Hepatitis symptom series: Depression and anxiety

Depression and anxiety are common mental health conditions which can affect a person’s quality of life. According to the Ministry of Health’s Te Rau Hinengaro: The New Zealand Mental Health Survey (2006), nearly six per cent of New Zealanders over the age of 16 years will experience a major depressive disorder over a one-year period. Indeed, the risk of mental illness is greater for people living with health conditions such as hepatitis B or C. Reasons for this may include the social stigma and emotional distress associated with such a diagnosis, and the side-effects of hepatitis C interferon-based treatment.

Depression is a disorder that can affect a person’s thoughts, feelings and behaviours. It can range from mild, moderate to severe. Depression is an illness that affects people’s moods, lingers for more than two weeks and negatively impacts one’s physical, emotional, social and occupational functioning.

Common warning signs of depression include a persistent feeling of sadness or low mood, loss of pleasure and loss of interest in life, hopelessness and pessimism.

Other symptoms of depression include:
  • thoughts of death or suicide
  • fatigue or decreased energy
  • insomnia and other sleep-related problems
  • appetite loss and weight loss or overeating and weight gain
  • feelings of guilt, worthlessness and helplessness
  • difficulty concentrating, sometimes accompanied by decision-making and memory problems.

Anxiety disorders are even more common than depression, with 1 in 4 New Zealanders experiencing some form of anxiety disorder across their life span. There are different types of anxiety disorders from Generalised Anxiety Disorder to Post-traumatic Stress Disorder. Anxiety is a fear or uneasiness over what’s about to happen and what could happen in the future, including having worrying thoughts or a belief that something could go wrong. Similar to depression, it can affect your thoughts, feelings and behaviours.

We can all feel anxious from time to time, such as before taking a test or waiting for the outcome of a biopsy but feeling this way all the time is not okay. Stress hormones associated with anxiety, such as cortisol and adrenaline, activate the brain’s fight-or-flight mechanism or the ‘stress response’. These hormones help us cope and achieve things in the short term, but too much of these hormones over a prolonged period of time can be problematic.

Common symptoms of anxiety include:
  • nervousness
  • racing thoughts
  • dry mouth
  • feeling short of breath
  • difficulty falling asleep
  • dizziness
  • perspiring excessively
  • feeling tense or agitated
  • feeling jittery or trembling
  • heart racing or chest tightness.

Depression and anxiety are common in people with hepatitis B and C for a number of reasons. For instance, the virus depletes a substance called tryptophan. Tryptophan is a key ingredient in the production of serotonin, which helps to balance mood. The psychological impact of living with hepatitis B or C may also increase the incidence of these mental health conditions.

The good news is that both depression and anxiety are very treatable. Research has developed effective ways to ensure you are able to manage the symptoms of depression and/or anxiety to improve your health.

If you experience symptoms of depression and/or anxiety, contact a registered mental health professional such as a general practitioner, psychologist, psychotherapist or psychiatrist. Let your doctor know about any history of substance abuse, mental health conditions and any family history of mental health conditions.

Tips for managing depression and anxiety


  • Balance rest and activity. Pace yourself, take breaks, plan ahead and delegate responsibilities. Eat a healthy, balanced diet. Eat a variety of foods that include protein, fruit, vegetables and whole grains.
  • Avoid isolation. You could look for a support group for either hepatitis or depression or both.
  • Reduce stress. Try some stress management techniques such as breathing exercises, mindfulness techniques, meditation or yoga.
  • Avoid alcohol and other substances such as tobacco, caffeine and illicit drugs, as these can worsen depression and anxiety.
  • Get enough sleep. Adults require 7 – 9 hours’ sleep every night.
  • Get support from your family and friends. Sharing your feelings and concerns with people you trust can help.
  • Find ways to laugh and amuse yourself. Pick at least one pleasurable activity and find time to do it often.
  • Be active. Physical activity can help to lift a person’s mood. Consider even gentle exercise such as a daily walk or yoga.
  • Engage in positive thinking. Try to replace negative thoughts with messages of hope and affirmation.
  • Talk to your doctor, who can refer you to a registered mental health professional for treatment. Contact Depression Helpline 0800 111 757 or Lifeline Aotearoa 0800 543 354.

If you continue to have problems with depression or anxiety, speak to your health provider. Useful websites for more information include www.depression.org.nz and www.mentalhealth.org.nz.

Written by Iris S. Fontanilla, MSc(Hons), PGDipHealthPsych, FMNZPsS, MIHP
Health Psychologist, New Zealand Registered Chair of the Institute of Health Psychology, New Zealand Psychological Society. 

This story was published in edition 13 of Talking Hep C magazine. 

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© The Hepatitis Foundation of New Zealand 2016