Living with diabetes, high blood pressure, sickle cell, HIV or long-term pain is hard work, every single day. Low mood often comes along with it. Here’s how to tell when it has become depression, and what helps.
Depression is common in people living with long-term illnesses such as diabetes, hypertension, sickle cell, HIV and chronic pain. It isn’t weakness, and it isn’t just part of being ill. It can make the illness harder to manage, and it can be treated alongside it.
Why the two go together
Long-term illness brings pain, tiredness, treatment routines, costs and uncertainty. It can take away work, roles and plans. Some illnesses, and some medicines, can also affect mood directly.
In WHO surveys across 60 countries, between about one in ten and one in four people with a long-term condition such as diabetes, asthma or arthritis had depression in the past year. People with both had worse health than people with either on its own.
In Nigeria, studies at hospital clinics have found depression in between about one in eight and one in two people with diabetes or high blood pressure, depending on the clinic and how it was measured. A large household survey across 21 states found depression often came with chronic pain, and only about one in six people with recent depression had received any treatment.
Is it depression, or understandable sadness?
Grief, worry and frustration after a diagnosis are normal. Depression is when low mood or loss of interest sticks around and starts to take over. UK guidance suggests two simple questions:
- Over the past month, have you often felt down, depressed or hopeless?
- Over the past month, have you often had little interest or pleasure in doing things?
If you answer yes to either, talk to your doctor or a therapist. Tiredness, poor sleep and appetite changes can come from the illness itself, so a professional can help untangle what’s what.
Why it matters for your physical health
Depression makes the daily work of an illness harder. In studies, people with depression were about three times as likely not to follow their treatment: missed medicines, missed appointments, less self-care. In low- and middle-income countries, depression goes with poorer blood-sugar control in diabetes.
These are links, not proof that depression causes the harm. But in trials in the US and India, joined-up care for depression alongside diabetes or heart disease improved both mood and physical measures such as blood sugar and blood pressure.
The extra weight in Nigeria
- Cost. About seven in every ten naira spent on health in Nigeria comes straight from households. Long-term medicines, tests and transport add up, and money worries feed low mood.
- Insurance. About 21.7 million people were enrolled with NHIA at the end of 2025. WHO’s 2020 profile of Nigeria recorded that depression care wasn’t included in national health insurance, so most people pay for mental health care themselves.
- Roles and stigma. Losing work, relying on family, or hiding a condition such as HIV or sickle cell can bring shame and isolation.
- Faith. Many people ask, “Why me?” Faith can be a real source of strength, and it can sit alongside treatment.
What helps
- Tell the doctor treating your illness how your mood has been. Ask whether the illness or any medicine could be playing a part.
- Talking therapy. Cognitive behavioural therapy (CBT) and other talking therapies help with depression alongside physical illness. UK guidance notes therapy can be done by phone when getting out is hard, and online therapy works the same way.
- Group activity and peer support. For milder depression, structured group exercise and peer support groups are recommended first steps. Many hospitals and charities run groups for specific conditions.
- Medicines, if needed. For moderate or severe depression, a doctor may suggest an antidepressant, chosen to fit with your other medicines. Tell them about any herbal remedies too, because some interact with medicines.
- Carers need support too. Read our guides to caregiver burnout and when your partner is depressed and you’re tired.
You can find a therapist who works with depression, by video, voice or chat, and our guide to affordable therapy in Nigeria covers lower-cost options. Read more about depression and high-functioning depression.
Suggested read: Binge Eating Disorder: Signs and Help
If you’re having thoughts of ending your life, call Safe Place Nigeria on 0800 800 2000, free and open 24 hours. If you’re in immediate danger, call 112, or 767 in Lagos.
Frequently asked questions
Is depression common in people with chronic illness?
Yes. In WHO surveys, between about one in ten and one in four people with a long-term condition had depression in the past year, and Nigerian clinic studies have found similar or higher rates.
How can I tell depression from normal worry about my illness?
If you’ve often felt down or hopeless, or lost interest in things you usually enjoy, over the past month, talk to a doctor or therapist. They can separate depression from the effects of the illness itself.
Can depression make my illness worse?
Depression is linked with finding it harder to take medicines, keep appointments and look after yourself, and with poorer blood-sugar control in diabetes. Treating it can help both.
Can I take an antidepressant with my other medicines?
Often, yes, but the choice needs a doctor. They’ll pick one that fits with what you already take. Tell them about every medicine and herbal remedy.
Does health insurance cover therapy in Nigeria?
Often not. WHO’s 2020 profile of Nigeria recorded that depression care wasn’t included in national health insurance. Some HMO plans include it, so check yours.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
