Coping With the Mental Aspects of Hepatitis C

Living with the hepatitis C virus doesn’t just take a toll on your liver. It can also affect your mental health.

“People with hepatitis C have higher rates of mental health disorders compared with people in the general population,” says Andrew J. Muir, MD, MHS, a professor of medicine and chief of the division of gastroenterology at Duke University School of Medicine in Durham, North Carolina.

Here are the psychological challenges you might face from having and being treated for hepatitis C — and what you can do to feel better, both mentally and physically.

The Link Between Anxiety, Depression, and Hepatitis C

Mood changes, including anxiety and irritability, can come with a diagnosis of hepatitis C. You may feel anxious about the illness and your future when you learn you’re at risk for liver cancer or other complications, says Camilla Graham, MD, an assistant professor of medicine at Harvard Medical School in Boston.

Depression can also be common, affecting anywhere from 20 to 50 percent of people who have hepatitis C, according to a review published in August 2021 in the World Journal of Gastroenterology.

There can be an unfortunate stigma attached to a hepatitis C diagnosis, especially when people don’t understand the condition. A study published in November 2020 in the Journal of Viral Hepatitis found 95 percent of study participants reported experiencing some type of stigma related to their infection.

As a result, people with hepatitis C may become isolated, which can pave the way to depression, says Dr. Graham. Many people with hepatitis C become withdrawn and depressed, because they feel judged or shunned by others.

People with hepatitis C may also struggle with substance abuse — today, the virus is often contracted through needles or other equipment used to inject drugs — as well as the mental health issues that can go hand in hand with it, she says.

Regardless of whether mental health issues were present before a hepatitis C diagnosis or caused by the diagnosis or treatment, people with the illness should benefit from getting treated.

“Hepatitis C can be cured. It is so meaningful to help patients get past this,” Dr. Muir says. Too many people are still out there, struggling with hepatitis C, and I hope they seek care to get treated and cured.”

To that end, you may want to seek social support from loved ones as well as other people who have hepatitis C, who may be able to relate to you, suggests Graham. If the sadness becomes overwhelming, she says, it may be time to seek medical help. “It’s really important to deal with any mental health issues, especially depression, because they can get in the way of faithfully taking medications to treat hepatitis C,” says Graham. “It also increases the risk for engaging in unhealthy behaviors that may make hepatitis C progress faster.”

If you believe you may be depressed, consider asking your doctor if you’re a candidate for antidepressants. In the past, there was concern that these drugs were linked to liver injuries, but Graham says that most of today’s antidepressants are safe for people living with hepatitis C. Your doctor will often start with the lowest possible dose, she says, and may monitor your liver enzymes more closely if you have cirrhosis (scarring of the liver that can occur after having hepatitis C for many years.)

If you struggle with substance abuse, seeking treatment for it can make a big difference in your mental health and the health of your liver, Graham says. There are also 12-steps programs for substance use available.

Keep in mind that healthy lifestyle choices, such as exercising regularly, can also help treat the depression and anxiety associated with hepatitis C. As Graham says, “Healthy choices can improve overall mood and general feelings of well-being.”