What to Expect Before Treatment

Caring for your friend or family member with hepatitis C may begin as soon as he or she is diagnosed with the disease. All hepatitis C patients react differently to the diagnosis. Some get angry. Some go through a severe depression. Some become victims of extreme stress or anxiety. As a caregiver, you will need to remain positive in the face of these emotions.

Handling Anger

Many people get angry over having hepatitis C, and sometimes they take that anger out on the people around them. Here are some tips for handling anger:

• Accept that your friend's anger is a normal and common response to having a chronic illness like hepatitis C. Your friend may be angry at himself or herself for getting infected, or at the doctor for not having a cure, or at other people's negative attitudes. You need to help your friend focus on controlling angry feelings and expressing them in a useful way.
• Don't tell your friend it's useless to feel angry. This only makes things worse. Accept your friend's anger, be open and sympathetic to his or her feelings, and give your friend the opportunity to vent that anger to you.
• Encourage your friend to talk freely about his or her feelings of anger and frustration without blaming someone else for the way he or she feels. This way, your friend can avoid blowing up at a friend or family member.
• Don't take it personally if your friend acts angry with you. If you get offended when your friend speaks honestly with you, he or she will bottle up feelings of anger.
• Help your friend find an outlet for angry feelings, like new activities or hobbies to distract him.
• Suggest taking a "time out"-walking away from an angry situation, or counting to 10 before acting. This can give your friend time to cool off and relax.
• Recommend becoming spiritually active. Participating in a church, synagogue, temple, or other house of worship and spending time in prayer and meditation can help some people feel more peaceful.

Dealing with Depression

It is common for patients to experience brief mood swings, confusion, anxiety, and sadness during therapy. However, long-term depression is more serious and should be addressed. Signs of clinical depression (a disorder that can be treated) include long-lasting feelings of extreme sadness, crying, major mood swings, loss of interest in things once enjoyed, and trouble concentrating. These feelings may last for more than a couple of weeks, despite a patient's efforts to cheer up. Here are some tips for dealing with depression:

• Make sure that your friend reports feelings of depression, agitation, restlessness, or anxiety immediately to their medical professional. Sometimes, if depression is severe, the patient may not be motivated enough or able to ask for help.
• Be a good listener. Ignoring depression won't make it go away, but sitting down and listening can help your friend get through it.
• Don't gloss over the truth by saying things like, "Don't worry," or "Everything will be all right." This may actually cut off your friend's attempts to open up. Everything is not all right with him or her.
• Talk about their sadness with a statement like, "You never complain, but you look so sad." Saying what you notice rather than what you feel is more supportive and puts less pressure on your friend. Being sensitive also makes it more comfortable for someone to open up to you.
• Let your friend have control. Don't make all the decisions about what he or she can or cannot do-going to dinner, attending a meeting, etc. Wait for your friend to ask for your help with a decision.
• Have a good belly laugh with your friend to relieve tension for both of you. Laughter really can be good medicine.
• Remember to give your friend a hug or gentle touch on the arm whenever you see him or her. Being held sometimes offers more than words can ever express.
• Take a walk with your friend. Light to moderate physical exercise can chase away the blues.

Coping with Stress

Be alert to the following clues for stress:

Physical symptoms

• Tension headaches
• Troubled or changed sleeping and eating patterns
• Rashes
• Shortness of breath
• Biting fingernails
• Grinding teeth
• Clenching jaw

Emotional symptoms

• Nervousness
• Irritability
• Unhappiness
• Impatience
• Difficulty concentrating

Realize that people who want to get rid of stress often use negative or harmful behaviors, such as:

• Drinking alcohol
• Overeating
• Smoking
• Abusing drugs
• Shutting themselves off from other people

Talk to your friend about why he or she feels stressed. Let your friend know that these behaviors may temporarily avoid stress, but don't get rid of it. Also, emphasize the fact that drinking alcohol when a person has hepatitis C very probably will cause further damage to his or her weakened liver.

Recommend these healthy ways to relieve stress:

• Eating healthy, nutritious foods while avoiding drugs and alcohol
• Talking about it with family and friends
• Getting a better sense of control by learning as much as possible about hepatitis C and how to live with it
• Volunteering to help others
• Working more closely with a doctor or nurse to monitor and improve your friend's health
• Learn about stress management/reduction techniques (for example, biofeedback, meditation, hypnosis, and visualization)

Start walking together. Exercise relieves stress by releasing chemicals in the brain called endorphins, which relieve pain and lift your spirits naturally. It's convenient and free-plus regular physical activity increases energy and encourages a healthy appetite.

You might also suggest that your friend see a therapist or counselor. (First check his or her insurance to make sure mental health services are covered.)