Liver Disease - Anxiety and Depression - British Liver Trust

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Liver Disease - Anxiety and Depression

Richard-Allen profile image
Richard-Allen

There does appear to be an increased number of people on this site recently who appear to have other underlying mental health conditions, such as Anxiety and Depression.

Back in Feb 2015. A journal was published in Gastroenterology about research being carried out at The University of Edinburgh into the link between those people suffering from anxiety or depression and an increased risk of death from liver disease: ed.ac.uk/clinical-brain-sci... this report concluded that a greater amount of research into this was required.

However, I have some personal views on this subject as liver disease and mental health seem to go hand in glove.

Many people with depression may seek to self-medicate with alcohol in an attempt to lift the mood. But alcohol in itself is a depressant, so a vicious cycle can begin. A person drinks the lift the mood, and in doing so they become more depressed which causes them to want to drink more, and so it goes on. (In my past, this would lead to me going on a three-day bender.)

When a person goes on to develop a serious liver condition and needs to stop drinking, they may turn to recreational drugs as a safer replacement to alcohol.

Some people on here in the past have been openly praising the virtues of cannabis and have even referred it to as being a safe wonderdrug.

However, over time, Cannabis also carries its own set of problems. These include:

1.Affect your motivation to do things

2.Impair your memory so you can’t remember things or learn new information

3. Give you mood swings

4. Disturb your sleep and make you depressed

5. Make you anxious, panicky, or even aggressive

6. Make you see or hear things that aren’t there (known as hallucinating or tripping)

7. Cause hours (or days) of anxiety, paranoia and hallucinations, which only settle down if the person stops taking it – and sometimes don’t settle down at all

8. Cause a serious relapse for people with psychotic illnesses like schizophrenia

9. Increase your chances of developing illnesses like schizophrenia, especially if you have a family background of mental illness and you start smoking in your teenage years.

So, a person’s liver may well be improving due to the lack of alcohol. But there is also a danger of other complications arising over time.

Some years ago I had a friend who was also a fellow liver transplantee. She used to attend a local mental health support group as she was suffering from survivors guilt and PTSD. She became frustrated that no one else in the group could relate to her emotional state as they had not endured what she had. I used to go along to offer her some moral support.

There used to be around 12-people in this group, all suffering from some form of anxiety or depression. What really surprised me was that none of these people seemed to question why they had this condition. There are many different causes for depression and one cap doesn't fit all. “Why do you have depression?” “Because the doctor told me I did”.

Many forms of depression may be caused by a hormonal imbalance, an overactive immune system, or other medical conditions. Some conditions may be very complex and hard to talk about.

I believe that understanding the cause of the depression is like having a form of closure. Other causes of anxiety also need to be understood and this may involve drilling down to find the root of the problem. Understanding and treating the cause may help to alleviate the condition. (Also it may mean that there is one less tablet having to be processed by the liver, as antidepressants would no longer be required).

This may be a contentious subject and I post this as a form of open debate. It isn’t aimed and anyone in particular, but merely as a point of interest.

47 Replies

Thank you 😊.

Quite honestly I’ve been thinking about this lately. Alcohol is the worldwide self medicate because it’s easy to get. If doctors took more time in prescribing something to actually help instead of just kicking you out and telling you “you’re fine”, alcoholism wouldn’t be where it is today. I’ve been drinking a lot more recently because of the hurdles and how doctors treat you when you clearly state you aren’t well. I’m now trying to cut back on it but I know I’ll just do it again.

Dogmadpam profile image
Dogmadpam in reply to Tvlr112

When I woke up from an operation a few weeks ago I felt so happy it was unreal, almost alien to me. Whatever they give you I wish I could get me some of that. I self medicated with alcohol for over 20 years and it never made me feel that happy. This was like elation.

Ordinarily when someone does have an operation, or even a transplant, the immune system goes into overdrive as it see's the first cut of the surgeon's scalpel as being an assault upon the body. The immune system's response is to realise many Macrophage cells into the body to destroy any invading germs or bacteria. Cytokines are a protein that act like a foot-soldier. They go in search of the invading bad guys and tell the macrophages where they are.

It has been discovered that these Cytokines can actually cross over the blood brain barrier and alter a person's mood. This can bring on a feeling of depression and a feeling of melancholy. I think in your case though this may have brought about a more elated feeling.

I really do find that by understanding what is going on, makes for a great form of acceptance: youtu.be/fLeHsJ_ui5A

I hope things are a lot better for you now.

