Mental health and cystic fibrosis

Mental health and emotional wellness

Mental health and emotional wellness are essential components of a person's overall health and well-being. This is particularly true in people with chronic diseases (defined as a condition that persists for longer than three months), who often experience anxiety and depression. 

According to the international depression/anxiety epidemiological TIDES study, evidence shows that people living with cystic fibrosis are two to three times more likely to experience anxiety and depression. Similar statistics were reported for parents and caregivers of people living with CF, reporting elevated anxiety and depression (Quittner et al, 2014). 

The Canadian cystic fibrosis community has identified mental health as a main issue for those living with CF, and a top research priority. Cystic Fibrosis Canada continues to promote learning, increase awareness around mental health and provide resources to better identify and treat mental health concerns. Learn about some of the work we are doing in mental health below: 

• Funding research on mental health aspects of CF 
• Developing national Canadian consensus guidelines for CF care, including mental health care 
• Clinician knowledge exchange and resource development for mental health topics 
• Mental health resource hub that includes links to community mental health resources in each province 
• Continuous learning from the CF community on specific mental health needs 
• Continuous collaboration with our international colleagues on new research, tools and models to support mental health in cystic fibrosis.

Depression and anxiety 

Children, adolescents and adults may experience occasional periods of feeling down, nervous or worried. For some individuals, these feelings can improve over time. For others, symptoms may worsen over time and may become overwhelming. 

Depression is a common medical illness that negatively affects the way you feel, think and act. Unlike occasional sadness, clinical depression can last for a long time—weeks, months or years—if not treated. People who have depression can have extended periods when they feel hopeless and lose interest in things they normally would enjoy. If you have thoughts of suicide or death, or have five or more of the following symptoms present over a two-week period, it’s important that you consult your health care provider. They will ask you questions about your wellbeing and overall mood. 

• Sadness/irritability 
• Changes in weight/appetite 
• Guilt, hopelessness or worthlessness 
• Inability to concentrate, remembering things or making decisions 
• Fatigue/loss of energy 
• Loss of interest in sex and other activities once enjoyed 
• Sleep disturbances 
• Restlessness or decreased activity 
• Physical aches and pains with no medical cause 
• Thoughts of suicide or death 

Another common mental health concern that may accompany depression is anxiety. Anxiety is a feeling of worry that may include nervousness or agitation. Everyone may experience this on a short-term basis, but prolonged feelings of anxiety may lead to cognitive, physical and behavioural symptoms. 

One of the most common forms of anxiety is Generalized Anxiety Disorder (GAD). GAD is defined as excessive anxiety and worry i.e. apprehensive expectation, occurring more days than not for at least six months. It could relate to a number of events or activities such as work or school performance. The individual is unable to control the worry and the anxiety, GAD is associated with at least three of the following six symptoms: 

• Restlessness or feeling ‘keyed up’ or on edge 
• Being easily fatigued 
• Difficulty concentrating or mind going blank 
• Irritability 
• Muscle tension 
• Sleep disturbance such as difficulty falling or staying asleep, or restless, unsatisfying sleep. 

Anxiety, worry, or physical symptoms cause clinically significant distress or impairment in social, occupational or other important areas of functioning.