Living with a long-term health condition takes work: appointments, medicines, tests and changes to daily life. It can also wear on your mood. Depression is common in people with chronic illness, and it is treatable. Here is how the two are connected, why it helps to treat them together, and how care that brings your mental health into your primary care can help.
How chronic illness and depression are linked
The National Institute of Mental Health (NIMH) says people who have a chronic disease are at a higher risk of developing depression. Examples of chronic diseases include autoimmune diseases, diabetes and cancer. The link runs both ways: NIMH notes that depression may raise the risk of other conditions, including heart disease, diabetes, stroke, pain, osteoporosis and Alzheimer's disease.
Diabetes is a clear example. The Centers for Disease Control and Prevention (CDC) says people with diabetes are 2 to 3 times more likely to have depression than people without diabetes. CDC also describes diabetes distress, the overwhelming feelings that can come with managing diabetes every day, which may cause some people to stop taking care of themselves.
Why treating both matters
NIMH says research suggests that people who have a chronic disease and depression tend to have more severe symptoms of both illnesses. CDC notes that depression can get in the way of how well you function at work and at home, including taking care of your diabetes. When your mood improves, the daily work of managing a chronic condition can feel more possible.
Signs that are easy to miss
Some signs of depression can look like part of a physical illness. NIMH lists fatigue, lack of energy or feeling slowed down; trouble sleeping, waking too early or oversleeping; and changes in appetite or unplanned weight changes. Other signs include a sad, anxious or "empty" mood that lasts, losing interest in things you used to enjoy, and feeling hopeless. If these have lasted for 2 weeks or more, tell your provider. NIMH also suggests telling your provider about all the medicines you take and treatments you receive, so they do not interfere with one another.
Depression is treatable, even with a chronic illness
NIMH says depression is treatable, even if you have a chronic disease. Treatment typically involves talk therapy (psychotherapy), medication or both. CDC says treatment, whether therapy, medicine or both, is usually very effective. Treatment can include medication, counseling or both, and your provider can help you decide what fits.
Care that brings mental health into primary care
NIMH notes that research supports a collaborative care approach, in which primary care and mental health professionals work together to provide mental and physical health care at the same location, and that this approach can improve the overall health of people with depression.
Behavioral Health Integration (BHI) is the Medicare service built on that idea. Medicare covers two kinds: psychiatric Collaborative Care and general BHI. Hope offers general BHI. The Centers for Medicare & Medicaid Services (CMS) describes general BHI as care that systematically assesses and monitors how you are doing, adjusts the care plan if you are not improving enough, and gives you a continuous relationship with an appointed member of your care team. At Hope, that is a care coordinator who works closely with your provider, so your mood and your physical health are part of the same plan.
Medicare Part B may pay for BHI services if you have a behavioral health condition such as depression or anxiety and you are eligible. After the Part B deductible, you generally pay 20% of the Medicare-approved amount. Medicare Advantage plans must cover everything Original Medicare covers, but costs and rules vary, so check with your plan. Before BHI begins, we ask for your consent, and you can stop at any time.
Ready to Get Started?
Primary care, mental health, and addiction medicine in one practice. New patients are often able to be scheduled within a week of requesting an appointment.
A question to bring to your next visit
"My chronic condition has been wearing on my mood. Could we look at my mental health as part of my care plan?"
If you or someone you know is struggling or having thoughts of suicide, call or text the 988 Suicide & Crisis Lifeline at 988. In a life-threatening emergency, call 911.
Care coordination at Hope Integrative Medicine
Our primary care, mental health and addiction medicine teams work as one practice, connected by care coordinators who keep your plan moving between visits. Care is available in person in West Ashley and through hybrid care across South Carolina.
Want a care team member focused on your care between visits? Ask us about enrolling. Bring it up at your next visit, send us a message or call (843) 737-0312, and we'll check whether Behavioral Health Integration or Chronic Care Management is right for you. New to Hope? Request an appointment.
Sources: National Institute of Mental Health, Understanding the Link Between Chronic Disease and Depression (2024); National Institute of Mental Health, Depression (2024); Centers for Disease Control and Prevention, Diabetes and Mental Health (2024); Centers for Medicare & Medicaid Services, Behavioral Health Integration Services, MLN909432 (January 2026); Medicare.gov, Behavioral health integration services; Medicare.gov, Compare Original Medicare & Medicare Advantage.
This article is general information, not medical advice, and does not create a patient–provider relationship. Every situation is different, so see a provider who can evaluate yours and develop a plan of care. Any medication discussed here may not be right for you: the right choice depends on your diagnoses, other health conditions and current medicines, so take medication only as directed by the provider managing your care. If you are ever in doubt about an emergency, call 911 or go to the nearest emergency room.
Frequently Asked Questions
Yes. The National Institute of Mental Health says people who have a chronic disease are at a higher risk of developing depression. The Centers for Disease Control and Prevention says people with diabetes are 2 to 3 times more likely to have depression than people without diabetes.
NIMH says research suggests that people who have a chronic disease and depression tend to have more severe symptoms of both illnesses. CDC notes depression can get in the way of taking care of a condition such as diabetes.
CDC describes diabetes distress as the overwhelming feelings that can come with managing diabetes, which may cause some people to stop taking care of themselves. Tell your provider if managing diabetes feels like too much.
Yes. NIMH says depression is treatable, even if you have a chronic disease. Treatment typically involves talk therapy, medication or both, and CDC says it is usually very effective.
Behavioral Health Integration (BHI) is a Medicare service that brings mental health care into your primary care. Hope offers general BHI, which tracks how you are doing, adjusts your plan if you are not improving enough and gives you an appointed care team member.
Medicare Part B may pay for BHI services if you have a behavioral health condition such as depression or anxiety and you are eligible. After the Part B deductible, you generally pay 20% of the Medicare-approved amount.