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Depression and Macular Degeneration

Macular degeneration, especially age-related macular degeneration (AMD), is a common cause of vision loss in those over the age of 50 years old. Depending on your type of macular degeneration, as well as the stage of the disease, your vision loss can vary. It is a progressive condition, although treatments exist that can help slow disease progression and preserve your existing vision.

Increasing risk of depression

Despite advances in treatment, as well as the variety of adaptive equipment, therapies, and services, the reality is that eventually, many individuals with macular degeneration often find themselves with some sort of visual functional disability, increasing their risk of depression.1

Emotional and physical health

Depression is a serious illness that can significantly impact one’s quality of life, and it’s important to get treatment for it, just as one would for macular degeneration or any other medical condition. Emotional and physical health are both important for overall well-being.

Vision loss and depression

Both depression and anxiety are common in older adults, but even more so in those with vision impairment; the prevalence is approximately twice that of those with no vision problems.1

Macular degeneration-related depression

Patients with AMD are more likely to have depression compared to those with other eye disorders, especially when treatment isn’t going as planned.1 Individuals with Stargardt disease have been found to have increased levels of depression, with the depression increasing as functional vision decreases.2 Loss of visual functioning for any reason, including macular degeneration, has shown to have negative effects on psychosocial well-being.3

Prevalence of depression

The prevalence of depression is thought to occur for several reasons, including decreased functional status or loss of independence, social isolation and less interpersonal engagement, the progressive nature of macular degeneration, and the sense of helplessness one might feel regarding control over the disease.1

Signs and symptoms of depression

Depression isn’t always merely just feeling sad or out of sorts. There are a variety of symptoms, including4:

  • Persistent sad or empty feeling
  • Feelings of hopelessness or guilt
  • Decreased energy
  • Increased fatigue
  • Feeling restless
  • Trouble concentrating
  • Talking or moving slowly
  • Changes in appetite or sleeping habits
  • Unexplained body pains, aches, or digestive problems

If you’ve experienced symptoms for most of the day, almost every day for two weeks, then these could be signs of depression. Talk with your eye doctor or general practitioner about how you’re feeling. Depression is treatable, and you don’t have to feel this way forever.

Treatment for macular degeneration-related depression

Depression is often treated with medication and/or talk therapy, and while these might be helpful for individuals with macular degeneration, other treatment possibilities exist as well. Behavioral interventions were found to be effective in reducing depression in patients with AMD.1 This is especially important to remember because in people with macular degeneration, depression isn’t necessarily idiopathic (or without cause). It can be seen as a consequential reaction to a serious medical diagnosis.5

Behavioral interventions

Behavioral interventions can consist of occupational therapy and the use of low-vision adaptive devices. Providing individuals with the adaptive devices and skills that can help them maintain their independence may help reduce feelings of depression; developing problem-solving skills and the ability to adapt to changing vision are important stepping stones toward maintaining a healthy emotional state.

What can you do?

Talk with your eye doctor about your condition and the course of your disease, and what you can expect as time goes on. Ask him/her about adaptive devices and therapies that might be helpful for you. He/she can provide you with information about where to get low-vision aids and refer you to occupational therapists who specialize in low-vision clients. You might also think about joining a support group for macular degeneration, either online or in-person (or both!). Social support is important and can reduce a sense of isolation while providing practical assistance and information.

Jaime R. Herndon | December 2018
  1. Cimarolli VR, Casten RJ, Rovner BW, Heyl V, Sorensen S and Horowitz A. Anxiety and depression in patients with advanced macular degeneration: Current perspectives. Clin Ophthalmol. 2016; 10: 55-63. Doi: 10.2147/OPTH.S80489. Accessed November 13, 2018.
  2. Moschos MM, Nitoda E, Lavaris A. Estimation of depression prevalence in patients with Stargardt disease using PHQ-9 and Zung scores. Eur J Ophthalmol. 2016; 26(3). Doi: 10.5301/ejo.5000700. Accessed February 5, 2019.
  3. Nyman SR, Gosney MA, Victor CR. Psychosocial impact of visual impairment in working-age adults. British Journal of Ophthalmology. 2010; 94(11). Doi: http://dx.doi.org/10.1136/bjo.2009.164814. Accessed February 5, 2019.
  4. National Institutes of Health: National Institute of Mental Health. Depression. 2018. https://www.nimh.nih.gov/health/topics/depression/index.shtml#part_145397. Accessed November 13, 2018.
  5. Wyse A. Depression in age-related macular degeneration. American Macular Degeneration website. n.d. https://www.macular.org/depression-amd-arnold-wyse-md. Accessed November 13, 2018.