How Depression Can Change People's Vision

14 sources cited
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Can Depression Affect Your Vision?

According to eye experts, depression can affect your vision.1 

When you’re depressed, your body produces high levels of cortisol and adrenaline, potentially causing an increase in eye pressure. This can lead to visual distortions and diseases such as glaucoma and optic neuropathy. In severe cases, vision loss (blindness) may result.

Other visual effects of depression include:

People with severe depression may experience chronic eye strain accompanied by headaches.

What is Contrast Sensitivity?

Contrast sensitivity (CS) is the ability to identify and distinguish objects without a clear outline from their background contrast. The National Institute of Biotechnology Information (NCBI) also describes contrast sensitivity as the “degree of blackness to the whiteness of a particular object.”2

Someone with sensitivity to high spatial frequencies may recognize sharp edges, color, and facial features. Those with sensitivity only to low spatial frequencies can only make up the overall shape rather than the detailed features of an object.

Typical situations requiring contrast sensitivity are:

  • Night driving
  • Reading a newspaper
  • Locating objects on a similarly colored background.

 Factors influencing CS include:

Low contrast sensitivity may indicate optic nerve issues, such as optic neuropathy (optic nerve damage).

How Depression Affects Contrast Sensitivity

Studies show a disconnection between the central and visual nervous systems in depressed people.5 Visual perception is affected if visual information is not relayed well from the brain to the eyes. In this case, your brain may have difficulty interpreting and recognizing what you are seeing.

Other studies indicate that depressed people often lack retinal contrast sensitivity.6 The retina is the light-sensitive part inside the eye that sends signals to the brain for interpretation.

Can Depression Cause Vision Loss?

Severe depression can cause vision loss (blindness). The risk is higher among people with sight-threatening conditions, such as optic neuritis, alongside depression.

A serious eye condition caused by depression is central serous chorioretinopathy (CSCR). It’s characterized by fluid accumulation under the retina.7 The retina is the light-sensitive part of the eye that receives light signals and sends them to the brain for interpretation. 

CSCR damages the retinal pigment epithelium (RPE), a layer involved in the renewal of visual cells. This can lead to blindness.

Do Antidepressants Impact Vision?

Some antidepressants, such as selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), have visual effects. Common side effects include:

  • Blurry vision
  • Floaters
  • Night blindness
  • Photophobia (light sensitivity)
  • Double vision
  • Dry eyes (citalopram, fluvoxamine, fluoxetine, etc.)
  • Tunnel vision
  • Visual snow syndrome (VS) 

Atypical antidepressants such as bupropion (Wellbutrin), mirtazapine (Remeron), and trazodone (Desyrel) can cause dizziness and blurry vision.8 The conditions may worsen in people with pre-existing eye conditions such as glaucoma and dry eyes.  

Alternatives to Antidepressants

To avoid the shortcomings of antidepressants, you can explore the following alternatives:

Cognitive Behavioural Therapy

Cognitive behavioral therapy (CBT) is a talk therapy aimed at changing how you think, feel, and behave. It’s supervised by a mental health counselor (psychotherapist). 

Some therapists combine CBT with other therapies to enhance outcomes.9 However, CBT alone is an excellent option for managing depression. You can choose between in-person or online sessions.

Interpersonal Therapy (IPT)

Interpersonal therapy (IPT) helps you build good relationships with others when your relationships might be broken due to depression (such as when coping with grief). IPT programs are often structured like cognitive behavioral therapy (CBT).

According to research, IPT is as effective as antidepressants and CBT, although more studies are needed.10

Exercise

Good exercise boosts serotonin and dopamine levels in the brain. Both neurotransmitters help elevate mood. Serotonin is associated with happiness, focus, and calmness, whereas dopamine is linked to motivation, productivity, and reward.

Exercise also boosts self-esteem and confidence, which can relieve depression. According to research, regular exercise is as effective as antidepressants.11

Support Groups

Talking about your feelings with a friend or relative can significantly help reduce depression symptoms. There are online chat rooms and groups that offer support to members. Your doctor can also recommend a support group for you.

