Extreme fatigue. An adverse reaction to the sun. Constant joint pain. Living with lupus means never knowing precisely what the day will bring. The unpredictability of the disease can cause depression and other mental health problems, such as stress and anxiety. This is known as reactive depression. Chemical or clinical depression is characterized by feelings of hopelessness and loss of interest in things you once enjoyed. It is a debilitating and prolonged state caused by a chemical imbalance in the brain and requires prompt professional attention.

“Everyone who has a chronic disease experiences depression of one degree or another,” says Patty Dunn, who has lived with lupus for 40 years and has learned ways to cope with the inevitable depression and sadness. Studies have found that between 15 and 60 percent of people with a chronic illness will experience clinical depression. The good news is that there are effective treatments and lifestyle changes that can help combat depression and the symptoms.

Join a Support Group

Whether it is in-person or virtual (online), a support group can help beat back feelings of loneliness and isolation by connecting you with others who share your diagnosis. Support groups are also a great resource for learning coping skills and finding out what’s new in research and treatment. Since joining the Piedmont chapter of the Lupus Foundation of America nearly a decade ago, Patty has shared her experience and strength with hundreds of lupus patients and drawn upon their support during her rough patches.

Be Open With Friends and Family

An erratic disease for which there is no cure can be a strain on any relationship. Many lupus symptoms are not readily visible, so it’s up to you to tell your loved ones how and what you are feeling and what they should expect. Involve them in your care, and tell them what they can do to help.

Meditate on It

Recent studies have found that meditation is a powerful tool for treating depression. It also decreases stress levels and increases the level of endorphins, chemicals in the brain that causes feelings of euphoria. Best of all, meditation can be done almost anywhere at any time.

Be Wary of Drug Side Effects

Corticosteroids are prescribed to counter lupus-related inflammation, but they can also make you more emotional and increase the risk of depression.

Seek Counseling

A recent study found that cognitive behavioral therapy (CBT)—a type of psychotherapy that explores the role of thinking in people’s well-being—is an effective treatment for lupus patients with high stress levels. CBT significantly reduces the incidence of psychological disorders associated with lupus and helps to improve and maintain quality of life. Psychotherapy, alone or in conjunction with medication, can help you better cope with your emotions and illness.

Consider Medication

Antidepressants can help ease the effects of depression, whereas anti-anxiety medicines reduce anxious and fearful feelings. Ask your doctor if they may be right for you. These medications have side effects and may heighten symptoms associated with lupus, such as increased dryness in the mucous membranes. Keep your doctor informed about any physical changes you notice.