Q. I am in acute kidney failure, on dialysis, and have been put on a transplant waiting list. I am struggling with fatigue, irritability, and a generalized sense of pain. I really am ready just to throw in the towel and give up. My nephrologist wants me to see a psychologist and to consider a prescription for an antidepressant. I don’t want to add another drug to my current “cocktail,” and I talk to my sister regularly. Isn’t this enough? Do I really need to follow the advice of my doctor?
A. It is not unusual for a person living with a chronic illness and its accompanying pain to feel depressed from time to time. Dealing with constant physical symptoms takes a great deal of energy. Sometimes you get to a point at which you are fed up with it all.
As long as the feelings are temporary — two weeks or less is the benchmark — you are probably OK. If the emotions last longer, you may be moving into a depressive episode that can make dealing with the demands of the kidney failure much more difficult. High-quality research suggests that people in your situation may be responsive to a combination of medication and talk psychotherapy.
Good antidepressant medicine can help mobilize energy, and newer drugs may reduce the impact of physical pain. Regarding therapy: Talking with a family member such as your sister can help relieve some of the burdens you are experiencing. Mental-health professionals, however, are trained to listen in particular ways. When you feel fully heard by a good therapist, you can work strategically to create new ways of caring for yourself.
I always recommend that people who are waiting for a transplant have a good counselor to rely on for consultation, particularly for situations like the one in which you find yourself now. Once your transplant is complete, you will have a new lease on life and will regain feelings of autonomy and a sense of being in charge of your day-to-day activities.