Mental health issues in kidney disease patients

Dialysis treatments are hard experiences for both patients and relatives close to them. Since patients depend on a machine from that moment on (or on other devices) to live, dialysis means a very drastic change in their lives. This is not easy mentally speaking. It means adapting to completely unknown conditions, a lot of fear, and, above all, fear to what life will be like from that moment on. Worst of all, the stress, anxiety, and depression may be so severe sometimes, that it may even worsen the current health status of patients. There is an additional problem: many people still underestimate the extent of depression and other mental problems. These people are doctors (sadly) as well as patients and their relatives. It is true that depression is a delicate issue that requires immediate and sufficient answers, and, for this reason, there are social workers and psychologists who are aware of the mental and emotional state of patients with kidney disease in several centers where dialysis treatments are carried out.

The main causes of anxiety, depression, and high levels of stress are fear of death, fear of relying on a machine, fear of suffering, and, especially, fear of change. Many people believe that dialysis means the end of a great cycle. That’s not true at all. Although dialysis does mean a big change in patients’ routines, patients are able to live perfectly normal lives. They can keep pursuing their dreams; they can keep working on their careers and go beyond their limits. In this post, we will talk about depression and anxiety in dialysis patients, as well as some basic tools to combat them.

The first thing to understand is that we all face many changes throughout life. Life, in essence, is about that: a great succession of changes. Some of those changes are more pleasurable than others, and, therefore, it is a so naïve idea to think that things will always stay the same way. This is the first step to face depression in the middle of a dialysis treatment: to take dialysis as one of many great changes in life. One of many limitations that can bring out the best (or the worst) of ourselves.

Read also: What is it like to live with dialysis?, by Joe Cosgrove

Secondly, it is very important to count on the support of professionals. A good psychotherapy, in which, if necessary, the patient receives prescription antidepressants, could be of tremendous help to overcome depression. In addition to the above, it is just key that patients remain active. Performing different activities that make them feel better, besides helping them to significantly increase the level of physical and mental energy, could help them to let go of the negative thoughts of depression, and learn to face them when they arrive. Physical exercise, hobbies, relaxing activities such as meditation, gardening, fishing, volunteer work, etc., may be great alternatives to feel useful and help you understand that dialysis treatment is not the end of anything.

On the other hand, it is very important that therapists help kidney disease patients to increase their self-esteem. Although this may sound hard to believe, self-esteem is a kind of immune system of the mind to resist different mental problems such as anguish, anxiety, existential dread, and fear of the unknown. A fundamental practice for developing self-esteem is to identify and learn to eliminate self-critical thoughts. After all, when it comes to depression, the main antagonist is the patient himself, especially when guilt, and other recurring thoughts, make the patient feel that there are no choices left.

It is also very important to develop assertiveness. Assertiveness is the human capacity to know how to defend oneself in a non-aggressive way in the face of pressure, demands or abuse from others or from oneself. Assertiveness is an intermediate point between aggression and calmness. It is very important to learn to be assertive in the midst of depression; and, to be assertive it is necessary to strengthen self-esteem in the first place. It is very common to find patients with depression, in particular, those who are undergoing dialysis treatment, in whom there is a high level of escape from problematic situations. This is not just a psychological problem that may increase depression and anxiety even more: it could be dangerous. Many patients, due to the fear of dealing with dialysis, avoid going to health centers to undergo dialysis. This behavior, in addition to self-destructive, is absurd from any point of view. It’s understandable, but it does not make any sense.

Finally, patients should not feel guilty for suffering from depression. It is perfectly normal that they are going through that, and it is necessary to call things by their name. Depression is an illness, and nobody decides to suffer from it. There are solutions for this, and it is not the end of the road. It’s just a station.

I hope this post has been useful in some way. Remember to share it with someone who is going through this situation.

Recommended: Depression in dialysis patients

* Featured Image courtesy of Quintin Gellar at


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