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In this thoughtful discussion, Dr. Nancy Reau from RUSH University Medical Center explores the often-overlooked psychological impact of Primary Biliary Cholangitis (PBC). While managing the physical symptoms of PBC is critical, addressing the emotional and mental health challenges faced by patients is equally important. Dr. Reau highlights how the lifelong nature of PBC, its familial implications, unpredictable progression, and extrahepatic symptoms like fatigue and pruritus can contribute to significant stress, anxiety, and emotional strain. Many patients may appear physically healthy yet suffer from symptoms that disrupt their daily lives and relationships—leading to frustration, isolation, and misunderstood expectations from others. Even those in biochemical remission can experience mental health burdens, especially if they’ve seen loved ones struggle with the disease. Dr. Reau emphasizes the need for providers to initiate open conversations about these psychological effects to validate patient experiences and support overall wellness. If you're a clinician or caregiver seeking a more holistic approach to PBC management, or a patient navigating the emotional side of liver disease, this video offers compassionate, practical guidance.