There are many reasons chronic dry eye can, and often does, lead to clinical depression or severe anxiety.
Dry eye patients need to be on the alert, understand why they may be susceptible to depression and why this is normal, seek good medical care and seek real personal support.
This is not an exhaustive list, but it should help explain why something that to outsiders might seem "trivial" may test our coping skills to the utmost. These are listed in random order.
UNREMITTING PAIN: With dry eye, pain can be constant and severe. Most people who have never had dry eye or a serious eye injury have no conception how much pain the eyes are capable of producing. It can drive one to distraction. When chronic, it is a constant drain on one's coping resources.
LIFE IMPACT: There is a direct and sometimes dramatic impact on lifestyle. Outdoor activities may become impossible, because of irritation from air and wind and/or because of extreme light sensitivity. Work, especially in air-conditioned or heated offices and with fluorescent lighting, not to mention working on a computer, can become much more difficult or indeed impossible.
FINANCIAL IMPACT: This works in two directions:
- Direct medical costs can spiral out of control. Most of the medical and consumer products required by dry eye patients are sold over-the-counter and have to come from discretionary spending money. Artificial tears, especially if preservative-free types are required, become a significant monthly expense. The first year or so after diagnosis can be particularly costly as one seeks multiple opinions, sometimes requiring travel to specialists, and as one experiments with the large numbers of over-the-counter products available.
- Income can be threatened if ability to work is compromised. The office environment is very, very hard on dry eyes, especially when heavy computer work is involved. The fear of whether one will be able to continue working, and how long, is a major source of stress.
PERSONAL APPEARANCE: Chronically dry eyes may be unsightly. Women often struggle with accepting that they can't tolerate cosmetics, or that they are losing their eyelashes. Men and women alike struggle with chronic red eyes, and besides the impact on self-confidence it can lead to discomfort and embarrassment in the workplace especially if frequent personal interactions are part of one's job.
GETTING MEDICAL CARE AND ANSWERS: This is such a contentious and painful subject for many patients that I hardly know how to address it both briefly and adequately. For the moment suffice to say that, again, this is a very complex and very poorly understood disease where good medical, let alone practical, advice is extraordinarily difficult to come by.
OTHER FACTORS: Patients who got dry eye from elective LASIK surgery or even as a side effect of a drug that was not medically necessary may face unique struggles because of the suddenness of the change. They often also experience self-blame, or resentment against medical professionals if they were not informed of the risks. Furthermore, since some common depression and anxiety medications may exacerbate dry eye symptoms, patients may feel stuck in a catch-22.
If you feel you are struggling with depression and/or anxiety:
- KNOW that this is normal even if prolonged but it should, can and will get better. You are not a wimp. It is OK to be going through this, even if no one around you understands! Believe us, there are many, many extremely capable people out there struggling just as you are!
- TALK to your GP about it. This is key. Don't let things get out of hand before you seek help.
- TALK to your family and friends about it. Let them know you're struggling and why. If you think they won't understand, print out some materials from this website - even this page may help them understand why this is impacting you so profoundly.
- CONNECT with others who understand. Isolation is a big problem for dry eye patients - don't let it happen to you. JIf you don't know where to start, go to our community forums called Dry Eye Talk, register, and introduce yourself in the Welcome Center. Find one or two people you feel like you can relate to and contact them by email or phone if possible. Make a real personal connection so that you have someone to reach out to as you go through the ups and downs. When you're going through a better period, consider starting a support group.
- READ, READ READ to get a better understanding of your disease, of the treatment options, and of techiques and products that can help you cope.
- TAKE OWNERSHIP of your disease. We cannot sit back and expect doctors to "fix" this poorly understood disease for us. We have to own our medical care and own our coping
- SUBSTITUTE "MANAGE" FOR "CURE" in your vocabulary. Like it or not, for many of us this is a chronic disease. To accept that does NOT mean that we give up hope of a cure, it means that we face up to our current needs for coping and that we make things more practical for ourselves by dealing with today's problems, and not try to anticipate or live the future in advance.
- LIMIT NEGATIVE INPUT. The good thing about the internet is that you can find others going through the same thing. But when you're going through a rough time, sometimes reading the stories of other patients may make you feel frightened or even hopeless, because there are patients who have been dealing with it for longer or who are in a worse condition. The last thing you need when you're going through a 'dark place' is to hear about even darker places. When you sense it's dragging you down, do the sensible thing, turn off the computer put your efforts into finding some positive input.