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Amy Nester, MSW
(patients with last names starting with A-K)

Krista Wendel, MSW, LCSW
Pronouns: she/her
(patients with last names starting with L-Z)

Health & Wellness

UNC Cystic Fibrosis Clinic recognizes that health and wellness include the benefits of good physical, psychological, and financial health. Living with CF, however, can be challenging in all three of these important aspects of life. Knowing the resources that are available to you is a critical first step. Your Adult CF Social Worker can provide guidance as you navigate your health insurance coverage, make tough decisions about school or the next steps in your career, and can also provide expertise in identifying and treating problems with emotional challenges such as depression or anxiety.

Depression & Anxiety

It is common for those living with chronic illness to experience depression or anxiety. In one study, the rates of patients living with CF and parent caregivers in the United States and Europe were 2-4 times higher than in the general population. Some may read this and think, “isn’t being sad or down just a normal part of being human?” Yes. It is normal to experience a full range of emotions including sadness, anger, or joy. However, some emotions, like sadness, can become more than a normative response.

Here is how to tell the difference between depression and normal blues or sadness:

– Depressed mood lasts for at least two weeks or more and for more time than not in the day
– It is associated with decreased interests, motivation, and enjoyment/ For example, you don’t want to do things that usually bring you pleasure; you have been isolating.
– It is associated with changes in your bodily functions: sleep, appetite, energy
– It is associated with decreased concentration and ability to make decisions
– It is associated with increased thoughts about death
– It affects your functioning: decreases your ability to take care of yourself and your health, has a negative impact on your relationships, school, work and/or hobbies

For those living with chronic illness, anxiety surrounding medical interventions is very common. For patients living with cystic fibrosis, these anxiety-producing interventions can include: PFTs, throat cultures, venipuncture, PICC line placement, NG tube insertion, manipulation with the G/J tube, or physiotherapy/ nebulizer treatments, just to name a few. This can add to the anxiety of coming to the clinic appointments or staying in the hospital, and for some patients might lead to avoidance of these anxiety-producing situations and thus some essential care.

Because we know that depression and anxiety can have a direct effect on a patient’s quality of life and their ability to keep up with daily treatments or doctor’s appointments, the UNC staff started screening patients at both outpatient appointments and during a hospitalization. We hope that by doing this, we can have richer conversations with our patients about how CF is impacting your mood and resources available for support. We appreciate the honest dialogue that has been occurring and the trust that you put in your team when you disclose how CF is impacting the many facets of your life.

If you recognize that your mood and/or stress level has been impacted and are considering therapy, there are a few ways to go about finding a counselor:

  1. You can call the CF Center social worker to discuss further at (984)974.5128.
  2. If you have private insurance, you can call the Mental Health number listed on the back of your insurance card.
  3. If you have private insurance or Medicaid, you can browse therapist profiles on by filtering for zip code and insurance type.
  4. If you do not have insurance and live in North Carolina, you can call your county’s LME and be scheduled for an appointment in your local area. LME Directory

Financial Health

For many people living with CF, the financial costs of care are burdensome. Whether navigating insurance plans, affording the costs of medications and treatment, or making choices related to food, housing, and transportation, affordability is a usual question on our patients’ minds. There are many resources available that can assist in supplementing. This list is not exhaustive and resources do change frequently, so please discuss your specific circumstances with your social worker.

UNC Financial Assistance Programs

Charity Care
Uninsured Discount Program

CF Foundation Compass

The Cystic Fibrosis Foundation Compass is a personalized service to help you with the insurance, financial, legal and other issues you are facing. There are more resources available to people that are county specific. Please discuss with your CF center social worker for more information.