Richard

Well I never knew this! Very interesting indeed thanks so much Richard. So this means unless I hurt myself I won’t get that feeling again 😳, that’s a shame! 🤣

Yes also good thank you, the lumps and bumps I was left with after my op have now disappeared so overall happy. Sadly I still have some pain but seeing my Gastro end May to discuss..

There is another video that I often refer to. I've posted this up a few times on here before. This one is a little more in depth, but does explain things more clearly. Sadly new studies and findings are slow to come to medical practice and it takes a while for such discoveries to filter down to GP level: youtu.be/iw7b0-yTnT0

Fingers crossed that all goes well in May. Good luck,

Massively appreciate this as I happen to have chronic pain and depression. Only thing is because I spent 30 years drinking I’m scared to take painkillers because I’m trying to be as gentle as I can with my liver, even when in agony but it just occurred to me that I can ask for bloods to check the liver maybe every 6 months to make sure any anti inflammatory isn’t affecting anything 😊. Thanks again.

laura53923 profile image
laura53923 in reply to Tvlr112

Actually the problem isn't with doctors, it's the alcohol industry which has blood on it's hands. The death and major disease the poison they produce and sell causes is scandalous and yet again it's the NHS who has to pick up the pieces of broken lives and families.

purple64 profile image
purple64 in reply to laura53923

It’s constantly advertised and if you watch any tv programmes the minute something goes wrong they reach for the bottle. Maybe they should think more closely about what they are doing 🤔

Very interesting/thoughtful points. Another angle to this, at least in the states, is that often when a patient presents to a doctor/specialist with an admitted history of anxiety (which could be driven by serious physical illness, let's be honest) it seems that all symptoms related by that patient are dismissed as anxiety driven. It's happened to me and family and to many who have discussed their long paths to diagnosis here. Anxiety *can* be caused or heightened by symptoms of a physiological illness.

Anxiety does pose a challenge to clinicians, I'm sure. They probably see many who are suffering solely from health anxiety and no real underlying disease. But those with serious health problems are often anxious as well, and for obvious reasons. When health systems default to treating *anyone* who is anxious about health as *only* suffering from a mental health condition, too many fall through the cracks. For some, the consequences can be disastrous, as with delayed cancer diagnoses.

Regarding the liver, I've seen American discussion board posts discussing people's shock at being dxed with cirrhosis, even end stage cirrhosis, following a mention of NAFLD or even NASH by a doc a few years prior who made no serious issue of it and gave no strong warnings to the patient about the importance of making lifestyle changes lest things progess.

I'm not sure I have a coherent point, but maybe it's this: anxiety does not rule out severe liver disease, and especially for those with a clear risk and *specific* symptoms.

Dogmadpam profile image
Dogmadpam in reply to Str8jacket

Excellent on on point. This has happened to me repeatedly. They read I’m autistic and have chronic history of anxiety and then dismiss symptoms.

Of late I was misdiagnosed twice at A&E and cleared to go home in absolute agony on my knees. I had gall stones stuck in my bile duct, and acute on chronic cholecystitis And large gallstones. I was told it was a simple case of gastritis both times leaving me in agony for months and on a mediation I had no need to take. The doctors didn’t give a hoot.

People do fall through the cracks for sure.

..... and pleased to officially report, to correct a reply to me that there is no cure for health anxiety..... it IS absolutely treatable and curable.

I totally agree with you, Laura. It’s a case of finding that coping mechanism that works for you.

I suffered from depression all my life. That dark cloud would descend every 25-days. It would last for three days and then just lift and vanish. During those three days, I used to go on a drinking bender and drink solidly. Passing out, drinking more, passing out. And so on. After the three days, It would take a further two days to rid my body of all the toxins, and then I wouldn’t drink again for another three weeks.

When I stopped drinking in 2014 after my variceal bleed, that dark cloud would still descend every 25-days and I’d go into a withdrawn state. I was on anti-depressants and would just such myself away and switch off mentally.

When I had my liver transplant back in 2016. I was lying in that hospital bed, looking back upon my life and trying to understand how it all led to this moment. I sort of psychoanalysed myself. By doing this, I realised that there were a lot of undealt with childhood events. I was both physically and mentally abused by my step-father. I grew up having these issues but had become good at hiding them from others. I now knew what was driving the depression every 25-days.

