We are called Sickle Cell Warriors for a reason. We are tough, resilient fighters. But because we are so often seen as such strong people, it’s easy to overlook our inner struggles, which can lead to devastating outcomes such as depression or suicide. Chronic pain is associated with depression and other psychological disorders. According to the American Foundation for Suicide Prevention “This is primarily due to psychological states such as hopelessness, helplessness, and desire for control over death.” 

Sickle Cell and depression are major health concerns as separate entities. Thousands of people are hospitalized from these diseases or complications. There are racial and ethnic disparities in healthcare where minorities are sometimes under-treated and symptoms of depression are sometimes overlooked. But what happens when these two illnesses are coupled together?

It’s not simply just having a chronic illness like Sickle Cell that causes someone to be depressed or think of ending their life, it’s the quality of life that that person is actually living. For people who live with Sickle Cell that are generally able to maintain good health and have infrequent pain episodes, the risk of depression and suicide is definitely lower. On the other hand, patients who experience higher occurrences of crises are at increased risk. Depression increases as the severity of the disease increases.

As stated in this Journal of the National Medical Association article, some studies estimated that Sickle Cell patients experienced a lifetime rate of depression at 50%. Other studies estimate between 35% – 50%. Depression is a major factor in considering suicide. As one may assume, education, socioeconomic status, access to medical treatment, and access to weapons or drugs can also play a part in whether or not someone may consider suicide.

Patients, especially Black patients with chronic illnesses tend to “suffer in silence”. This may be due to the social stigma in the Black community that if you admit that you are depressed, that people or society would think you are “crazy” and shun you, so therefore a significant amount do not report symptoms to their physician. These patients need to be made aware that people with chronic illnesses do experience signs and symptoms of depression, and that it is acceptable to talk about it with their healthcare provider, close relatives and friends. Religion should also be looked at as important factors as to why these patients do not report depressive symptoms or think they are depressed. 

Psychological therapies should be offered as a standard of care, and Cognitive Behavioral Therapy (CBT) and/or antidepressants should be started immediately when necessary. It is shown that having a good support system improved one’s quality of life. More support groups should be developed for those patients who do not have the support of family or friends.

On a more positive note, quotes from @sicklecell101 on Twitter.

Sickle Cell has taught me…

“Sickle Cell has taught me to believe that suffering has its unique benefits. My life with Sickle Cell has made me a person more capable of enduring. Making it through lets you know that you can make it through. My endurance allows me to continue the fight.”

“To put myself first and also the importance of priority. Also letting go whatever doesn’t deserve my time and energy.”

“To live today to the fullest because I do not know what tomorrow will bring.”

We are called Sickle Cell Warriors for a reason. We are tough, resilient fighters.