Living with the hepatitis C virus doesn’t just take a toll on your liver. It can also affect your mind. What’s more: Negative mental health effects can also stem from your hepatitis C treatment.
“People with hepatitis C are at increased risk for mental health issues compared with people in the general population,” notes Andrew J. Muir, MD, MHS, an associate professor of medicine and clinical director of hepatology at Duke University Medical Center in Durham, N.C.
Here are the psychological challenges you might face — from both having and treating hepatitis C — and what you can do to feel better in mind and body.
The Link Between Depression and Hepatitis C
There can be an unfortunate stigma attached to a hepatitis C diagnosis, stemming from people who don’t understand the disease. As a result, people with hepatitis C may become isolated, which can pave the way toward depression, says Camilla Graham, MD, an assistant professor of medicine at Harvard Medical School in Boston. Many people with hepatitis C become withdrawn and depressed because they feel judged or shunned by others.
In fact, a review of research on hepatitis C published in the journal Hepatitis Monthly in 2013 found that people with the virus are more likely than others to report problems with social and physical functioning, general health, and vitality.
Help lift your mood by seeking social support from loved ones and others who also have the condition, suggests Dr. Graham. If the feelings of sadness become overwhelming, she says, it may be time to seek medical help. "It’s really important to deal with any mental health issues, especially depression, because they can get in the way of faithfully taking medications to treat hepatitis C," says Graham. "It also increases the risk for engaging in unhealthy behaviors that may make hepatitis C progress faster."
If you're worried about taking antidepressants, know that most of the antidepressants used today are safe, says Graham. "Your doctor may monitor liver enzymes more closely if you have cirrhosis, and he or she will always start with the lowest possible dose."
Anxiety, Mood Changes, and Hepatitis C
Mood changes, including anxiety and irritability, can come with a diagnosis of hepatitis C. You may feel anxious about both your diagnosis and your future when you learn you're at risk for liver cancer or death, Graham says. Learning more about the disease and its treatments can help you better cope with anxiety.
These same mood changes may also be a side effect of hepatitis C treatment. For example, irritability is an under-acknowledged side effect of interferon therapy, according to a study published in the Journal of Clinical Nursing in 2011.
“Some of the older treatments can make depression, anxiety, and irritability worse due to their side effects,” says Dr. Muir. “The new treatments are less likely to cause these side effects and also offer more hope for their ability to clear the virus.”
The Connection Between Sleep Problems and Hepatitis C
Sleep disturbances are common among people with hepatitis C, affecting about 60 percent of people with the infection, according to the Hepatitis Monthly research review. Some sleep issues may be due to psychiatric problems, substance abuse issues, or advanced liver disease. In turn, not getting proper rest can increase your risk for depression, anxiety, and not feeling well in general, Graham says. Effectively treating hepatitis C can help alleviate some of the fatigue and sleep problems once the virus is cleared, she says. However, sleep disturbances may also be a side effect of certain hepatitis C treatments.
Substance Abuse, Mental Illness, and Hepatitis C
Hepatitis C is often contracted through needles or other equipment used to inject drugs, and many people with hepatitis C also struggle with substance abuse — as well as the mental health issues that can go hand-in-hand with that abuse. “Pre-existing mental health issues can increase risk for substance abuse and hepatitis C,” Graham says. Seeking treatment for substance abuse can make a big difference in your mental health and the health of your liver, she says.
Severe Mental Health Issues With Hepatitis C
Some people with hepatitis C also face severe mental health issues. The prevalence of hepatitis C infection in people with severe mental illness, including psychosis, may be as high as nine times that of the general U.S. population, according to a 2010 study in The Primary Care Companion to the Journal of Clinical Psychiatry. Mental health treatment is crucial in these cases.
Getting Mental Health Support
Regardless of whether mental health issues were present before a hepatitis C diagnosis or were caused by diagnosis or treatment, people with the disease should benefit from getting treated. Treatment can include medication, therapy, attending support groups, or a combination of these options."There is no reason to feel alone or helpless, especially now that we know hepatitis C is curable,” says Muir.
Keep in mind that healthy lifestyle choices, like engaging in regular exercise, can also help treat the depression and anxiety associated with hepatitis C. As Graham says, “Healthy choices can improve overall mood and general feelings of well-being.”