Living with pulmonary hypertension is tough. It changes routines, relationships, and can make you feel uncertain or isolated.

  • Feeling sad, worried, or hopeless at times is normal.
  • But when these feelings last for weeks, it may be depression.
  • Depression is common in people with PH — and it’s treatable.

Because of its high incidence in the PH community, it’s important for you and your family to become familiar with its warning signs. Being prepared can make it easier to identify depression early.

Depression vs. ‘the blues’

  • Everyone feels down sometimes.
  • Depression lasts longer and affects daily life.
  • It’s not weakness or something you can “shake off.”

In reality, depression is a real illness — just like PH — and it can be a dangerous one. Depression is associated with higher rates of mortality, pain and physical illness. Aches and pains, digestive problems, fatigue, trouble sleeping and weight and appetite changes are problematic side effects of depression that may interfere with a PH patient’s already compromised health.

As you watch for symptoms of depression, looking for changes in behavior that present themselves over an extended period of time.

Depression can make activities of daily life almost impossible because it consumes an enormous amount of energy. Be aware of changes in the amount of energy or number or intensity of tasks your loved one seems able to handle. This may present itself as an inability to keep up with everyday grooming, work, shopping and household chores. Keep in mind that in patients, increased fatigue, weight changes and sleep trouble related to depression may be mistaken for worsening symptoms of PH.

Depression can make it hard to think clearly or pay attention to tasks and conversations. Even simple choices can feel overwhelming. Notice if there is difficulty completing tasks such as deciding which medication to take or if there is frustration built into even simple decisions, like which sweater to wear or magazine to read.

Be particularly aware of a loss of interest in things your loved one used to enjoy, such as exercising, cooking or hobbies. Sexual interest may also decrease.

People suffering from depression frequently isolate themselves and pull away from loved ones. Take note if your loved one begins avoiding conversations and wants to be alone more than usual.

Depression may feel like a dark cloud that can make everything seem hopeless. Be aware of any irritability or lack of humor. Not everyone expresses these feelings in words. Pay attention to non-verbal cues, such as crying or shutting off from family more often than is normal compared to past behavior.

More than half the people diagnosed with depression also suffer from anxiety. Someone who is depressed may find it difficult to kick back and stop worrying, even for short periods of time.

These feelings are often inappropriate to the situation. Someone who is depressed might feel guilty for things they have no control over, including getting ill in the first place.

If you suspect that you may be depressed, a psychologist or physician will look for a collection of symptoms that are present over a significant period of time. You and your loved ones can also keep an eye out for these symptoms to determine whether you should seek treatment.

Signs of depression

Look for symptoms lasting more than two weeks:

  • Persistent sadness or hopelessness
  • Loss of interest in activities
  • Changes in appetite or weight
  • Trouble sleeping or oversleeping
  • Low energy or constant fatigue
  • Guilt or feelings of worthlessness
  • Difficulty concentrating or deciding
  • Withdrawing from others
  • Restlessness or anxiety
  • Thoughts of death or suicide

If you or someone you love is thinking about suicide, call 988 (Suicide & Crisis Lifeline) right away.

Why depression happens

Depression doesn’t have a single cause. It’s usually a mix of:

  • Biology: Genetics and brain chemistry are thought to play a large part in depression. Many medical treatments attempt to regulate chemicals in the brain, including the neurotransmitters serotonin and norepinephrine.
  • Life experiences: Trauma, stress or loss, especially when untreated.
  • Medical conditions: A major medical diagnosis and chronic illnesses like PH.
  • Medications/substances: Some drugs or alcohol use.

Depression and PH

As someone living with PH, you are much more likely to suffer from depression than someone without a chronic illness. Whether you’re newly diagnosed or you’ve been living with PH for years, the challenges of daily life and health changes can lead to guilt, grief, sadness, disappointment, uncertainty, lowered self-esteem and emotional fatigue.

These feelings are normal — but when they take over, it may be depression.

Getting help

Depression is treatable with professional care. Mental health professionals (psychologists, social workers and psychiatrists) use psychotherapy, lifestyle changes and sometimes medication to help people identify and overcome difficult issues and negative thinking patterns. The goal of treatment is to help you reclaim a sense of control and rediscover pleasure and fulfillment in daily activities.

  • Psychotherapy or talk therapy: Helps you process feelings and build coping skills.
  • Medication: Antidepressants may help regulate brain chemistry.
  • Combination: Many benefit from using both.

Just like physicians, different therapists have different qualifications and specialties. It may be important to you to find someone who works with people with chronic illness, though this specialization isn’t always necessary. The most important thing is to find someone you connect with and trust. Ask for recommendations from friends and family, your medical team or PH support group members, or visit the American Psychological Association’s website to find a therapist in your area.

Speak with a number of professionals on the phone and ask questions about their approach and style. Don’t be afraid to meet with several people before settling on someone you feel comfortable with. Finding the right therapist for you is a process, and it’s worth the time and effort.

Tip: Make sure your PH doctor and psychiatrist coordinate to avoid medication conflicts. Your PH care team needs to know all of your medications.

Coping strategies at home

  • Stay present in the moment without judgment.
  • Accept feelings instead of pushing them away.
  • Try breathing exercises, meditation or gentle yoga.
  • Remember: Emotions come and go, like waves in the ocean.

  • Stay connected: Friends, family or PH support groups.
  • Be kind to yourself: Set small, realistic goals.
  • Accept change: Plan ahead for challenges.
  • Control what you can: Eat well, rest, follow medical advice.
  • Add joy: Include hobbies and reduce exposure to negativity.
  • Reflect on past coping: Use strategies that worked for you before.

  • Depression is common, but it’s not your fault.
  • It can be managed with treatment, lifestyle changes and support.
  • With help, many people living with PH find relief and improve their quality of life.
  • Remember: You don’t have to face depression alone.

Support resources worldwide

If you are struggling with depression, reach out for help.

United States

International

You are not alone. Reaching out is a strong and important step.