Lana Barhum is a legal assistant, patient advocate, freelance writer, blogger, and single parent. She has lived with rheumatoid arthritis and fibromyalgia since 2008 and uses her experiences to share expert advice on living successfully with chronic illness.

For so many with chronic illness, depression is a fact of life.

In fact, depression is one of the most common complications of chronic illness. Just the idea of facing a long life with illness brings about uncertainty, grief, anger, and sadness. While some of this is a normal part of living with chronic disease, it is when you continue to experience these feelings and they start to affect your daily life that you should seek medical help.

Be aware of depression triggers

Be aware of the following aspects of your illness that can lower your mood and possibly trigger depression.

Your feelings about your illness. You should expect to feel overwhelmed. There is so much to learn about your illness and you may need to give up favorite activities due to fatigue, pain and/or physical limitations. And sometimes giving up the things you love can be discouraging. Research suggests a connection between chronic illness and depression when people withdraw from activities they find rewarding and involve social support.

Changes in appearance and independence. Changes to your body and mobility may make you feel as if you have lost a part of yourself. You might be embarrassed that you have a chronic illness or feel ashamed of the symptoms you experience.

Depression as a symptom of iIllness. It is very possible that depression is a physical symptom of your disease, just like pain is. It is important to discuss all your symptoms — physical, emotional, and psychological — with your doctor.

Pain. A 2006 study conducted for the American Pain Foundation found that three quarters of people who live with pain have reported symptoms of depression. When depression is a symptom or complication of chronic illness, it can go undiagnosed and untreated. As a result, a person's quality of life is complicated and treatment is affected because symptoms of depression can make pain and illness worse.

Medication side effects. Certain medications prescribed to treat your chronic illness can cause feelings of sadness and despair. The best way to know if your medications are affecting your moods is to learn about the side effects of every medication you take. You should also talk to your doctor about different medications that won’t cause you to experience symptoms of depression. Keep a mental or written log of your moods while taking the medication and see if they differ from your normal moods.

Social pressure. Chronic illness is often associated with misinformation, especially when the illness doesn’t cause symptoms that are visible to others. Most people don’t know a lot about chronic illness and pain and how they affect mood. Chronically ill people encounter negative reactions, including the stereotypes about people who live with pain or pressure to keep up with their healthy counterparts. These reactions can undermine quality of life and result in feelings of hopelessness and despair.

Depression symptoms are often overlooked

Depression occurring with a chronic illness is often overlooked by patients and their loved ones. Moreover, symptoms of depression can be disguised as other medical conditions, so it's possible doctors may miss a patient’s depression. It's vital to be aware of these symptoms and to talk to your doctor about treating both illnesses at the same time.

Treating depression in chronically ill persons

Chronically ill people who are depressed tend to have more severe symptoms of illness and depression. But when depression is treated, most experience improvement in their medical condition, resulting in a better quality of life. Treatment of depression in chronically ill patients is similar to treatment of anyone with depression. Early diagnosis and treatment are vital to reduce further illness complications and prevent suicide.

Managing illness and avoiding depression

Here are some ways to manage chronic illness stress and avoid depression:

1. Make sure you are on the same page as your doctor. Your relationship with your doctor is one of the most important relationships you will ever have. Make sure you are getting the medical support you need from someone you trust and can be open with about ongoing concerns and questions, including any symptoms of depression you experience. Don’t forget to ask about pain management since pain and depression are closely linked.

2. Keep friends and family close. Do not isolate yourself. Instead, reach out to loved ones. Communicate your needs and ask for and accept help. Loved ones care about you and want to help and support you, so don’t go at it alone.

3. Join a support group and seek out professional help. If you don’t have an adequate support system, work to build one. Talk to your doctor about support groups and community resources. Seek the help of a mental professional if you experience feelings of sadness or hopelessness that are ongoing.

4. Reset your life goals. Reevaluate what is important in your life and determine what goals are still possible despite your illness. Remember, your life isn’t over simply because you have had to give up some dreams or favorite activities. Find new ways to be happy and successful. And if you can, keep doing the things you like and stay connected to boost your confidence and self-esteem.

5. Learn as much as you can about your illness. Remember the old saying that knowledge is power. Knowing your illness will help you get the best treatments available and allow you to stay independent and in control of your health and your life.

Seek help If needed

Depression is nothing to be ashamed of. It is a medical disorder, like arthritis, fibromyalgia, MS, or diabetes. If you are dealing with symptoms of depression such as trouble sleeping, racing thoughts, continuous sadness, anxiety or empty feelings, a loss of appetite, loss of interest in activities you once enjoyed, constant feelings of guilt of worthlessness, or thoughts of suicide or death, don’t be embarrassed or try to convince yourself you can manage depression alone.

Talk to your doctor, and get the help you need and deserve.