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Depression and Hepatitis C

Treatment for the hepatitis C virus, some times referred to as Hep C or HCV, can cause or exacerbate the development of depression. The virus itself depletes tryptophan, a substance needed to make the brain chemical serotonin. Low serotonin levels can lead to mood swings and depression. The stigma and embarrassment sometimes associated with having a chronic health condition can bring on feelings of fatigue, stress, and depression.1,2

Hepatitis C and mental health

Hepatitis C is a major cause of liver disease worldwide.3 Approximately 2% of people in the US have hep C, but the rate is 9 times higher in people with mental health conditions. Psychological problems can cause people to do risky things, like having unprotected sex and sharing needles, which increase the chance of acquiring the virus.3

Depression is a mental health condition that affects people’s moods. It is characterized by sadness, low self-esteem, and difficulty functioning in everyday life.2 Diagnosis is generally made after symptoms have been present for more than two weeks. Such symptoms can include feelings of sadness, hopelessness, irritability and anger. Some people experience anxiety, fragile emotions, thoughts of suicide, and most commonly, fatigue, often due to changes in sleep and appetite.3,4

More than 1 in 3 people living with Hep C have depression.1,2 Living with hep C can cause significant health-related quality of life issues. Many get worse if their treatment regimen includes receiving anti-viral therapy, particularly peginterferon and ribavirin.3 This therapy, while effective at treating the virus, can lead to depression and other psychiatric complications. In fact, because of the presence of depression, some people stop using their hep C treatment too early, making the treatment ineffective.5

Your doctor should routinely check for signs of depression, as they are often overlooked. They may ask questions using the Major Depression Inventory (the MDI), which quantifies the symptoms of depression into a score.5 Antidepressant medications can help manage clinical depression.

Before you start treatment

Speak with your doctor about any prior history of mental health issues or substance use, as well as all medications, vitamins, and supplements that you take, before beginning hepatitis C treatment.1 Some doctors look to treat preexisting psychological problems before beginning HCV antiviral therapy. This practice has resulted in improved compliance with treatment regimens and overall medical improvement.5 Studies have found that people with depression that are monitored closely while taking hep C medications experience fewer interruptions in treatment because of their depression.3,6

Tips for managing your hep C and depression

Take the time to take care of yourself. People report feeling better when they slow down, take time for themselves, and listen to their mind and body. Hep C is hard to manage without a support system. What each person shares with their friends and family is an individual choice. Knowing you have loved ones who can help is vital in sticking to the hep C treatment.1,8

Taking care of yourself

Here are some ideas for self-care:1

  • Don’t drink or use drugs
  • Take medication as prescribed
  • Get enough sleep
  • Eat right and exercise
  • Take steps to protect your health
  • Practice safe sex
  • Have a strong support system
  • Use stress management techniques
  • Consider therapy

Getting help

Consider seeking professional help if you experience:

  • Feeling sad or hopeless
  • Thoughts of suicide
  • Insomnia
  • Excessive fatigue
  • Loss of interest in food, or overeating
  • Sudden weight loss or gain

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The HepatitisC.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

  1. Ilades, C. 8 Ways to Relieve Depression From Hep C. Available at: https://www.everydayhealth.com/news/steps-to-overcoming-depression-from-hepatitis-c/. Accessed 3.5.19.
  2. Depression and Hepatitis C. Available at: https://www.hepmag.com/basics/hepatitis-c-basics/depression. Accessed 3.5.19.
  3. Gallegos-Orozco, JF, Fuentes, AP. et Health-Related Quality of Life and Depression in Patients with Chronic Hepatitis C. Available at: https://www.sciencedirect.com/science/article/abs/pii/S0188440903000031. Accessed 3.4.19.
  4. Hep C, Depression, and Anxiety: Is There a Link? Available at: https://www.webmd.com/hepatitis/hep-c-depression-anxiety#1. Accessed 3.4.19.
  5. Derek, P., Leutscher, C. et al. Evaluation of depression as a risk factor for treatment failure in chronic hepatitis C. Available at: https://aasldpubs.onlinelibrary.wiley.com/doi/full/10.1002/hep.23699. Accessed 3.4.19
  6. Dwight, M, Kowdley, K. et al. Depression, fatigue, and functional disability in patients with chronic hepatitis C. Available at: https://www.sciencedirect.com/science/article/pii/S0022399900001550/. Accessed 3.5.19.
  7. Dan, A., Martin, L., et al. Depression, anemia and health-related quality of life in chronic hepatitis C. https://www.sciencedirect.com/science/article/abs/pii/S0168827805008196. Accessed 3.6.19.
  8. Hepatitis symptom series: Depression and anxiety. Available at: https://www.hepatitisfoundation.org.nz/news/hepatitis-symptom-series-depression-anxiety/. Accessed 3.6.19

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