Part Two: Dialysis and Depression

By Devon Osborne

In my previous article about dialysis and depression, I wrote about my personal experience with that personal demon and how I worked through it.  Since then I’ve received a few calls, e-mails and comments from other patients and professionals relating their own experience with this issue. It looms large in the dialysis milieu. Many people deal with it themselves and with others. The solution to depression is simple. Don’t feel that way. I’m being facetious. Actually it’s rather slippery. 

Here’s the honest-to-God truth, being on dialysis is depressing. It’s rather like the prisoners of old who were chained to a heavy ball so they couldn’t escape; wherever they went the ball was ever-present.  It affects every aspect of your life.  It’s a constant interruption. So, from a “quality of life” point of view, it sucks.

There are some moments when life on dialysis is manageable, but there are other times when it’s not.  I find it tends to come crashing down when a series of events combine to make it unbearable such as what happened to me and as I described in the previous article. 

It’s the proverbial “straw that broke the camel’s back” when it’s part of a load too heavy to bear.  So, in a word, dialysis patients are always in a “tentative” situation and this should be taken into consideration by staff and social workers. Any patient is subject to being struck by the wall of emotional bricks falling on them at any time.

Depression and dialysis go together like a perfectly suited couple, and so we patients deal with in constantly.  It comes with the diagnosis.  In my research I found an entire issue from LifeOptions.org committed to the emotional well-being of renal patients. 

One article relates the story of a young mother, Michelle Horn, whose kidneys failed while she was pregnant.  She delivered by cesarean section and spent several weeks in the hospital along with her 1.7 pound child.  It describes her struggle with depression and, what I found particularly interesting, her manner of dealing with it.  Like me, she found staying active and involved an important element on how she dealt with depression and helplessness.  The article notes:

“Horn feels that having outside goals, interests, and activities helps emotional wellness. 'A lot of people on dialysis are very apathetic,' she says. 'They come and dialyze, then they go home and sleep.'"

She maintained this outlook and regimen as the child grew and eventually attended college and planned a career in the medical field.  Her advice from lessons learned is:

“Though she knows how difficult it can be to adjust to kidney failure and dialysis, Horn feels the keys to success ultimately lie within each individual patient. 'Your doctor can tell you what to do, but he can’t force you to do it,' she says. 'You are the only one who can make things better—or make things worse.'"

So when I say facetiously, “don’t feel that way,” there’s some truth to that.  In the rather helpless state of our condition as dialysis patients, tied to the ball of constant and never-ending treatment sessions, we need to find our own source of empowerment and purpose. 

For me, that means setting goals, seeking things I can do rather than focusing on what I can’t do, and connecting with others so I don’t become isolated— in short, finding purpose in our lives. In the case of Michelle Horn, she had little choice, she had a child to care for and raise, but she went beyond that and set some long-term goals for herself.  I also have two boys living at home and still finished their education but I need more than that to justify the next decade or so in dialysis. For me, it was getting involved in several dialysis-related organizations and operating my blog. In other words, doing what I can and ignoring what I can’t do.  The demon of depression is always present but I have other, more important things to do.