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"Can Hepatitis C cause depression?"

ZocdocAnswersCan Hepatitis C cause depression?


Can hepatitis C cause depression? My wife, who's 37, was diagnosed with hepatitis C several months ago. Since then, she has started losing interest in things she used to enjoy, and acting despondent.


Two questions are at issue here: first, can hepatitis C cause depression, and second, is your wife actually experiencing clinical depression? The second question can only be answered by directly meeting with a physician (primary care doctor or psychiatrist), but we will address some basic principles here. Hepatitis C is a viral infection of liver cells, and has been linked with depression. The reason for this connection is not entirely clear to researchers and clinicians. The virus is able to cross the blood-brain barrier, therefore, one possible explanation is that the virus itself can directly cause depression. However, the prevalence of depression in patients with hepatitis C is approximately 30%, which means that the presence of the virus alone is not sufficient to explain why some patients are depressed. In one recent study published by researchers from University of California in San Diego, social and psychological factors (eg. worse reaction to diagnosis, lower salary, less social functioning, prior suicide attempt) were more closely linked with depression than were markers of liver damage and hepatitis viral load (e.g. the amount of active virus). Patients with hepatitis C who use tobacco, alcohol, or inject drugs are more likely to be depressed than those who do not, according to another recent study by University of California in Los Angeles. As a side note, patients with hepatitis C should stop smoking, drinking alcohol, and using illicit drugs since these can make their liver disease worse. Additionally, patients who undergo treatment for hepatitis C generally receive a medication called interferon-alpha, which in and of itself is linked with depression. It is important for your wife to see her primary care doctor or a psychiatrist before initiating treatment for hepatitis C to evaluate her mood. The mood symptoms you describe may indicate a reaction to her diagnosis, major depression, or something else. One important characteristic of mood disorders like major depression is that they cause impaired daily functioning or significant distress to the patient. You describe her symptoms as starting after her diagnosis of hepatitis C, therefore, one possible diagnosis is adjustment disorder with depressed mood. This type of mood disorder starts within 3 months of a stressful event (here, the diagnosis of hepatitis) and lasts no longer than 6 months. This and other psychiatric diagnoses can only be made after an in-person discussion with a physician. Major depression is diagnosed by a physician if the patient has a number of symptoms for 2 or more weeks, including but not limited to depressed mood; lack of enjoyment; changes in sleep, appetite, and weight; guilt; thoughts of suicide; and other symptoms. These symptoms can also occur in patients who use alcohol and illicit drugs, in which case the diagnosis is modified. If your wife is having thoughts of suicide, she should call 911 or go to the emergency room immediately.

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