Learning that you have kidney failure can come as a shock, even if you have known for a long time that your kidneys were not working well. But starting dialysis does not have to mean ending the things you enjoy. It may take some time to adjust to your new routine, but you are not alone. Your doctors, nurses and social workers are there to help you.

Depression and anxiety

Depression is a feeling of sadness that lasts for an extended period of time. Anxiety is a feeling of nervousness that may come and go. You may feel sad or nervous without knowing why.

It is normal to feel sad or nervous when you are going through big changes in your life, especially when those changes affect your health and well-being. When you start dialysis, you may have to change your daily routine, your diet and the types of activities you do. You may have many different feelings as you adjust to this new lifestyle, such as sadness, fear, regret and anger. You may not understand what you are feeling right away, but you might notice that you don’t feel like yourself.

Some symptoms of depression include:

• Changes in your sleep patterns (sleeping too much or having trouble sleeping)
• Loss of interest in activities that you used to enjoy
• Loss of appetite

Some symptoms of anxiety include:

• Faster heartbeat
• Sweating
• Breathing too quickly
• Trouble thinking about anything except what you are worried about

It is important to know that you are not alone. Many people have gone through what you are going through. Many people have felt the way you feel. It is also important to know that you do not have to live with these feelings. Help is available. Talk to your social worker about ways to start feeling better. You might also find that support groups are helpful. Your social worker can help you find support groups in your area.

If you think you need more help, talk to your doctor. He or she can help you meet with a type of doctor who takes care of people with depression and anxiety. The doctor might recommend talk therapy, medicine or a combination of these treatments.

Exercise

Exercise is a great way to improve your health. Most people can and should exercise, even if they are on dialysis.

People who exercise regularly usually feel better both physically and emotionally. Some of the benefits of exercise include: feeling happier; better heart and lung health; weight loss; less joint pain; and more flexibility.

Exercise does not have to be hard or painful. In fact, if it hurts to do a certain exercise, you should not do it! There are many ways to exercise without having pain or discomfort. Consider doing some low-impact exercises. These are types of exercise that do not put a lot of stress on your joints. Some examples of low-impact exercise include:

• Walking
• Swimming
• Bike riding
• Yoga
• Pilates
• Tai chi
• Stretching
• Using an elliptical
• Climbing stairs

You do not need to belong to a gym or buy expensive equipment to exercise. You can take walks around your neighborhood or through the shopping mall. Or you can do yoga at home on your living room floor. Your doctor can help you make an exercise plan that is safe for you and fits with your dialysis schedule.

Important! Talk to your doctor before you start any exercise routine.

Working

Continuing to work may still be possible when you are on dialysis. Working may help you feel happier and more fulfilled. If you have health insurance through your job, continuing your work may allow you to keep your insurance. If you want or need to keep working while you are on dialysis, talk to your doctor about your treatment options. Some types of dialysis allow you to have a more flexible schedule during the day. For example, if you choose nocturnal (nighttime) in-center or home hemodialysis, you can do your dialysis treatments at night, while you sleep. This is also an option with continuous cycler-assisted peritoneal dialysis (CCPD).

If you do keep working while you are on dialysis, it is important to understand your limits. You may feel tired or weak during the day. If you are on peritoneal dialysis and you do your own exchanges, you will need to have a clean place at work to do your exchanges. If you are on hemodialysis, you should not lift heavy things or put pressure on your vascular access arm. Talk to your doctor and social worker about the type of job you have to plan a treatment schedule that will work for you. Your social worker can also help you work with your employer to meet your treatment needs.