This is going to sound really weird. But I got to thinking about “Phantom limb syndrome” This a condition in which patients experience sensations, whether painful or otherwise, in a limb that does not exist anymore. Here the brain becomes confused and sends out signals to the missing limb to try and establish a connection.

By using mirrors, the brain can get to see two limbs and so stop sending out signals. Say a person has lost their right hand. By making a reflection of the left hand, brian sees two images of the hands, and stops sending out signals.

I thought I’d try something similar. I convinced myself that our brains often store memories and experiences in other organs in our bodies. I told myself that all those bad things from my childhood were stored in my old liver. Because that liver had now gone. Nothing to come back to hurt me anymore. On the 2nd October 2016, I took my last antidepressant tablet.

Now five years later, I no longer have those dark phases every 25-days anymore. I still have those memories, but it is as if they have now been processed and dealt with. By doing that little trick it sort of gave me closure.

This is why I say that understanding that driving source of the depression should be the first step in trying to find a way forward. A chemical cure is never the answer long-term.

This is my personal journey, and we are all different. So, what has worked for me might not work for everyone. It’s a case of finding out what works for you.

The same goes for anxiety as well. Try and go back and understand what caused these issues in the first place.

I post this in the hope it may help others. I am not ashamed of my life. I just have a greater understanding of the road I’ve been down.

Dogmadpam profile image
Dogmadpam in reply to laura53923

Sorry to say that whilst there is treatment, not everyone gets “cured”. Having been in mental heath services for most of my life I have first hand experience of that. Whilst it IS curable for some, it ISNT for others.

laura53923 profile image
laura53923 in reply to Dogmadpam

As Richard says it's finding the right method for each individual. And since the goverment are now throwing millions of pounds into mental health, everyone encouraged to "talk about their issues" councellors in every County, if someone wants to be cured, they will find the way.

Dogmadpam profile image
Dogmadpam in reply to laura53923

It certainly is, but at MIND we see people that have been in the system for decades with it. I feel so bad for anyone trying getting help for the condition or any other mental health condition for that matter as there is nobody providing treatment. It takes up to two years to even get the basics of a phone call. I went to A&E feeling the worst and it took 3 months for anyone to even come back to me. The nhs whole system is a massive failure and there is no help or treatment 😐.. that is unless you are a danger to others or ill enough to need sectioning.

laura53923 profile image
laura53923 in reply to Dogmadpam

Don't you think it's possible that there are people convincing themselves they have a mental disorder who actually don't and are clogging up the system denying those who truly need help from getting it?

Dogmadpam profile image
Dogmadpam in reply to laura53923

Not sure, I’m seeing lots of posts from people with liver issues posting myself. Can’t see any from anyone who doesn’t have liver issues, but can from an alcoholic concerned for his liver who hasn’t been tested but fallen off the wagon sadly. As for your question you might be best to direct it at the person you are concerned about as I haven’t seen any post relating to your question sorry.

I doubt the system is “clogged” however as there are people that have posted regarding liver issues that haven’t even been replied to even over the last few days but hopefully the moderators will reply at least and help those people.

laura53923 profile image
laura53923 in reply to Dogmadpam

No person in particular and not even liver related just mental health in general l was asking about

Dogmadpam profile image
Dogmadpam in reply to laura53923

Let me know who/which posts you are referring to as I haven’t seen any and I’ve been on here under different accounts (having closed and rejoined) for over a year? I’ve seen some posting about concern over fatty liver which is the initial stage of liver disease but not anyone posting about mental health alone out no relation to liver, or symptoms that can be caused by liver issues...

I’m not even sure if those people with no formal diagnosis but symptoms I.e elevated bloods, white stools etc are allowed to talk about their concerns/anxieties here now. The liver trust didn’t make things completely clear. I had a person with Hep C message me yesterday because they had read the liver trusts recent post and was too scared to post because they are concerned it might be seen as anxiety because they are very anxious which is what they wanted to talk about, and still drinking 😬. . That’s where some may miss out on the help they need... Mental health and liver issues whether suspected, early symptoms or disease or actual diagnosis go hand in hand which is why I’m confused as to why they are being separated on a liver forum.

100% agree that nobody should be posting here that doesn’t have anything related to liver, but unsure if let’s say as an example those with alcoholism and concern for their liver, anxious over bloods etc can now post here.. plus those with first stages of liver disease curable or not, it would deffo make me very very anxious if I had Diagnosis fatty liver, especially if I’d watched my partner pass from alcoholic liver disease.

