Living with Stage 4 Chronic Kidney Disease

Dealing with emotions

Living with any chronic disease such as CKD can be physically and emotionally challenging. It is very common to feel sad, scared, frustrated or angry about a chronic illness. Your emotions and feelings can also change throughout the course of your disease. It is important to realize that a chronic illness can affect your mental health. When you have a chronic illness like kidney disease, you have a lot more to think about, which can lead to feelings of anxiety, anger, worry, and stress. Living with the seriousness of kidney disease, day in and day out, can lead to a more negative view of life. It can make you feel confused and leave you feeling down.

There are a few general things you can do to help deal with emotions. Do not be afraid to tell others what you are feeling and to ask for help and support when needed. Sometimes bad days or bad things happen, so you should not be so hard on yourself. A chronic illness can create stress. Be prepared to handle stress by finding ways to relax. Maybe call a friend up, exercise, read, or listen to music.

It is important to remember that your emotions and physical health are connected. A healthy emotional life will help you to live longer and feel better. Set reasonable goals for yourself. Be flexible. Allow for mistakes. Try to keep a positive attitude. Spend time with people who make you laugh. All these things can help you stay healthy.

Understanding depression

Feeling sad or upset on occasion is a normal part of life, especially when living with a chronic disease. However, there are times when you may need help coping with these feelings. Asking for help is not a sign of weakness, but of your desire to do well. Many people need help with their emotions as they learn to cope with CKD and kidney failure.

If you find yourself feeling overly sad, irritable, isolated, overwhelmed, unable to face each day, crying too much, or feeling like you want to give up, you may have depression. If your sadness doesn’t lessen over several weeks, talk with a member of your healthcare team who can help you figure out if you are experiencing depression. Some additional symptoms of depression include difficulty doing things you usually enjoy, feelings of guilt, shame, worthlessness, or hopelessness, crying, sadness or irritability, withdrawing from friends or family and thoughts of harming yourself.

It is important to know that depression is a medical condition. It can be treated. You do not need to suffer from it, or be embarrassed about it. Depression has been associated with kidney disease. For example, studies show that 20 to 40% of people with kidney failure may have depression. Do not be afraid to ask for help. Your healthcare team can help you find additional support and ways to cope, which might include medication, counseling or other things.

Managing stress

We all experience stress. It’s part of life. But too much stress can contribute to poor health. Stress is anything that can upset or disturb your equilibrium or balance. Stress can be physiological (infection, injury, disease), or psychological (anxiety, argument, conflict, threats to personal safety or well-being). Living with a chronic illness, such as kidney disease, can be a significant source of stress. Stress is normal, and your physical response to stress is a natural and normal process. The levels of fats and sugars in your blood can also increase. The body’s response to stress is commonly known as “fight or flight.” Although it is a natural process to help us survive immediate dangers, these reactions from too much or constant stress can eventually take their toll on your health. It is very difficult, if not impossible, to completely get rid of stress. However, there are steps you can take to manage stress and help control your body’s response to stress. Some ways to reduce stress in general can include:

• Set aside time to relax
• Relaxation techniques (yoga, meditation, etc.)
• Prayer
• Write down your problems and think about the best solution for each of them. A list can help you evaluate and prioritize what issues need to be addressed
• Get enough sleep and maintain a regular sleep schedule as best you can
• Keep involved in the pleasures, activities and responsibilities of daily living
• Find time to exercise at a level to suit your individual limits
• Find time to enjoy the outdoors
• Find out as much as possible about the illness through the National Kidney Foundation, local or national support groups, written materials and educational classes
• Share your feelings with family or close friends
• Seek help from a clinician or counselor, if family or personal problems need further attention
• Be patient and set realistic goals in adjusting to all lifestyle changes

This list does not include all of the ways you can manage stress. No matter the technique, managing your stress can help you feel better and live a healthier life.

Finding support

Having people to turn to for support can be a great help while living with kidney disease. Even your closest family members cannot read your mind. It is important to tell them how you feel. Don't be afraid to tell others what you are feeling and to ask for help and support when needed. Different kinds of people can help provide emotional support. Among those who can be a part of your support system include:

• Family and friends
• People also living with the same disease
• A spouse or significant other
• Mentors and co-workers
• Members of you healthcare team
• Social, religious and spiritual groups

You can also contact organizations like the National Kidney Foundation to help navigate the challenges of kidney disease or to request to speak with someone living with the same disease: NKF cares

Online communities are also available for people to share their experiences, ask questions and get answers: View NKF communities

Coping: What can I do?

Here a few ways that can help manage the emotional challenges of chronic diseases such as CKD:

• Have people to turn to for support. Do not be afraid to tell others what you are feeling and to ask for help and support when needed.
• Do not be afraid to seek assistance from family or friends to handle any physical challenges; they want to help.
• Consider peer support. You can ask your healthcare team for help finding peer support or contact an organization such as the National Kidney Foundation.
• Try to manage stress as best you can. Find ways to manage stress that work best for you.
• Understand the signs and symptoms of depression and seek medical help if you are experiencing any of these symptoms.
• Talk to a social worker if you feel you need counseling or help finding services.