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Anxiety and Hepatitis C

Anxiety is a common mental health disorder in the US. In fact, surveys indicate that roughly 1 in 3 American adults suffer from anxiety.1 For those with health conditions, such as hepatitis C, that rate may be even higher. Medical problems, as well as certain medications used to treat these problems, can both have an impact on anxiety.2

What is anxiety?

Occasional worry or feelings of anxiety are normal. However, anxiety disorders can cause serious, persistent worry or fear. People with anxiety may experience sudden and intense feelings or worry or fear, or these ongoing feelings may interfere with day-to-day life.

Common signs of an anxiety disorder include:2

  • Nervousness, tension, or restlessness
  • A sense of impending danger
  • Increased heart rate
  • Rapid breathing
  • Sweating
  • Trembling
  • Feeling tired or weak
  • Trouble focusing or concentrating
  • Sleep disruption
  • Stomach upset
  • Lack of control over worry
  • Avoiding situations that may trigger anxiety

How common is anxiety with hep C?

Many studies have shown a link between anxiety and hepatitis C. In fact, it is fairly common for patients with hep C to also experience anxiety. 1 in 4 patients with hepatitis C report symptoms of anxiety.3 And for patients with chronic hepatitis C, the rate of anxiety accompanying the disease is significantly higher when compared with healthy people.4 Many times, anxiety is undetected and not treated3, so it is very important to mention how you are feeling to your doctor.

Can hep C cause anxiety?

It isn’t unusual to experience anxiety or worry at the beginning if you have been diagnosed with hep C. Continuing anxiety often occurs. The impact of living with hep C can contribute to accompanying anxiety. In addition, you may experience fear about the diagnosis, symptoms, or future health problems from the disease. You may also worry about how your diagnosis might impact relationships with family or friends.5

The virus itself may also be a contributing factor. Hepatitis C is known to deplete a substance in the brain called tryptophan. Tryptophan is important in the production of serotonin, which is brain chemical that helps balance mood. The decrease in tryptophan in the brain may be linked to symptoms of anxiety.5

Anxiety as a treatment side effect

Patients undergoing treatment for hep C may also experience symptoms of anxiety as a side effect of treatment. If you have a prior history of mood disorder (anxiety or depression), you may be at an increased risk. Or, you may experience symptoms differently than you otherwise may have in the past. For example, if in the past you have suffered from feeling withdrawn or depressed, side effects from treatment may include anger or irritability, which can be symptoms of anxiety. It is important to notice any mood changes you may experience during treatment, and report those to your doctor.6

Managing anxiety symptoms

If you are a patient with hepatitis C who is also experiencing anxiety, know that anxiety is a very treatable condition. First and foremost, be sure to contact your doctor, or a healthcare professional who specializes in anxiety, and be sure to let him or her know about your hep C and any other health conditions.5

Usually, the first step toward managing anxiety is psychotherapy. Your doctor or healthcare professional may refer you to a specialist who can work with you on strategies to manage your anxiety.7

There are also several “self-help” approaches you can implement to support your therapy and help relieve anxiety symptoms, such as:6

  • Take care of yourself. Make sure you get enough rest, eat well, and take breaks when you need them.
  • Avoid being alone. Look for support groups or to friends and family to provide emotional support when you need it most.
  • Try stress management techniques, such as breathing exercises, mindfulness techniques, meditation, or yoga.
  • Avoid alcohol or other substances, like tobacco or drugs, as these can make symptoms worse.
  • Exercise. Physical activity can improve mood.
  • Don’t forget to talk to your doctor!

Your doctor may choose to prescribe medication to treat your anxiety. There are different treatment options available for anxiety. Depending on your symptoms and the severity of your symptoms, your doctor may prescribe:7

  • An SSRI (selective serotonin reuptake inhibitor)—Medications such as Celexa, Paxil, Prozac, and Zoloft fall into this category. These medications are thought to work by blocking the brain’s reabsorption of serotonin, which may improve mood.
  • An SNRI (serotonin-norepinephrine reuptake inhibitor)—Similar to SSRIs, SNRIs increase the levels of both serotonin and another mood chemical, norepinephrine. Medications include Cymbalta and Effexor.
  • A tricyclic antidepressant, which works in a similar fashion to SNRIs.
  • A benzodiapine, such as Klonopin or Xanax, which promote relaxation and reduce other physical symptoms of anxiety, and are typically prescribed for short-term usage only.

If you are prescribed a medication to treat your anxiety, be sure to report any side effects to your doctor.

  1. Bandelwo B, Michaels S. Epidemiology of anxiety disorders in the 21st century. Dialogues Clin Neurosci. 2015;17(3)327-335. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4610617/. Accessed January 31, 2019.
  2. Mayo Clinic. Anxiety Disorders. https://www.mayoclinic.org/diseases-conditions/anxiety/symptoms-causes/syc-20350961. Accessed January 31, 2019.
  3. Golden J, O’Dwyer AM, Conroy RM. Depression and anxiety in patients with hepatitis C: prevalence, detection rates, and risk factors. Gen Hosp Psychiatry. 2005;27)6):431-8. https://www.ncbi.nlm.nih.gov/pubmed/16271658. Accessed January 31, 2019.
  4. Alavian SM, Tavallaii SA, Abadi Farahani MA, et al. Evaluation of the severity of depression and anxiety in hepatitis B and hepatitis C patients: a case control study. Iranian J of Clin Infect Diseases. 2007;2(3):113-19.
  5. The Hepatitis Foundation of New Zealand. Hepatitis symptom series: Depression and anxiety.
  6. https://www.hepatitisfoundation.org.nz/news/hepatitis-symptom-series-depression-anxiety/. Accessed January 31, 2019.
  7. Porter LK. HCV Advocate. HCSP Fact Sheet. Anxiety, Mania, and Depression. http://hcvadvocate.org/Hepatitis/factsheets_pdf/SEM_anxiety_mania_depression.pdfCirrhosis. Accessed January 31, 2019.
  8. Roy-Byrne P. Anxiety and Depression Association of America. What medications are used to treat anxiety disorders? https://adaa.org/learn-from-us/from-the-experts/blog-posts/what-medications-are-used-treat-anxiety-disorders. Accessed January 31, 2019.

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