How age-related macular degeneration can impact mental health

Age-related macular degeneration (AMD) is an eye disease that causes damage to the macula, which is part of the eye’s retina. It is the leading cause of vision loss among older adults.

AMD causes central vision loss—the center of the vision becomes blurred, making it harder to see faces, read, drive, or do other routine tasks like cooking. These are challenging symptoms to live with, and they often lead to less independence and a lower quality of life.

In addition to the physical and practical challenges of living with vision loss, there are also the ways that vision loss impacts mental and emotional health.

Depression, anxiety, and AMD

If you’ve found yourself struggling with your emotions because of AMD, you are not alone.

A study in the Journal of Visual Impairment and Blindness found that rates of depression are substantially higher in people with AMD compared to the general population of older adults.

The study cited several factors that can result from visual impairment—including social isolation, feeling a lack of control over one's life, and restricting one’s movements, such as walking less for fear of tripping and falling.

Another study in the journal Clinical Ophthalmology found that the prevalence of both depression and anxiety are high in people with AMD, particularly when AMD is in the advanced stages.

Researchers suggested that older adults who are visually impaired might develop anxiety disorders related to specific places or social situations that are made difficult by having AMD, such as being on a bus or eating at a restaurant.

Signs your mental health may be impacted

Dramatic symptoms like thinking of suicide or having panic attacks may be clear indications that you're struggling emotionally, but many signs of depression or anxiety are not as obvious—in fact, they are sometimes mistakenly attributed to aging, even though they are not.

Here are some signs of depression and anxiety to watch out for:

• Your habits are changing. If you're sleeping or eating a lot more than usual—or a lot less—this can be a sign of depression. Drinking more alcohol than usual, or not caring how your health choices impact you, are signs as well.
• Your mood is all over the place. Going from happy to very sad, or getting easily impatient and irritated, can be signs of depression or anxiety.
• You routinely seek isolation. Living with AMD can be isolating, but if you're opting to stay away from others because it takes too much energy or you're too down or nervous to do so, these can be signs of depression or anxiety.
• You're chronically worried. It's understandable to worry how AMD will continue to impact you, but if you're feeling paralyzed with concern, can't make decisions, or are fearful all the time, these can be signs of an anxiety disorder.
• You feel helpless, hopeless, or fatigued. If you feel there's nothing to be done to improve your life, if life feels meaningless, or if you're constantly fatigued, these can all be due to depression.

Of course, some of these symptoms can also be due to other health conditions. For example, fatigue can be caused by heart disease, chronic pain, or sleep apnea (to name a few). Working with a healthcare provider to identify what’s causing a particular symptom is crucial.

Managing mental health and AMD

If you think you’re struggling with depression or anxiety—or even if you’re not sure, but you suspect you might—make an appointment with your healthcare provider. Depression and anxiety are highly treatable in many cases.

Your primary care provider can be a good person to talk to. A primary care provider can screen you for other medical conditions and refer you to a therapist or other specialist if needed. If you don’t have a primary care provider, you can also talk to your eye doctor, who may be able to recommend one.

It's also important to keep your eye doctor informed about your moods and emotions, and how you feel about having AMD and treating AMD. They can monitor AMD and make sure you are on the latest and best treatment possible. They can also refer you to support groups, occupational therapy, and low-vision adaptive devices that can help you maintain your independence and quality of life.