What is the relationship between anemia and depression?

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According to a 2016 study that examined the association between anemia and depression among healthy middle-aged adults, people with depression are more likely to have anemia than people without depression.

A 2018 cross-sectional study of 1,616 older adults suggests that anemia can cause the onset of depressive symptoms. In addition, people with depressive symptoms may have a higher prevalence of anemia than people without depression.

According to the National Library of Medicine, people with anemia may have some depressive symptoms, including tiredness, weakness, and a lack of energy.

A 2022 study published in the Journal of Affective Disorders indicates that people with anemia may develop depression as a result of:

• low oxygen levels in body tissues
• lack of physical activity
• impaired monoamine synthesis

According to a study published in Neuropsychiatric Disease and Treatment, anemia can affect a person’s mental health, causing psychiatric symptoms such as depression and cognitive function disorders.

Additionally, if a person has a preexisting mental health condition and has not received treatment for it, anemia can worsen that condition.

Anemia and depression may have similar symptoms, but they are separate conditions.

Symptoms of anemia

According to the National Institutes of Health (NIH), symptoms of anemia may progress slowly or quickly depending on the cause. Different types of anemia have similar symptoms, such as:

• weakness
• tiredness
• paleness
• bleeding
• chills
• headache
• shortness of breath
• dizziness
• fainting
• jaundice

Symptoms of depression

A person with depression may show the following symptoms:

• tiredness
• low mood
• changes in appetite
• loss of interest in activities
• weight loss or gain
• difficulty thinking
• lack of concentration
• inability to make decisions
• suicidal thoughts

Anemia has several types, each of which has distinct symptoms and an underlying cause. Common types of anemia include:

• aplastic anemia
• iron deficiency anemia
• hemolytic anemia
• vitamin B12 deficiency anemia

Iron deficiency anemia and depression

Iron deficiency anemia is the most common form of anemia.

It is due to insufficient iron in the body. The body needs an adequate amount of iron to produce hemoglobin, the oxygen-carrying component in red blood cells (RBCs).

According to a 2020 study, iron deficiency anemia can increase a person’s risk of depression. Iron deficiency can cause low levels of serotonin, an important neurotransmitter and mood stabilizer.

Pernicious anemia and depression

Pernicious anemia is an autoimmune condition in which the body cannot absorb enough vitamin B12, or cobalamin. This may be due to a lack of intrinsic factor, a glycoprotein that the body needs to absorb vitamin B12.

A survey by the Pernicious Anaemia Society found that 86% of the 1,300 participants experienced emotional symptoms, including impatience, irritability, mood changes, and thoughts of suicide.

Research from 2015 suggests that pernicious anemia can cause neurological effects such as depression, mania, and psychosis.

The main causes of anemia are:

• Blood loss: Excessive blood loss can lead to anemia if the loss of RBCs is greater than the production of new RBCs. This also reduces the iron necessary to produce new RBCs. Any condition that causes a person to lose a lot of blood — including bleeding from the menstrual cycle, a serious injury, or surgery — can increase their likelihood of iron deficiency anemia.
• Age: Older adults may have a greater chance of anemia than people in other age groups. This may be due to age-related chronic conditions or iron deficiency that depletes RBCs.
• Family history: A person can inherit anemia if their parents carry the trait in their genes.
• Other health conditions: Conditions such as cancer, autoimmune diseases, and infections can cause the body to produce fewer RBCs than a person needs.

Health experts do not know the exact cause of depression. However, they have identified certain risk factors that can increase a person’s risk of the condition, including:

• stress
• drug or alcohol use
• a family history of depression
• life changing events such as divorce, financial problems, relocation, work issues, and grief
• use of certain prescription drugs such as interferon, beta-blockers, and corticosteroids

This section looks at how doctors can diagnose anemia and depression.

Diagnosing anemia

To diagnose anemia, a doctor will ask questions about specific risk factors. They may also order the following tests to rule out some underlying causes:

• RBC count, which measures the number of RBCs in the body
• hemoglobin count, which measures the amount of hemoglobin in the blood
• hematocrit level, which measures the space between RBCs in the blood
• mean corpuscular volume count, which measures the average size of RBCs in the body

Diagnosing depression

There are no specific diagnostic tests for depression.

However, a doctor can ask a person to complete a questionnaire to measure the severity of a person’s depression.

They may use the Hamilton Depression Rating Scale, which consists of either 17 or 21 questions to measure the severity of depression.

The Beck Depression Inventory can also help mental health professionals assess a person’s symptoms.

People can manage both anemia and depression in a few ways.

Diet

If a person has anemia and depression, a doctor will recommend a healthy, balanced, iron-rich diet that includes nuts, seeds, seafood, and dark leafy greens to replenish the body’s iron.

They will also advise that a person consume vitamin C-rich foods and avoid foods that can block iron absorption.

Exercise

A doctor may recommend some light exercises to improve blood circulation and prevent fatigue.

According to the United Kingdom’s National Health Service (NHS), 150 minutes of moderate-intensity exercise per week can improve a person’s mood and increase their energy levels.

Iron supplements

A 2020 study found that taking iron supplements as a doctor recommends can reduce the risk of psychiatric disorders in people with anemia.

People taking iron supplements should stick to the dose their doctor recommends because taking too much can lead to iron poisoning.

Improving sleep

A small 2015 study suggests that iron deficiency anemia can affect a person’s sleep quality. Experts associate poor sleep quality with depression.

A doctor may recommend sleep hygiene practices to improve sleep quality, such as:

• reducing exposure to natural light
• limiting TV and phone use before bedtime
• avoiding caffeine before bedtime

Therapy

Psychotherapy or talk therapy can help people identify factors that may be causing depression.

It can also help them learn the skills to deal with depression effectively. A person can try various approaches to psychotherapy, including cognitive behavioral therapy, interpersonal therapy, and psychodynamic therapy.

The outlook for a person with depression and anemia depends on the individual.

Sometimes, people may manage anemia and depression through dietary habits alone. However, some types of anemia and depression can be life threatening and may require more in-depth treatment protocols.

A person may have a good outlook with early diagnosis and treatment.

According to a 2021 review, people can prevent some forms of anemia. A person can avoid iron deficiency anemia by maintaining a balanced diet and taking iron supplements if a doctor recommends doing so.

While a person may not be able to avoid anemia due to blood loss, urgent medical attention can improve the outcome.

Anemia occurs when a person does not have enough RBCs circulating in their body.

Research suggests that people with anemia may have a high risk of depression. This may be due to low oxygen and a lack of physical activity as a result of anemia.

If a person experiences symptoms of anemia, depression, or both, they should contact a doctor immediately.