Major Depressive Disorder and Lupus


When the Body Fights Itself

What is lupus?  The proper name for lupus is systemic lupus erythematosus, or SLE.  Lupus is an autoimmune disorder that is a chronic condition among sufferers.  Symptoms of the disease vary among patients, but it is essentially the immune system mistaking healthy cells for pathogens and lashing out at them.

Lupus affects the central nervous system, causing physical and psychological distress.  When lupus causes psychiatric symptoms that affect the sufferer’s quality of life, this is called neuropsychiatric systemic lupus erythematosus, or NPSLE.

Depression and Lupus

The existence of an illness, particularly a chronic and painful one, is plenty of cause in itself for depressive symptoms to occur.  When that illness affects the mechanisms of the body that coalesce to create our physiological responses to stimuli, like hormones, a perfect storm of unease is created.

Some common physical symptoms of lupus are:

  • Thyroid problems.  People with lupus are at an increased risk of developing thyroid problems, which affects hormones and metabolic regulation.
  • Muscle and joint pain, which can inhibit mobility or the amount of physical effort the patient can put forth.
  • Oral lesions that make eating and oral hygiene painful.
  • Skin rashes, particularly covering the bridge of the nose and cheeks in a “butterfly.”
  • Fever and tremors.
  • Anemia, which can cause irregular heartbeat and shortness of breath.
  • Hair loss.  Illness-induced changes to one’s appearance are a common cause of anxiety.
  • Fatigue and malaise, which also inhibits mobility and stamina.


When someone suffers from NPSLE, major depressive disorder (MDD) can accompany it.  NPSLE can also strongly mimic the symptoms of bipolar disorder.  Here’s how:

  • MDD and similar are common with chronic illnesses like lupus.  Many sufferers express that their whole life has changed.  Some even feel that their lives now revolve around managing their illness.
  • Needing more care or having to cut back on tasks that prove too taxing is hard on the psyche and can make one feel inadequate.
  • NPSLE can be misdiagnosed and/or take a long time to pinpoint, resulting in partial relief or ongoing suffering.
  • Some drugs for lupus, like prednisone, may help the more tactile symptoms of lupus but disrupt the patient’s mental health.

Fighting Back

We always advise our patients to communicate with their general physician first if they are experiencing physiological unease.  Lupus is a perfect example of how mental and physical pain and malfunction are woven together.  This is why general physicians check the thyroid when investigating a patient’s complaints of depression, fatigue, joint pain, and more.

Always be thorough when describing the nature, time, and placement of your symptoms, and ask to be tested for any conditions you suspect that have not yet been explored.  For questions and recommendations, contact us any time.