Depression and Dialysis

Depression is not just about feeling sad, it can affect your physical health, your relationships, and how well you follow your treatment plan. For people on dialysis, untreated depression may lead to:

• Lower energy and motivation to attend treatments or follow dietary restrictions
• Poorer treatment outcomes, including more hospitalizations
• Strained relationships with family, friends, and caregivers
• Reduced quality of life, making daily activities harder to enjoy

When depression is recognized and treated, patients often experience:

• Improved mood and emotional well-being
• Sticking to schedule dialysis sessions and taking medications on time.
• Stronger coping skills to handle the challenges of kidney disease
• Greater confidence in managing their overall health

Talking about your feelings is an important part of your dialysis care. If you don’t share how you’re feeling with your healthcare provider, they won’t know how to help. By opening up, you can access treatments and support that improve your well-being. Getting help for depression is just as important as taking care of your physical health during dialysis.

Depression in dialysis patients can result from:

• Changes in the brain’s chemicals caused by chronic illness
• Fatigue, pain, and other physical symptoms
• Social isolation or loss of independence

Treatments may include counseling, medications, support groups, and lifestyle adjustments. These treatments work by balancing brain chemistry, building coping skills, reducing stress, and helping you feel supported.

Common types of depression seen in dialysis patients include:

• Major depressive disorder
  • Persistent sadness and loss of interest are lasting weeks of longer
• Persistent depressive disorder (dysthymia)
  • Less severe but long-lasting symptoms
• Adjustment disorder with depression
  • Emotional reaction to dialysis or illness-related changes

There are several treatments that can help manage depression while you are on dialysis. Your care team will work with you to find the approach that fits your needs, lifestyle, and kidney health.

Counseling and Therapy

Talking with a mental health professional, such as a therapist or counselor, can help you understand your feelings and learn ways to cope.

• Cognitive Behavioral Therapy (CBT) is often used to treat depression. It focuses on changing negative thoughts and building healthy coping skills.
• Counseling can be done one-on-one, in groups, or even by phone or video.
• Many dialysis centers have social workers who can offer support or refer you to a therapist.

Support Groups and Peer Programs

Connecting with other people who are on dialysis can make a big difference. Sharing experiences, tips, and encouragement helps reduce feelings of isolation.

• The NKF Peers program offers one-on-one phone support from a trained peer mentor who understands what you are going through.
• Local support groups may also be available through your dialysis center or community organizations.

Lifestyle Approaches

Small daily changes can also improve mood:

• Staying active with gentle exercise (as approved by your doctor)
• Practicing relaxation techniques like deep breathing or mindfulness
• Keeping a regular sleep schedule
• Staying connected with friends and loved ones

Medications

Sometimes, antidepressant medications are recommended to help balance brain chemicals linked to mood.

• These medications can take a few weeks to start working.
• Your doctor may choose an antidepressant that is safe for your kidneys. Some may need smaller doses or extra monitoring.
• Common types include SSRIs (such as sertraline or citalopram) and SNRIs (such as duloxetine), which are often considered safe options with careful use.
• Not all antidepressants are safe for everyone on dialysis, so it is important to talk openly with your doctor about any side effects or concerns.

How Treatments Help

Treatment for depression, whether it’s therapy, support, lifestyle changes, or medication, works by:

• Improving brain chemistry
• Building coping skills
• Reducing stress
• Strengthening support systems

With the right treatment plan, many people on dialysis find they have more energy, better mood, and an improved outlook on life.

Treatments for depression can be very helpful, especially when they are matched to your personal needs and health. Many people on dialysis who get help for depression report feeling better and find it easier to manage their care.

• Counseling and therapy often lead to better mood, improved coping skills, and less anxiety. Patients who participate in therapy may also find it easier to stick to their dialysis schedule and diet plan.
• Peer and group support helps reduce feelings of loneliness and provides encouragement from others who understand the challenges of dialysis.
• Medications can improve mood and energy, especially when combined with counseling. These medications need to be chosen carefully for people with kidney disease, but when monitored, they are often safe and effective.

Everyone responds to treatment differently. Some people feel better quickly, while others may need to try more than one approach before finding what works best. With the right support, most people see improvements in their emotional well-being and overall quality of life.