Supplements

Although most are not FDA-approved, some herbal and dietary supplements are promoted as potential alternatives for relieving depression. However, they should not be a replacement for medical diagnosis and treatment. Common supplements for depression include:

  • St. John’s wort. For mild to moderate depression.
  • Saffron. Believed to improve depression symptoms.
  • Dehydroepiandrosterone (DHEA). Limited studies show DHEA improves depression symptoms.
  • Omega-3 fatty acids. Currently being studied as a potential treatment for mood disorders.12

How to Care for Your Vision and Mental Health

Do the following to keep your vision and brain healthy:

  • Physical activity/regular exercise to boost your mood and reduce stress.
  • Eat a healthy diet to improve mood and prevent diseases like diabetic retinopathy that can cause vision loss.
  • Talk to your doctor about your family history if mental disorders run in your family.
  • Avoid smoking; it’s known to worsen mental health disorders.
  • Manage chronic health conditions. Conditions such as cancer and heart disease can increase the chances of depression.13
  • Use enhanced lighting and adjust contrast settings on your digital devices around the house to prevent eye strain.
  • Wear protective glasses when outdoors to prevent blue light or ultraviolet (UV) damage.
  • Manage existing eye conditions such as myopia or age-related macular degeneration because poor vision can negatively impact your mental health.

Treatment Options

Fortunately, most visual symptoms of depression are mild and often go away with these treatment options. However, some cases are severe and may need professional intervention.

  • Persistent vision issues. If you experience frequent dry eyes, eye strain, and headaches even after your stress is gone, there may be an underlying problem requiring examination.
  • Blindness (vision loss). Temporary or permanent blindness should always be treated as an emergency. The sooner you seek help, the higher the chances of saving your sight.

Lithium treatment

Lithium is a known mood stabilizer. It’s prescribed for disorders such as bipolar disorder, mania, and depression. It also helps prevent harmful or aggressive behavior. 

Before prescribing lithium, doctors will administer a blood test to ensure a healthy kidney and thyroid. Lithium is known to affect these organs negatively. 

Shock Therapy

Electroconvulsive therapy (ECT) is a common option when all other treatments have failed. It involves the application of an electric current to the brain through electrodes in weekly sessions for about 3 to 6 weeks.

The working mechanism of ECT is not known, but scientists believe it impacts an area of the brain linked to depression.14 Short-term side effects of ECT include memory problems, headaches, nausea, and muscle aches.

Discuss with your doctor before going for any of these options to ensure successful outcomes.

Summary

  • Depression can affect your vision through visual distortions and the development of visual system diseases.
  • People with severe depression may experience regular eye strain accompanied by headaches, contrast sensitivity, blurred vision, or even blindness.
  • Depression medications such as SSRIs and SNRIs also have visual effects. 
  • Better antidepressant alternatives include cognitive behavioral therapy (CBT), interpersonal therapy, exercise, and support groups.
  • Your doctor can examine your mental and vision health to determine the best therapies for your case.
14 Cited Research Articles
  1. Sabel, Young, et al., “Mental stress as consequence and cause of vision loss: the dawn of psychosomatic ophthalmology for preventive and personalized medicine,” National Center for Biotechnology Information (NCBI), 2018. 
  2. National Library of Medicine. “Contrast Sensitivity,” www.ncbi.nlm.nih.gov, 2022.
  3. Oshika, Tokunaga, et al., “Influence of pupil diameter on the relation between ocular higher-order aberration and contrast sensitivity after laser in situ keratomileusis,” Investigative Ophthalmology & Visual Science, 2006.
  4. National Eye Institute. “Diabetic Retinopathy,” www.nei.nih.gov, 2022.
  5. Bubl, Van-Elst, et al., “Vision in depressive disorder,” The World Journal of Biological Psychiatry, 2009. 
  6. Salmela, Socada, et al., “Reduced visual contrast suppression during major depressive episodes,” Journal of Psychiatry & Neuroscience (JPN), 2021.
  7. American Academy of Ophthalmology (AAO). “Central Serous Chorioretinopathy,” eyewiki.aao.org, 2022.
  8. Mental Health America (MHA). “Atypical Antidepressants,” screening.mhanational.org, 2022.
  9. American Psychological Association. “What is Cognitive Behavioral Therapy?,” www.apa.org, 2017.
  10. Hees, Rotter, et al., “The effectiveness of individual interpersonal psychotherapy as a treatment for major depressive disorder in adult outpatients: a systematic review,” National Center for Biotechnology Information  (NCBI), 2013.
  11. Netz. “Is the Comparison between Exercise and Pharmacologic Treatment of Depression in the Clinical Practice Guideline of the American College of Physicians Evidence-Based?,” Frontiers in Pharmacology, 2017. 
  12. Harvard Medical School. “Omega-3 fatty acids for mood disorders,” 2020.
  13. National Institute of Health. “Heart disease and depression: A two-way relationship,” 2017.
  14. Qiu, Li,  et al., “Electroconvulsive Therapy-Induced Brain Structural and Functional Changes in Major Depressive Disorders: A Longitudinal Study.” National Center for Biotechnology Information (NCBI), 2016.
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