I do think the liver trust needs to Re-clarify their post so not to scare people away that need help.

laura53923 profile image
laura53923 in reply to Dogmadpam

I am simply asking you a question because you say you are involved in mental health and have said the waiting lists are so long, ..... do you think there are people on that waiting list who don't actually need to be there? It is my belief that since the media put mental illness out there, too many people have convinced themselves they have anxiety when in fact it's merely a case of nerves. Are depressed when they are just having a bad week. There has to be a way of defining the difference between a personality trait and a real mental condition and should be recognised before reaching a waiting list for therapy/ treatment surely ?

Dogmadpam profile image
Dogmadpam in reply to laura53923

Laura that’s a question for a health anxiety forum, not liver.

laura53923 profile image
laura53923 in reply to Dogmadpam

Yes l have replied to him .... you are making a huge assumption that he is an alcoholic unless you are sending him private messages which means the most qualified on here to help him are missing a large chunk of his story and condition. Which is why the trust insist on open forum dialogue.

Dogmadpam profile image
Dogmadpam in reply to laura53923

Oh I presume you mean the guy from yesterday. Sorry but if we messaged eachother that’s our business and nobody else’s. The message function on here is there for a reason and if the trust only wants open dialogue then they should delete the messaging function.

I would appreciate it if you refrain from contacting me Laura because you appear to be looking for argument and sorry I’m not. If the trust or moderators have an issue, they will contact people, it’s not your job and I don’t appreciate being harassed. I am ill and do not want or need it.

laura53923 profile image
laura53923 in reply to Dogmadpam

Certainly not attacking you l am merely interested in where the line is drawn between mental illness and personality traits. The difference between feeling low and depression, anxiety and nerves. The lines appear blurred to me.

Hi I fit this glove exactly. I had a complete breakdown four years ago and after that all I wanted to do was die. It was as if I just couldn't stand my life any longer. Couldn't cope and even with every antidepressant going Diazepam Sertraline Venaflaxine etc etc I still tried to commit suicide on many occasions and I drank non stop.I was admitted to mental hospitals on several occasions. The last one because I was insisting I had chirrosis which I have I gave up drinking in September last year. But the symptoms of chirrosis then began to get worse or at least I now felt and saw them. By January my lower legs were very swollen. I could hardly walk with the pain. My hair started to fall out my urine dark orange, fatty deposits on my eyelids, and my bones started to deteriorate forming spurs of bone at an an alarming rate and I knew I was dying. All the doctors told me I was fine! Blood results normal that my bones were just due to wear and tear eg simple arthritis. I was diagnosed with diabetes 2. I wrote pleading with my doctor to believe me. I was referred to a gastroenterologist who told me he wasn't concerned as my blood tests were all improving

I asked for a fibroscan and was told that I had to wait at least six months maybe more. So I decided I just couldn't just wait to die or for the doctors to diagnose me I had to act and act now! So I started pushing myself to walk taking painkillers all day. I ordered every available pill natural remedy found through the Internet and stopped smoking, went vegan , have weaned myself off Venaflaxine. I don't know what the future holds for me but I do know this journey all started with major depression and anxiety and I do know now ill continue to fight my condition for as long as I am able.

Atm my bones have stopped deteriorating, I walk every day 2 to 3 times without painkillers. I'm actually physically very fit apart from my liver. I still ache and tingle and get stiff after stopping moving. Get v tired before bed. If you can believe it I can actually feel my hardened liver. All this I believe happened because I suffered tremendous anxiety and depression. History of PTSD and many years abused in my marriage followed by further abuse.

Worriesalot profile image
Worriesalot in reply to Flang

Have you been diagnosed with cirrhosis Flang? Hope you continue to improve.

Flang profile image
Flang in reply to Worriesalot

No I haven't. Not yet, still waiting on another ultrasound atm. Its v weird I'm so used to being in pain atm it feels like I'm almost at a breakthrough just on the edge of not feeling any? I can't quite describe it. Anyway thank you so much for your response.

Worriesalot profile image
Worriesalot in reply to Flang

Maybe the warm weather warming your bones up. Could be arthritis or something like that. You’ll be tap dancing next!!!!!!!

laura53923 profile image
laura53923 in reply to Flang

Hi Flang . I am very sorry for what you have been through and the health problems you have, but please do not assume you have cirrhosis. Only your doctors can confirm your diagnosis one way or the other. Constant worrying about what you may or may not be suffering from will itself create symptoms. So take up new hobbies, continue to keep as fit as you can physically and your mind occupied on new, more productive tasks.

