Depression May Cause and also be a Result of Diabetes

Some people with Clinical Depression become depressed and then develop Diabetes. However, many other people develop diabetes first and then become depressed after they develop diabetes. Researchers are not sure why this is so, but at least one believes it may be because “depression” may be linked to the “burden of dealing with a disease that can drive you nuts at times.”

Don’t despair. There are strategies you can use to fight depression whether it developed before or after diabetes.

By Madeline Vann, MPH (Master of Public Health degree)

People who have diabetes are almost two times more likely to develop depression than their peers – with about one in four people with diabetes experiencing major depression in their lifetime.

Depression isn’t just a minor irritation. Major depression sucks the joy out of your life, and also often prevents you from managing diabetes effectively.

“We’re not sure whether depression risk is higher because of the higher levels of glucose in their bloodstream or because of dealing with a chronic disease,” says researcher Sue Penckofer, PhD, RN, Professor and Loyola Faculty Scholar at the Loyola University Chicago School of Nursing in Maywood, IL.

“We do know that for many people it appears that depression appears after they develop diabetes,” says William H. Polonsky, PhD, CDE, chief executive officer of the Behavioral Diabetes Institute and associate clinical professor at the University of California, San Diego.

Polonsky says the “depression” may be linked to the “burden of dealing with a disease that can drive you nuts at times.”

However, he says, it’s important to differentiate between clinical depression (which does occur more often among people with diabetes) and distress over diabetes, in which a person’s anxiety and sense of sadness or hopelessness is tied specifically to issues about controlling diabetes.

For a small number of people, diabetes developed after depression developed.

“Another group of studies have also pointed to the fact that there are people who are at elevated risk for developing type 2 diabetes if they become depressed,” Polonsky says. This could be because depression can lead to poor diet and poor exercise habits that then trigger diabetes.

Some Solutions

With so many possible causes contributing to the increased risk of depression among people with diabetes, it’s safe to say that researchers are still working on untangling all the factors involved.
Regardless of cause, patients often just want to find a solution. Discussions of depression tend to turn quickly to antidepressants, but you might be able to find a solution that doesn’t involve a prescription. In fact, many people with diabetes would prefer an alternative approach.

Penckofer points out that many people who had diabetes first already feel like they have enough medications to take, so antidepressants (which might be necessary for a while) can be difficult to keep up with because of cost or because you just have too many drugs to take already. For that reason, it may be a good idea to explore other ways to manage depression in addition to prescription antidepressants.

Finding relief from depression is possible, but you have to be careful to stick to your diabetes control plan as well.

“We’ve found that when people feel more energetic and less depressed, their blood sugar goes up! We think this is because they start to go out and socialize more,” says Penckofer.

So, the take-home message is this: you can get relief from depression, but you still have to make diabetes-friendly diet and activity choices!

Here are some ways that you may get relief from depression no matter when it started:

• Vitamin D. Dr. Penckofer has looked at ways to help people with diabetes manage depression, including supplemental vitamin D doses and cognitive behavioral therapy.
Many people who have diabetes and depression lack vitamin D (a vitamin the body manufactures when exposed to sunlight), says Penckofer. Her research looked at whether high doses of vitamin D (50,000 International Units a week) had an effect on mood. She found that, indeed, people reported feeling more energy after they took the supplements for a few weeks. If you’re struggling with feeling down and like you’ve lost your get-up-and-go, ask your doctor for a vitamin D blood test to ascertain your levels of that very important vitamin. (Don’t, however, increase your levels of vitamin D until you talk to your doctor about the results of your vitamin D test and what it means. Follow his or her advice about taking supplemental vitamin D.

• Cognitive behavioral therapy. This approach to therapy supports positive thoughts, positive self-talk and behaviors and also helps you identify and change thoughts that might be holding you back in your life. Penckofer’s research has shown that working on cognitive behavioral therapy on- on-one with a therapist or even in a group setting can relieve depression among people with diabetes.

• Problem-solving therapy. “This approach focuses on helping people get their lives back together, to get moving, to get out of the house, and find meaning [in their lives],” says Polonsky. Since many people with diabetes say they feel powerless over their disease and their life, this is an especially appropriate approach.

• Increase Vigorous Activity or Exercise. Being physically active has been shown to be just as effective as some antidepressants at controlling depression and some oral medications for controlling diabetes. Indeed, if you have diabetes, you should be working out anyway to help manage your weight and other medical issues. Aim for at least 30 minutes a day of increased activity or formal exercise.

• Get enough sleep. Sleep is a natural mood stabilizer. There’s also evidence that good sleep is linked to better diabetes control. If you’re having problems sleeping, talk to your doctor about possible solutions such as medications or changing some habits (such as drinking caffeine in the afternoon) that could be affecting your sleep.

• Take antidepressants. Your doctor might prescribe medications that are intended to help control your depression. Medications that are called selective serotonin reuptake inhibitors (SSRIs) are effective at controlling depression in people with diabetes, and might even help with diabetes-related health concerns such as weight and blood sugar control. However, the other two leading classes of antidepressants known as tricyclic's and MOA (Monoamine Oxidase inhibitors which may be harmful to people with diabetes. Work with your doctor to get the right medications.

• Socialize. Depression can rob you of your desire to go out with friends or attend group activities. You might have to force yourself to take baby steps back into your social life at first, but even a little contact with supportive friends can help you feel better. You might consider joining a diabetes support group so that you will have people around you who know what it is like to live with diabetes.

• Avoid harmful coping strategies. Drinking alcohol, using illegal drugs, overeating, and indulging in overspending or other risky activities won’t help your depression or your diabetes in the long run. These choices can make things worse, in fact. So, avoid them.

The good news is that depression can be successfully treated and managed. Work with your doctor to achieve the results you need, so you can get back to conquering your Diabetes.

© 2011 Sanare LLC, published on Reprinted with permission. This article can be used on your website provided all the links in the article are complete and active and the actual article is run as provided with no additions.

Author's Bio: 

I like reading and writing about emerging topics related to Health, Medical, Diabetes, technology, search engines, gadgets and travel.