Understanding Depression and Suicidal Thoughts in Kidney Disease

Andrew Kowalski, MD, FASN

You Are Not Alone

I am not a trained psychiatrist and what I learned in medical school was minor at best. What I am is a human being with patients that are going through a rollercoaster of emotions and I have seen my share of them struggeling with depression and spiraling into a dark place. I hope this blog can help patients that feel like the world is crashing into them.

Living with CKD or ESRD can be incredibly hard; physically, emotionally, and mentally. You may be dealing with fatigue, dietary restrictions, dialysis sessions, medications, and the constant reminder that life has changed. If you’ve ever felt overwhelmed, hopeless, or like you just can’t keep going, please know this: you are not alone, and your feelings are valid.

It’s not just about the physical illness but about your whole self, your thoughts, emotions, and sense of well-being. Many people with kidney disease experience depression and, sometimes, thoughts of giving up. Talking about these things can be difficult, but it’s also one of the most powerful steps toward healing.

Why These Feelings Happen

It’s common for people with CKD or ESRD to go through emotional ups and downs. For some, these feelings can become deeper, leading to depression or suicidal thoughts. Here are a few reasons why:

The Weight of Living with a Chronic Illness

CKD/ESRD changes your life. You may feel like you’ve lost your freedom, energy, or control. Dialysis can take up your time and energy, and managing your diet and medications can feel exhausting. All of this can affect your mood and mental health.

Feeling Alone or Misunderstood

You might feel like the people around you don’t really understand what you’re going through. Isolation can be tough—especially if you’ve had to give up work, social activities, or even relationships because of your health. We as clinicians hear this often, especially when patients have to apply for disability due to their worsening kidney disease, and unless we have been through it ourselves we truly do not understand the rush of emotions that you have.

Loss of Independence

Needing help with everyday tasks or relying on dialysis can make some people feel like they’ve lost their independence. This can lead to feelings of sadness or even shame—but it’s important to remember that needing help is not weakness. It’s simply part of being human.

Depression Is Common—and Treatable

Depression doesn’t mean you’re “broken” or “weak.” It’s a medical condition that many people with kidney disease face. And just like other medical issues, it can be treated—with the right support, care, and time.

Understanding Suicidal Thoughts

Sometimes, depression can lead to thoughts of not wanting to live or feeling like a burden to others. These thoughts might come and go, or they might feel constant. If you’ve ever thought this way, it doesn’t mean you really want to die, it often means you just want the pain to stop.

It’s okay to talk about these feelings. Reaching out can be scary, but it’s also one of the strongest and most courageous things you can do.

How to Cope and Find Hope

You do not have to go through this alone. There is help available, and many people with CKD/ESRD find ways to live meaningful, joyful lives—even with the challenges. Here are some things that can help:

1. Talk to Someone You Trust

Whether it’s a family member, a friend, a social worker, or a mental health professional—talking about your feelings can be a huge relief. You don’t need to hide your pain or pretend everything is okay.

2. Get Support from Your Care Team

Your kidney care team wants to support all of you, not just your kidneys. Many clinics have social workers, counselors, and patient support groups. Ask your nurse or doctor about what support is available.

3. Take Care of Your Mental Health

It’s okay to ask about therapy or medication if you’re feeling down or hopeless. Many people benefit from seeing a therapist or taking antidepressants (which can be safely managed with kidney disease).

4. Find Meaning in Small Moments

You don’t need to have all the answers right now. Try to focus on things that bring you even a little bit of peace—like listening to music, connecting with others, or spending time in nature. Small joys matter.

5. Join a Support Group

Talking with others who are going through the same thing can be life-changing. You’ll realize you’re not the only one feeling this way, and you might even be able to help someone else.

If You’re Thinking About Suicide

Please don’t wait—reach out for help. Here are some resources available 24/7:

• 988 Suicide & Crisis Lifeline (U.S.): Call or text 988

• National Alliance on Mental Illness (NAMI): 1-800-950-NAMI (6264) or nami.org

• Crisis Text Line: Text HELLO to 741741

Your life matters. Even if it doesn’t feel like it right now, things can get better—and there are people who care and want to help.

You Deserve Support and Healing

If you’re struggling with suicidal thoughts or depression, please know: you are not alone, and this is not your fault. Kidney disease is hard, but you are still here—and that means there’s still hope.

You are more than your illness. You are a whole person with a story, strength, and the ability to find light again, even in dark times.