How addressing mental health helps improve Hep C treatment

Chronic hepatitis C is sometimes called an “invisible illness” because it typically causes no symptoms. For most people infected with the hepatitis C virus, an infection will slowly but persistently damage the liver over many years. Symptoms only begin when the damage from the long-term viral infection has caused liver damage, scarring of the liver (called cirrhosis), or liver cancer.

Chronic hepatitis C can also be called an invisible illness for the other unseen symptoms it can cause—those that affect a person’s mental and emotional health.

Hep C and mental health

Mental health disorders like anxiety, depression, post-traumatic stress disorder (PTSD), and substance use disorders are more prevalent among people who have hep C. This means that people who have hep C are more likely to have these disorders than people who do not have hep C. There are multiple factors behind this association:

• Hep C infections as well as other blood-borne infections are more prevalent among people who have a serious mental illness. This higher prevalence is likely driven by the fact that people who have a serious mental illness are more likely to experience poverty, substance use, and other major risk factors for hep C.
• Learning that you have a hep C infection can also be a highly emotional, upsetting experience—one that can exacerbate existing mental health problems or trigger the onset of mental health problems.
• People who have hep C often report that they experience stigma, shame, embarrassment, and judgement because of their diagnosis—experiences that can result in low self-esteem, negative thoughts and moods, and an overall lower quality of life.
• There is also research that suggests depression may be the result of the inflammation that occurs within the body when a person has a chronic hep C infection. While the mechanisms behind this are complex—and more research is needed—the basic idea is that the inflammation caused by a long-term hep C infection interferes with the functioning of the central nervous system, affecting how a person thinks and feels.

A person’s mental health can also affect how well they follow a treatment plan for hep C—and consequently, how they respond to treatment.

Most cases of hep C can be cured

The vast majority of hepatitis C infections can be cured with treatment. Medications called direct acting antivirals (DAAs) can rid the body of a hep C infection in a matter of months when taken correctly. There are multiple DAA medications available, and a healthcare provider will be able to choose the best drug for a particular person, based on the genotype of the virus and other factors.

Addressing any problems or concerns about mental health should also be a focus of treatment. Depression, anxiety, substance use, and other mental health problems can make it more difficult for a person to follow their treatment plan.

In order to give a person the best chance of being cured of hep C, medications must be taken exactly as prescribed. Missing doses of a medication or stopping treatment can cause the virus to become resistant to that medication. This means that a person may need to begin treatment again using different DAA drugs.

If you are being treated for hepatitis C, talk to your healthcare provider about your mental health—your moods, thoughts, behaviors, anything that you’re having a difficult time with, anything that you want to change about yourself.

Your healthcare provider can help you come up with a plan to address what you are experiencing. Strategies like counseling, working with a therapist, or connecting with others who have hep C in a support group can be very helpful.