Anxiety and Depression in Meniere's Disease

It's been a long time since I've posted, but I came across this article this morning that really nails the psychological toll that having Meniere's disease can have.  I've definitely experienced all of these emotions.  I am emotionally much better off now having the vertigo controlled, but I frequently fight the fear of it coming back or, worse, it going bilateral.

Here's the article, with the link below:

Anxiety and Depression in Meniere's Disease
by Dr. Mary Alm

Posted: June 30, 2012 | Author: dralm | Filed under: Chronic Illness | Tags: anxiety, depression, meniere's disease |Comments Off

Becky is worried and sad.  A new school year is about to start and her vertigo attacks seem to be more frequent.  Last year, she had to take many sick days because she was recovering from a vertigo attack or her tinnitus was too loud for her to hear the students in her second grade class.  She loves being a teacher and she doesn’t want to quit or lose her job, but her Meniere’s disease seems to be getting worse.  Becky doesn’t know what to do. She feels afraid and helpless.

Becky is not alone.  Anxiety and depression are common among those with Meniere’s disease, an incurable and debilitating inner ear disorder, characterized by tinnitus, periodic episodes of vertigo, ear pressure, and progressive hearing loss.  People with Meniere’s disease are more likely to be depressed and anxious than people who do not have inner ear problems.

Causes of Distress

There are several reasons for the higher rates of anxiety and depression.  The symptoms of Meniere’s disease are unpleasant and can be unbearable.  Vertigo is often terrifying.  Tinnitus can be very loud and internal ear pressure can be excruciating.  Many have difficulty with word retrieval and thinking clearly, which can interfere with work or normal conversation.  The unpredictability of symptoms also causes much anxiety.  Some people experience more intense symptoms with weather changes, stress or fatigue.  Many have vertigo or an increase of other symptoms that come without warning.

The permanency of Meniere’s disease is also hard to bear.  People with Meniere’s disease may become sad and anxious after realizing that they will have the disorder for the rest of their lives.  Their sadness and anxiety may worsen when they lose more of their hearing or if the other ear becomes affected.   Having louder tinnitus or more frequent vertigo attacks can also cause more distress.

Symptoms often interfere with normal life.  People with Meniere’s disease may be unable to fulfill responsibilities at work, at home or in the community.  Others may not understand how Meniere’s disease impacts the ability to do common tasks.  Bosses may expect those with Meniere’s disease to be as productive as your coworkers.  Spouses may expect household chores to be done.  Friends may feel slighted if the person is not able to socialize.   People with Meniere’s disease may develop feelings of guilt if they are unable to meet the expectations of others.  Symptoms may lead to reduced responsibilities at work, termination from a job, family conflict and social isolation.  These situations often cause much distress.   Many people experience grief for the lives they once had and for plans and dreams that can no longer be realized.

Health Anxiety, Anxiety Disorders and Depression

An excessive worry or preoccupation with symptoms may result from having horrible experiences with symptoms and fear that the illness will get worse.  This extreme worry is called health anxiety.  People with health anxiety become very concerned with any slight changes in their symptoms.   These minor changes can lead to much distress.  If left untreated, health anxiety can spiral to hypochondria, which is when one worries about symptoms or an illness that the person does not have.  People with Meniere’s disease are at risk for developing health anxiety because the disorder is chronic, degenerative, incurable and unpredictable.

The distress of having Meniere’s disease can become so great that an anxiety disorder develops.  Panic attacks, agoraphobia, and generalized anxiety disorder are anxiety disorders that may be seen among those with Meniere’s disease.   Some people also show a few signs of post-traumatic stress disorder (PTSD).  Signs of the various anxiety disorders are distinctive.  A panic attack is an episode of intense fear that is quite frightening.  Some other signs of panic attack include a racing heart, shortness of breath, dizziness or sweating.  In agoraphobia, a person is afraid to be in a situation in which escape may be difficult, such as being in a crowd.  Generalized anxiety disorder is worrying about many different things.  PTSD is triggered by a traumatic event.  People with PTSD have flashbacks, nightmares or uncontrollable thoughts about the traumatic event.  They may be hypervigilent or have difficulty concentrating.

People with Meniere’s disease may feel sad when they reflect about how their illness has impacted their lives.  They may feel worthless, helpless and hopeless.  These feelings may indicate depression.  People who are depressed feel sad or have lost interest in doing enjoyable activities.  They may feel extremely tired and have insomnia or sleep too much.  Some other signs of depression include appetite changes, feelings of guilt, difficulty focusing on things, irritability and thoughts about death or suicide.

Help for Anxiety and Depression

            If you or a loved one has signs of anxiety or depression, it is recommended that you seek help from a psychologist.  Research shows that talk therapy is an effective way to reduce anxiety and depression and has longer-lasting effects than medication.  A psychologist will refer you to a psychiatrist if you also need medication to treat depression or anxiety.  Finding a psychologist who is knowledgeable about Meniere’s disease and who makes you feel comfortable is important.  To find a psychologist, ask your health care provider for a referral.  You can also search the websites forPsychology Today and GoodTherapy.org for psychologists and other mental health professionals in your area.

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