🤺We Dialyse at Dawn : CKD and Dialysis

By TinaMarie Cerreta


CKD and Dialysis: Looking Deeper


Living with chronic kidney disease (CKD) and dialysis creates an intense emotional toll that goes far beyond managing a physical illness. It forces patients to deal with continuous stress, a lack of control over their schedules, and major changes to how they view their bodies. [1, 2, 3]
MDD=Major Depressive Disorder
**Here is a breakdown of exactly what this means and how it affects everyday life:
The Emotional Weight:
  • A Life Ruled by Schedules: Dialysis is a massive time commitment, often requiring patients to spend hours hooked to a machine multiple times a week. It dictates when they can travel, work, or sleep, leading to a profound feeling of burnout and a loss of personal freedom. [1, 2, 3]
  • Depression and Anxiety: The constant cycle of treatments and the uncertainty of a chronic illness put patients at a very high risk for clinical depression and severe anxiety. Its incredibly common to have cycles of grief, anger, and feelings of helplessness. [1, 2, 3, 4]
Body Image & Dysmorphia
Permanent Surgical Marks: Dialysis requires medical access points—such as a fistula (a fused vein and artery) in the arm, or a catheter in the chest. The surgeries needed to create these leave noticeable, permanent scars. [1, 2, 3, 4, 5]
Visible Swelling: Over time, blood flow changes cause a fistula to enlarge, creating visible, bumpy bulges. Repeated needle sticks can also leave bruises and marks. [1, 2, 3]
Body Dysmorphia: Because the body has been permanently altered in a highly visible way, many patients experience body dysmorphia. They may feel intense self-consciousness, shame, or disgust, often going to great lengths to hide their access areas in public or around strangers. [1, 2, 3]
How Patients Cope:
Reframing the Narrative: Many patients work through body image issues by shifting their perspective, referring to their fistulas as "battle scars" or "lifelines" that are keeping them alive. [1, 2]
Professional Support: Managing this emotional and physical stress is just as important as medical treatment. Most dialysis clinics have dedicated social workers who specialize in helping patients process these feelings. [1, 2, 3]
Patient Communities: Many patients also find relief by joining support groups, where they can talk openly with others who truly understand what it feels like to live with these visible changes and treatment schedules. [1, 2]
**If you or a loved one is experiencing severe emotional distress or depression, support is always available. You can contact their care team social worker, reach out to the American Kidney Fund, or connect with the SAMHSA National Helpline for free, confidential mental health resources. [1, 2, 3, 4]

Reputable Resources:
Managing mental health and body image concerns while navigating dialysis and body dysmorphia requires specialized support. Start by utilizing the Psychology Today Therapy Directory to filter for licensed, vetted professionals. [1, 2]
Print & Audio Resources
  • Print Books: The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder by Dr. Katharine A. Phillips is considered the definitive guide on BDD. For a holistic guide to managing obsessive thoughts, look for Body Image Problems and Body Dysmorphic Disorder by Chloe Catchpole.
  • Audio Books: Both of these titles are available to stream or download on platforms like Audible.
  • Podcasts: To hear shared experiences and professional advice on the go, tune into the Body Dysmorphia Recovery podcast on Spotify. [1, 2, 3]
Dialysis & Medical Coping Resources
  • Social Workers: Dialysis units are mandated to have specialized social workers on staff. Discuss your feelings with them so they can connect you to care tailored for chronic kidney disease. [1, 2]
  • Peer Support: The National Kidney Foundation offers the NKF Peers program, connecting you with trained mentors who understand the reality of dialysis. You can contact them by calling 1-855-653-7337 or emailing nkfpeers@kidney.org. [1, 2, 3]
Therapist Finders & Virtual Mental Health
  • National Alliance on Mental Illness (NAMI): Offers free nationwide peer support services and resource referrals. You can find local support groups and directories through the NAMI Helpline. [1, 2]
  • International OCD Foundation: Because body dysmorphia is closely related to OCD, you can use the IOCDF Treatment Finder to find mental health specialists equipped with Cognitive Behavioral Therapy (CBT) experience. [1, 2, 3, 4] 


  • I have an opinion, wanna hear it?
  • I usually have a lot to say about almost everything! This is no different. I started out with mental illness and decades of all kinds of therapy. I've learned DBT, CBT, ACT, and a bunch of other acronyms I can't think of right now.
  • I really believe that a great therapist, psychologist, psychiatrist, or counselor (or even a life coach, clergy, family member, or spouse) is super valuable. When you find a good one, you hold on tight and enjoy the journey!
  • I have to admit, I'm a little self-conscious (but most of the time I forget about them) about my scars and the bulging from the stenosis in my fistula. It's from dialysis, and I can't change it. It's just what happens when you get your blood cleaned... It's unavoidable.
  • But I can get a good amount of the plaque buildup out every couple of months or so with an angioplasty that cleans out as much of the stenosis as possible. My doctor is a vascular access surgeon, and she's amazing! She even gives you a turkey sandwich and juice when you're done! She's famous for both her (some might say miraculous) work and her sandwiches.
Alright, I'm done rambling. Hope your day's almost over and you're heading home soon. Have a great weekend, and I hope we chat again!
Tina
This quote, to be honest, is for me today:
"This disease has forced me to talk with people about my challenges... I've adopted the mindset that kidney disease doesn't have to stop everything. It's one more thing we integrate into life." — Manusca Benony

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