Chronic Illness and Mood
Counseling and medication management for depression and anxiety alongside a long-term health condition, in person in West Ashley or by secure video.
How Physical Illness and Mood Affect Each Other
The National Institute of Mental Health (NIMH) describes a chronic disease as one that lasts a year or more and needs ongoing medical care, limits daily activities, or both. It names examples such as diabetes, heart disease, cancer, autoimmune diseases, epilepsy, HIV/AIDS, hypothyroidism, multiple sclerosis and pain.
NIMH explains that the link runs both ways. People with a chronic illness have a higher risk of depression, and people with depression have a higher risk of conditions such as heart disease, diabetes, stroke and chronic pain. When depression and a chronic illness occur together, NIMH says both tend to be more severe.
Depression can be set off by the stress or worry an illness brings, by changes in the brain from some conditions such as Parkinson's disease or stroke, and by some medicines used to treat the illness, NIMH notes. A personal or family history of depression adds to the risk.
Signs Worth Raising
NIMH lists signs of depression that include a sad, anxious or empty mood that does not lift; hopelessness; irritability or restlessness; guilt or worthlessness; less interest in things you used to enjoy; tiredness or feeling slowed down; trouble concentrating or deciding; sleeping too little or too much; appetite changes; and aches, headaches or stomach problems that do not get better with treatment. Not everyone has all of them.
Some of these signs can overlap with the illness or its treatment, so it helps to mention them to a provider instead of assuming they are just part of being sick. NIMH advises talking with a health care provider about symptoms that persist.
How Common Is Depression With Diabetes?
The Centers for Disease Control and Prevention (CDC) reports that people with diabetes are about 2 to 3 times more likely to have depression than people without diabetes, and that only 25 to 50 percent of people with both are diagnosed and treated. The CDC also reports that people with diabetes are about 20 percent more likely to have anxiety.
The CDC adds that 33 to 50 percent of people with diabetes have diabetes distress in any 18-month period. It describes diabetes distress as the discouragement, worry, frustration or exhaustion that can come with daily diabetes care, and notes that it can look like depression or anxiety but is not effectively treated with medicine. Helpful steps it names include seeing an endocrinologist, working with a counselor who specializes in chronic conditions, meeting with a diabetes educator to solve problems, and focusing on one or two small goals at a time.
The CDC notes that anxiety can feel like low blood sugar, so if you live with diabetes and feel anxious, it suggests checking your blood sugar and treating it if it is low.
Heart Disease, Stress and Mood
The CDC reports that depression, anxiety and PTSD can develop after a heart attack, stroke or heart failure, with pain, fear of death or disability, and money problems among the factors. It also explains that long-term depression, anxiety, stress and PTSD can raise heart rate and blood pressure and reduce blood flow to the heart.
According to the CDC, early access to mental health services and support can encourage healthier habits, such as more physical activity, a better diet and less smoking, which may lower the risk of a heart event.
How We Help
Your first visit is a 45 to 60 minute evaluation with a board-certified psychiatric nurse practitioner, in our West Ashley office or by video. Your provider asks about your mood, sleep, worry and daily life, how the illness and its treatment affect you, and your health and family history.
NIMH says depression is treatable in people with a chronic illness, usually with talk therapy, medication or both, and that more than one approach may need to be tried. Our individual counseling uses cognitive behavioral therapy (CBT), acceptance and commitment therapy (ACT), behavioral activation and CBT-I techniques for sleep. Medication, when indicated, is decided jointly with you.
NIMH advises telling your provider about every medicine and treatment you use so they do not interfere with one another, so bring a full list, including supplements. With your permission, we coordinate with your primary care provider, and lab work, when needed, is drawn at a local lab near you. We do not manage diabetes, heart disease or other physical conditions; that care stays with your own clinicians.
Visits From Home
On days when you feel unwell, a trip to an office can be hard. We see adults by secure video anywhere in South Carolina, on a smartphone, tablet or computer with a camera, as well as in person at our West Ashley office.
If You Are in Crisis
NIMH lists thoughts of death or suicide among the signs of depression. If you have thoughts of suicide, call or text 988 to reach the 988 Suicide & Crisis Lifeline at any hour. If anyone is in immediate danger, call 911 or go to the nearest emergency room. Hope Behavioral Medicine is not an emergency service.
Getting Care in the Charleston Area
Charleston County has about one mental health provider for every 214 residents, compared with one for every 437 across South Carolina. Our office is on Gardner Road in West Ashley, and we also see adults anywhere in South Carolina by secure video, so you do not have to wait for a local opening or take time off to drive.
We accept Medicare, most major commercial plans, and all South Carolina Medicaid managed care plans except Select Health (First Choice). New patients are often able to be scheduled within a week of requesting an appointment.
Sources
The facts on this page come from: National Institute of Mental Health, Understanding the Link Between Chronic Disease and Depression (revised 2024); Centers for Disease Control and Prevention, Diabetes and Mental Health (2024); Centers for Disease Control and Prevention, About Heart Disease and Mental Health (2024); CMS National Provider Identification file, 2024, via County Health Rankings & Roadmaps, 2025.
Common Symptoms
Treatment Options
Frequently Asked Questions
It can raise the risk. NIMH says people with a chronic illness are more likely to have depression, and that stress from the illness, some conditions and some medicines can play a part.
No. The CDC describes diabetes distress as the discouragement, worry or exhaustion that can come with daily diabetes care. It can look like depression but is not effectively treated with medicine.
The CDC reports that people with diabetes are about 2 to 3 times more likely to have depression, and only 25 to 50 percent of people with both are diagnosed and treated.
No. We treat depression and anxiety. Your primary care provider and specialists keep managing the illness, and with your permission we coordinate with your primary care provider.
Yes. We see adults anywhere in South Carolina by secure video, and in person at our West Ashley office.