MyFOXChattanoogaDiabetes raises depression risk

By Louis Neipris, M.D., Staff Writer, myOptumHealth

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If you have diabetes you may also feel sad, hopeless or overwhelmed. It's normal to struggle with your emotions after a diagnosis of diabetes. But if the feelings linger or are severe, you could have depression.

You are not alone. One out of every three people with diabetes has symptoms of depression. People who have diabetes have double the risk of becoming clinically depressed compared with those who don't have diabetes. Alone, each problem is a challenge. But having both depression and diabetes can be a dangerous mix. Why? Depression can interfere with your ability to take care of your diabetes. This can lead to:

• Poor blood sugar control
• Higher hemoglobin A1C values
• A greater risk of long-term complications, such as eye and kidney disease
• A higher chance of death

What is the relationship between diabetes and depression?

It isn't clear how diabetes is related to depression or if it causes depression. Like any chronic disease, diabetes presents a lot of life challenges. Feelings of depression can come from:

• A sense of loss when first being diagnosed
• Feeling overwhelmed with self-management issues
• Cost of care
• Worry over complications
• Effect on family relationships

Having "burn-out" after years of successful diabetes self-management can also happen and lead to depression. Having a family history of depression can also raise your risk.

What are symptoms of depression?

People with depression may have some of the following symptoms. They often last for most of the day on most days for at least two weeks:

• Feeling sad, down or depressed
• Crying spells
• Loss of interest in most activities
• No longer getting pleasure from usual sources of pleasure
• Having trouble sleeping (insomnia) or sleeping too much
• Eating too much or having no appetite
• Feeling agitated or nervous
• Feeling sluggish like you are moving slowly
• Feeling tired or having no energy
• Having trouble concentrating or making decisions
• Thoughts of death or suicide

Call 9-1-1 right away if you have any thoughts of hurting yourself or others.

How can depression affect diabetes?

Depression can make it hard for you to focus on taking care of your diabetes. You may miss your check-ups because you feel down. You may not feel like checking blood sugar as much, forget to take your medications or lose interest in eating the right foods.

If you have diabetes and think you are depressed, don't leave your feelings at home. See your doctor. He or she can evaluate your symptoms and help you get treatment if needed. Your doctor may recommend:

• Medication, such as an antidepressant
• Seeing a specialist, such as a psychiatrist or mental health counselor for further evaluation and treatment

How can an antidepressant help?

Most people with diabetes do well on antidepressant medications. In time, medication can help you to feel better and take control of your diabetes again. Remember that it may take a few weeks after you start an antidepressant before you start to feel better. Often, treatment with an antidepressant is combined with psychotherapy.

Here are some other things to think about while you are being treated for depression.

• Keep taking the medication as directed even if you are feeling better. This goes for both antidepressants and your diabetes medications.
• Join a support group. Group therapy lets you share your feelings and challenges with others who are going through a similar experience. You are likely to find good ideas of diabetes self-management.
• Seek the support of family and friends. It's helpful to find someone to talk about what's going on in your life.
• Get some physical activity. Exercise can help both your depression and the diabetes. Regular physical activity can boost your mood and self-esteem. Regular exercise also helps to keep your blood sugar under control. Always check with your doctor before you increase your activity level.

View the original Diabetes raises depression risk article on myOptumHealth.com 

SOURCES:

• Grandy S, Chapman RH, Fox KM. Quality of life and depression of people living with type 2 diabetes mellitus and those at low and high risk for type 2 diabetes: findings from the Study to Help Improve Early evaluation and management of risk factors Leading to Diabetes (SHIELD). International Journal of Clinical Practice. 2008;62(4):562¿568.

• American Diabetes Association. Recognizing and handling depression for people with diabetes. Accessed: 01/30/2009

• National Institute of Mental Health. What are the signs and symptoms of depression? Accessed: 01/30/2009

• American Diabetes Association. Depression Accessed: 01/30/2009

• Golden SH, Lazo M, Carnethon M, et al. Examining a bidirectional association between depressive symptoms and diabetes. Journal of the American Medical Association. 2008;299(23):2751-2759.