“In general, people with hepatitis C have been seen to have overall increased levels of fatigue, depression, and stress,” says Souvik Sarkar, MD, PhD, a hepatologist and hepatitis C expert at the University of California in Davis. Part of the problem may be physical: The virus can interfere with the body’s production of liver proteins, which may trigger a higher stress response, says Dr. Sarkar. But there are also some psychological explanations behind these emotions; for example, you may have been surprised by your diagnosis or worried about treatment and how much it will cost. The infection itself can also trigger fatigue. If that’s the case, it might be hard for you to carry on with your everyday activities, which can lead to even more stress and frustration, he explains. Although your feelings are normal, too much worrying can backfire. The National Institute of Mental Health says that long-term stress can weaken your immune system, interfere with your digestion, cut into your sleep, and make you more susceptible to infections. The good news: There are ways to manage the stress that may arise from a hepatitis C diagnosis, and as your treatment progresses, you may need to rely on them less and less. Here are eight strategies to try.
1. Start hepatitis C treatment and stick to it.
Starting on medication for hepatitis C can ease many of the symptoms that can contribute to your stress, anxiety, and depression — especially fatigue, says Sarkar. For example, for some people with hepatitis C, the fatigue is so overwhelming that they have to file for disability benefits, he explains. But treatment can help resolve this symptom and allow you to feel in charge of your life again, which brings a large psychological boost.
2. Ask your doctor about being screened for depression.
For people with hepatitis C, fatigue and depression can be related. In a study published in December 2017 in the journal Arquivos de Gastroenterologia, researchers found that in people with cirrhotic liver disease, fatigue and depression symptoms were closely linked. And the fatigue doesn’t always subside when treatment begins. In fact, research published in January 2021 in the Journal of Psychiatry and Neuroscience found that, for some people, the symptoms of depression actually increased as they underwent treatment. If you think you might be depressed — before, during, or after your treatment for hepatitis C — your doctor can refer you to a psychiatric specialist. You may be a candidate for an antidepressant or benefit from talking with a therapist.
3. Join a support group.
Interacting with other people with hepatitis C can make you feel less alone. But because not all doctors think to connect their patients to support groups, says Sarkar, you may have to speak up. Try visiting the American Liver Foundation, which maintains an online support forum and has links to in-person support groups in most states. You can also ask your doctor about local support groups that meet regularly or call hospitals, health centers, and community centers in your area.
4. Increase your physical activity.
Exercise can help fight fatigue, lower stress levels, and lead to improvements in mood, says Sarkar. This is especially helpful for people with hepatitis C. A study published in January 2017 in the journal Advanced Research in Gastroenterology and Hepatology found that a when people with hepatitis C participated in a 12-week exercise program, they experienced reductions in liver inflammation and felt less fatigued. If your liver disease is advanced or you have severe fatigue, talk to your doctor about how to start exercising in a way that’s safe and effective. Generally, walking and biking are great ways to engage in moderate aerobic activity.
5. Pay attention to your sleep schedule.
More than 30 percent of people with hepatitis C report sleep problems, according to an August 2018 article published in the journal PLOS ONE. The problem is, those sleep disruptions can increase levels of stress hormones, according to the National Sleep Foundation (NSF). To improve your sleep, go to bed and wake up at the same times every day and turn off all screens at least an hour before bedtime, the NSF advises. Relaxation or deep breathing techniques may also help you fall asleep.
6. Start writing in a journal or diary.
Keeping a journal of your symptoms and moods can be helpful to both you and your healthcare provider. “What patients feel before treatment, on treatment, and after treatment [can go unappreciated],” says Sarkar. Writing down your symptoms can also be a form of therapy. You may find that recording your thoughts in a journal can help you dwell on them less, he notes. And by keeping track of your symptoms and emotions, you might be better able to spot patterns in your mood.
7. Try meditation, yoga, or deep breathing.
These time-tested stress-reduction techniques aren’t specific to hepatitis C, of course, but there’s evidence that they may be commonly used by and helpful in people with liver disease. In a study published in May 2010 in the journal Gastroenterology Nursing, researchers found that meditation and deep breathing were used by 29 percent of people with hepatitis C to relieve tension and promote feelings of well-being. The study’s authors concluded that healthcare providers should be aware of and discuss mind-body techniques with their patients, given the strategies’ widespread successful use by people. Sarkar also discusses stress-relief measures such as meditation and yoga with his patients, and many of them find these practices helpful.
8. Take charge of your health.
Taking charge of your health as much as possible can help counter any feelings of helplessness you may have, says Sakar. It’s useful to understand the results of your liver function and hepatitis C genotype tests so you can discuss your treatment options with your doctor, he adds It’s also a good idea to keep track of your symptoms, including those that may be associated with other preexisting health conditions, and share this information with your healthcare provider, , says Sarkar. Be sure to tell your doctor every medication you’re taking and ask about potential interactions or side effects associated with prescribed hepatitis C treatments, he says. After all, knowledge is power.
