoms it does not always mean that you are suffering from depression, but it is important to discuss your symptoms with a professional who can help you. Other symptoms commonly experienced by people suffering from depression, such as difficulty sleeping and low appetite, can also be symptoms of uremia.

Usually, depression is easily treated. Many people find that talking about their feelings with the dialysis unit social worker or doctor, taking anti-depressant medication or seeing a counselor on a regular basis can make a big difference. Usually, a combination of counseling and medication is most effective in preventing or managing depression. Some people living with a chronic illness have a great deal of anxiety and nervousness. People who have an anxious emotional response to a diagnosis or treatment of CKD can sometimes have trouble sleeping and feel nervous and worried much of the time, often over things that they normally would not worry about. Anxiety can be quite disruptive to people’s lives, making it difficult to relax, concentrate, and become involved in everyday activities. Some symptoms of depression and anxiety are similar, and anxiety itself is sometimes a sign of depression , so a proper evaluation by your medical team is important. Anxiety is also treatable with counseling and medication.

Dialysis Social Workers

Every dialysis center has a team on site to handle the range of challenges that people on dialysis or with a transplant face. It is important for you to partner with the members of your dialysis team to make use of the skills that each has to offer. Fortunately, to find out about social support, professional counseling, and to learn about a variety of treatment options for depression, anxiety or difficulty adjusting to dialysis and CKD management, you need look no further than your dialysis social worker.

The dialysis social worker is the one member of the health care team with training and experience in dealing with mental health issues. His or her main role is to counsel people with CKD and their family members to help them adjust to the changes and challenges. Social workers can give brief therapy in the dialysis unit to help people better understand and manage some of the feelings and thoughts that can lead to depression or anxiety. The social worker can partner with individuals to identify and solve problems that often come along with the challenges of living with CKD and help them to develop better coping strategies.

Treatment Options

There are a variety of treatment options available to help with the emotional reactions to a CKD diagnosis. First, you should talk to your social worker about how you are feeling. In addition to helping you understand your feelings, your social worker may be able to help you learn the best treatment options for your unique experiences.

Among the treatment options available for depression and anxiety are individual and family counseling, offered through many counseling centers in the community. Social workers can give you resources for group counseling and support groups for people facing similar challenges.

Have questions about kidney disease?

Visit the National Kidney Foundation website or call them toll-free at 855-NKF-CARES (1-855-653-2273).

Reprinted with permission from the National Kidney Foundation Family Focus newsletter.