Warning Signs of Depression in Fabry Disease Patients

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by Vaidyanathan |

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Fabry disease is a rare genetic disease in which mutations in the GLA gene lead to the accumulation of a type of fat called globotriaosylceramide (Gb3 or GL-3) in cells and tissues.

Fabry disease affects multiple organs, and many patients experience Fabry crises, intense episodes of pain, fever, and burning sensations in the hands and feet. Dealing with these symptoms can be difficult both physically and emotionally, and can result in a feeling of helplessness. In severe cases, this may lead to depression. Below are some potential warning signs of depression to watch for in individuals diagnosed with Fabry disease.

Differentiating between grief and depression

Although grief and depression share similar characteristics, it is important to be able to differentiate between them. Grief is a temporary, natural response to a loss, whereas depression is an illness. Observe whether the individual is able to recover within a short period of time or is constantly sad with no hope about the future. If the latter is the case, seek medical help without delay.

Physical signs of depression

Depression can have physical signs. Family, friends, and caregivers of people with Fabry disease should watch for these signs, which include a drop in physical activity, lack of energy or enthusiasm, slower movements than normal, and an unwillingness to perform even simple, common tasks. People with depression may also experience back pain, headaches, and problems with digestion. Consult a doctor if you notice any of these signs.

Non-compliance with therapy

Enzyme replacement therapy (ERT) — such as Fabrazyme or Replagal — is the current standard of care for Fabry disease patients. ERT is a lifelong therapy and must be taken at regular intervals.

If you notice the patient is reluctant to comply with the set ERT schedule, bring it to the doctor’s attention immediately.

Signs of moodiness and increased irritability

Heightened or unexplained irritability may be a sign of depression. Frequently getting agitated and having a low tolerance for insignificant issues can lead to reckless behavior, which may be harmful to the patient and to others. Seek medical help as soon as possible if you notice such symptoms.

Appetite changes

Depression can have a profound impact on a person’s appetite. A depressed person may show either an increased or a decreased appetite, both of which can be harmful given that Fabry disease patients already are susceptible to gastrointestinal symptoms. A weight loss or gain of more than 5% of body weight in a month could indicate depression.

Proper dietary interventions are required to manage Fabry disease symptoms, so make sure a patient’s food intake is monitored at all times.

Sleep disorders

Sleep problems can affect mood and contribute to depression. Sleep disorders such as insomnia — a lack of sleep — or hypersomnia, too much sleep — may also be signs of depression. Monitor for changes in the patient’s sleep patterns and inform a doctor as soon as possible if you notice any drastic changes.

Low concentration and low productivity at work

Depression can cause loss of focus and concentration, leading to mistakes and lower productivity at work. If you or someone you know with Fabry disease is frequently experiencing lapses of concentration at work, it could be a warning sign of depression. Alert the organization’s human resources department about the situation as soon as possible, so that necessary accommodations can be made.

If you find yourself dealing with depression at work, look for workarounds such as cutting back on work hours, working different shifts, or working from home. Have a goal-based approach and set boundaries while at work, so that you and others are not inconvenienced.

Excessive dependence on smoking and alcohol

Excess smoking or alcohol abuse could be a sign of depression. Excess alcohol consumption can itself lead to depression and violent behavior, in addition to causing liver and heart problems.

Suicidal tendencies

Severe depression can lead to suicidal tendencies. If a Fabry disease patient is becoming increasingly pessimistic about life and talks about contemplating self-harm, make sure to consult a doctor or a psychologist immediately, or contact the National Suicide Prevention Lifeline.

 

Last updated: Feb. 25, 2020

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