Having and managing a chronic disease everyday can be stressful. Some other causes of depression and anxiety can be:

• Chronic conditions: Some chronic conditions can change the chemicals your body naturally makes which can lead to depression and anxiety. Also, certain chronic diseases such as diabetes and heart disease have been linked to depression and anxiety.
• Medications: Some medications such as, beta blockers for heart disease, steroids or pain medications called “opioids”.
• Family history: Depression can run in families.
• Major life changes: Getting older or stressful life events can also lead to being depressed and feeling anxious. 

Managing depression and anxiety works best when you play an active role. 

• Try to figure out if there is a cause for your depression and anxiety. 
• Is it better or worse at different times?
• What helps or makes it worse?

You may want to use a symptom diary to record information about your depression & anxiety. Tracking this information will help you talk to healthcare team about your depression and anxiety.

Physical steps you can try:

• Medication: If you take medication for your depression and/or anxiety, take it as prescribed so your symptoms don’t get too bad.
• Gentle exercise: If it is safe for you, do gentle exercises like walking, swimming or riding a stationary bike every day. 
• Eat a healthy diet: If you do not have dietary restrictions try and eat fresh fruit and vegetables. If you have lost your appetite eat whatever you feel like eating and try to eat every 3-4 hours. Keep snacks handy for when you feel like eating.
• Get a good night’s sleep: Depression and anxiety may make you tired. Not getting enough sleep can make your symptoms worse. 
• Create a sleep routine: Go to bed and get up the next day at the same time every day. Try not to nap in the afternoon or evening.
• Don’t try and force sleep: If you can’t fall asleep within 20 minutes, get up and do something you find relaxing in a dimmed light. Get back into bed when you feel sleepy.
• Create a sleep-friendly bedroom: Use your bedroom for sleep (and sex) only. Keep your bedroom cool, quiet and comfortable.
• Avoid: Using mobile phones, tablets or computers in bed. Also avoid watching TV 60-90 minutes before bed. The light from these can affect the hormones that make you feel sleepy.
• Limit or stop: Alcohol, caffeine and nicotine to see if your symptoms get better. These can make your depression and anxiety worse.

 Mental activities you can try:

• Think positively: How you think can affect how you feel. Positive thinking may ease anxiety.
• Distract yourself: Do something that you enjoy to try and keep yourself mentally busy. For example, crossword puzzles, Sudoku, needlework or video games.
• Don’t keep your worries and fears to yourself: Talk to someone about your worries during the day or write them down. Keep a notepad by your bed so that if you wake up, you can write down the thought and go back to sleep, instead of thinking about it all night.
• Get support from others: Let your family and friends help you. Find someone you can trust and confide in, and talk to that person. This includes telling people you trust about depression. It is usually better than being alone and keeping it a secret.

Relaxation techniques you can try at home:

Ask if someone on your healthcare team can help you get started. You can also learn some on your own. Some techniques include: 

• Progressive muscle relaxation: Focus on slowly tensing and then relaxing each muscle group.
• Deep breathing exercises: Slow your breathing to the point where you are as relaxed in your breathing as possible. Breaths should be deep and fill your lungs. 
• Meditation: Sit or lie in a comfortable position for 20 minutes. Be aware of your breathing, your sensations (including your anxiety), your thoughts and feelings. 
• Guided Imagery: Form mental images to take a visual journey to a peaceful, calming place or situation. 
• Yoga: Can relax your breathing, ease muscle tension, and energize your mind and body.
• Massage: Helps reduce all over muscle tension and pain, which can help you relax.
• Hydrotherapy: Uses flowing water to relax muscles.
• Music and art therapy: Listening, playing music, drawing and painting can help you to relax.

Speak with your healthcare team if depression and/or anxiety is a problem for you. Your worries and questions are important to you and them. Your healthcare team may speak to you about the different medications you can take.   

• Let them know if you think your medical condition or medications are the reason for your depression and anxiety.
• Let your healthcare team know if a medication is working for you or if you’re having side effects. You may have to try a few different ones to know what works best for you. 
• Speak to your healthcare team as soon as possible if you are hearing voices. This can be a possible side effect of some medications. 
• Talk to them before taking over-the-counter medication, including vitamins and herbal remedies.

Tips on sharing your symptoms with your healthcare team:

• Make some notes about your depression and anxiety symptoms and tell your healthcare team about them.
• Has there been a change in your depression and and/or anxiety?
• What does your depression and/or anxiety feel like? How bad is it?
• When does it happen and how long does it last?
• What makes it better or worse? What have you tried already?
• Make a list of all the medications you are taking including over the counter medications.

If you or someone you know talks about suicide, self-harm, a mental health crisis or any other kind of emotional distress, get help right away. Support is available 24 hours a day, 7 days a week:

• Mental Health Help Line: call 1-877-303-2642 for support, information and referrals for Albertans experiencing mental health concerns
• Talk Suicide Canada: call 1-833-456-4566 or text 45645 (4 p.m. to midnight ET). Visit https://talksuicide.ca for more information.

Call 911 immediately if you or someone you know is thinking seriously of suicide or has recently tried suicide.