Mental Health and Emotional Well-being on Dialysis

The emotional side of dialysis can be as hard as the physical one. Sadness, worry, grief and stress are common when living with a long-term illness and a demanding treatment. Recognising these feelings and looking after your mental health is not a weakness: it is part of good care, and it also helps your physical health.

Common emotional challenges

Depression is much more common in people on dialysis than in the general population: studies estimate that around one in four to one in five patients are affected. Signs include lasting sadness, loss of interest, changes in sleep or appetite, tiredness, poor concentration and feelings of hopelessness.

Anxiety can show up as constant worry about health, treatment or the future, sometimes with a racing heart, sweating or panic. Many people also grieve for the life they had before, or feel anger at the unfairness of illness. These are natural reactions.

When to ask for help

Talk to your care team or a mental health professional if you notice:

• Sadness or hopelessness lasting more than two weeks
• Loss of interest in everything you used to enjoy
• Sleeping much less or much more than usual
• Difficulty coping with daily life
• Irritability that affects your relationships
• Wanting to skip dialysis sessions because of how you feel

If you have thoughts of harming yourself, contact your local emergency number or a crisis line now.

Coping strategies

• Talk about your feelings with people you trust instead of keeping them inside.
• Try relaxation techniques such as slow breathing or muscle relaxation.
• Stay in contact with friends and family, even when you do not feel like it.
• Keep doing small things that bring you joy or meaning.
• Write in a journal to understand your emotions.
• Set realistic goals and celebrate small successes.
• Focus on what you can control.

Professional support

Your nephrologist can check for depression and refer you. Many dialysis centres have social workers or psychologists. Therapists who work with chronic illness can help, and some people benefit from medication, prescribed and followed by a doctor who knows your kidney condition. Support groups and online communities can also help.

The role of family and friends

Support from loved ones improves quality of life. Be open about what you need, and let people help in specific, useful ways. Meeting other patients who understand your experience can make a real difference.

Mindfulness

Mindfulness means paying attention to the present moment without judgement. Short daily practices, such as focused breathing or a body scan, can reduce stress, and some patients use them during their sessions.

Hope and resilience

Hope does not mean denying difficulties. It means believing that life can still hold good moments and that you can cope. Many people on dialysis travel, work, spend time with family and enjoy life. You are more than your illness.

Sources

• Depression and chronic kidney disease: a review for clinicians (PubMed)

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