When you have lupus, you might expect to feel tired sometimes. You may know that muscle pain and swollen joints are common symptoms. And you understand that you’ll occasionally feel frustrated as you learn to cope with the unpredictability of symptom flares. Still, there’s one thing you might not expect to experience when you have lupus: depression. Unexpected and, at times, overwhelming. Depression can impact more than your mood when you have lupus. It can make it hard to just get through the day and follow your treatment plan. Fortunately, a type of counseling called psychotherapy can help you feel more like yourself again. What Causes Depression? Up to 60 percent of patients with a chronic illness, like lupus, develop depression. For people with lupus, there are several reasons why depression may occur: Lupus can directly affect the central nervous system, which may lead to depression. Certain medications that help manage the disease, such as high-dose steroids, can cause depression. The stress, emotional challenges, and psychological strain of living with a chronic disease can lead to depression. Common concerns include strained social relationships, financial burdens, job performance, and overall reduced quality of life. Could I Be Depressed? Signs that you may be depressed include: Overwhelming feelings of sadness, anger, frustration, or hopelessness that don’t go away Difficulty with concentration and memory A lack of interest in activities you used to enjoy doing Difficulty getting out of bed Thoughts of suicide Who Can Help Me? If you’re feeling depressed, ask your doctor for a referral to a mental health expert who has experience treating patients with chronic illnesses. A psychotherapist may be able to help. Psychotherapy, also known as “talk therapy,” helps you gain a deeper understanding of the feelings that you’re experiencing. Working with a psychotherapist, you’ll learn strategies for dealing with the thoughts, feelings, and stresses in your life, and how to cope in healthier and more productive ways. You may also learn how to identify negative thoughts or behaviors, and how you can change them to make you feel better. This type of psychotherapy, called cognitive behavioral therapy, is often very effective for patients with depression. Based on your individual needs, psychotherapy may be used alone or along with anti-depressant or anti-anxiety medication.