I wish you well

Laura.

As if by magic, I have just posted up a new thread: healthunlocked.com/britishl...

This is a free course being run on “FutureLearn” by the University of Reading entitled “Understanding Anxiety, Depression and CBT” This might help to take your mind off your liver worries and help you to focus on something else. You know what they say about ideal hands, so why not give it ago?

Richard.

Did you mean to reply to flang?

No, the reply was to yourself as I saw your reply after I had posted the update.

Ah ha 👍

Its just you said it might take your mind off you liver worries.... as you know l don't have any 😀

Flang profile image
Flang in reply to Richard-Allen

Thank you Richard I certainly will

Flang profile image
Flang in reply to laura53923

Hi Laura thank you so much for your thoughts and concern. I really don't deserve any. Yes I do need a new hobby. I'd love to have my own dog as I love dogs but isn't that selfish when I'm not well? Anyway I take your point. I'm trying to learn Portuguese atm as my son has plans to go there in October this year He also plans I go with them as long as I'm healthy enough. We will see.......x

laura53923 profile image
laura53923 in reply to Flang

That sounds wonderful... my daughter's boyfriend is Portugese and is fluent in 3 other languages l would definately get absorbed in that.We have a Cavalier king Charles spaniel.... adorable not too demanding... as dogs go, loves his walks and lots of cuddles. Do whatever you think is right for you but never do yourself down you do deserve care and concern, we all do so ... deep breaths think positive and keep smiling😍🌻

Flang profile image
Flang in reply to laura53923

Thank you Laura x

laura53923 profile image
laura53923 in reply to Flang

You're welcome xx

That’s very interesting thank you

My husband used to drink because he couldn’t sleep. Very similar to what you said about feeling happy. Initially 1drink worked then he was on the slippery to being alcohol dependent. It’s now been 14 months since his last drink, he has cirrhosis. It is so easy to get to this without realising.

Flang profile image
Flang in reply to purple64

Hi purple yes I know that feeling so well. I used to say to people 'I just want to be able to sleep' I also just wanted to stop thinking so I just drank more and more. The worst thing is knowing that I've not only done this to myself but have caused so much pain to so many people including my two sons who are wonderful. When I consider all the people out there with disabilities the homeless etc why have I been so bloody selfish? I'm so grateful now for everything and everyone why couldn't I be like this before? Also having spent four years destroying myself I'm struggling with all the changes in the world including technology. Its like I've woken from a deep sleep but now don't know where I am or what to do? I feel very empathetic to your husband has he tried Valarium? I drink it every night now.

laura53923 profile image
laura53923 in reply to Flang

Hey ... put it all behind you, thrive on all the positives in your life now. You obviously have a great family who have stood by you and can now make up for those few bad years which you have learned a lot from. Enjoy your new life to the full, every day is a bonus and a blessing and a bad day is just that ... a bad day and a minor blip..... what did our inspirational man of the year Sir Captain Tom say ? ...... " Tomorrow will be a good day!" We should all carry that through our lives.Laura xxx

Hello, everyone -

I haven't been on this site for ages and just stumbled upon this thread. There are a lot of back-and-forths here and I don't know exactly who said what. But I do want to address the issue of anxiety and depression always being curable. (I do realize this is a liver forum, but the topic of mental health is related and has emerged here.) There are, in fact, individuals who have what's called TRD (Treatment-Resistant Depression). These are people who have tried every possible therapy up to and including extreme treatments such as electro-shock therapy. This would be in combination with talk therapy, exercise, nutrition, social support, and trying countless medications in countless combinations. But still, nothing works for them. We still don't know a lot about depression, despite centuries of trying to understand it. Those with treatment-resistant mental illnesses are some of the least fortunate in our society.

Excellent points. The same stands for anxiety and it is a complete misconception that anxiety is curable for all. It's common for people with health anxiety to have other mental health conditions as well, such as depression, an anxiety disorder, or post-traumatic stress disorder. For me I have autism which is likely my underlying cause for lifelong anxiety and depression as it’s co-morbid to my disability making is less treatable. There are hundreds of factors affecting treatment.

I consider myself one of those less fortunate, and I’ve nearly lost my life to the illness and this is why I advocate strongly with anyone affected xx

I'm quite sorry to hear your anxiety reached that point and understand the desperation that led you there.

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