Diseases of widely varying origins, such as hypertension, diabetes mellitus, and primary kidney disorders can lead to kidney failure. Kidney failure is end-stage kidney disease, in which kidney function is unsatisfactory to such an extent that a dialysis is required in order to sustain life. Dialysis is an artificial technique performed in order to replace some crucial functions of the kidney, until an appropriate kidney transplant becomes available.
If the transplant surgery goes well and if there is no rejection, you would expect the person with the new kidney to have a better quality of life. In most cases, that is true, but there is a certain number of patients who experience some emotional difficulties after a kidney transplant, which can make their life even worse than before. Scientists have several explanations for this phenomenon.
Causes Of Depression after Kidney Transplant
This type of depression is often called “paradoxical depression”, as it applies to patients with successful kidney transplants and without complications, who were expected to have a better quality of life. Scientists classify this disorder as paradoxical psychiatric syndrome. Psychiatrists suggest that one of the possible reasons for the occurrence of this syndrome might be the feeling of guilt towards kidney donors.
Studies have shown that persons who felt higher levels of guilt had more pronounced symptoms of depression. The reason the guilt appears after the transplant is because before the transplant it is being suppressed by the fear of the approaching death. Others think that the main cause of post-transplant depression occurs due to loss of an imagined past – the life they could have been living if they had not suffered from the chronic kidney disease for a long time.
The obligation to take anti-rejection medication for the rest of their lives is also an important obstacle for many patients. Although taking these medications is much easier than dialysis, there are often side effects of these medications which may lead to depressive disorders.
The Role Of Psychological Counseling
Despite the expected scenario of an improved quality of life, persons who develop paradoxical depression after kidney transplant usually feel worse than before the surgery. Sometimes they even wish they did not undergo the surgery. Therefore, it has been recognized that psychiatric counseling is very beneficial in patients scheduled for a kidney transplant. Education about the benefit they get from kidney transplant surgery is also very important. It is crucial that patients leave behind the guilt for the living donor, as every person makes a decision for themselves. Anti-rejection medications are necessary in order to sustain the transplant, and the recognition of their importance should be enough for these persons to consider them a new component of their daily routine.
Further research is certainly needed in order to assess the real consequences of paradoxical depression in patients with kidney transplant. Chronic kidney disease, kidney failure, long-term dialysis, and transplant surgery represent a series of stressful events which should receive more attention by psychiatrists and psychologists in order for the transplant treatment to provide its full benefit. Antidepressants can be used for the treatment of such depression if it becomes a long lasting and debilitating condition.
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