If you have diabetes, you've already been through your share of ups and downs. Some days, you may feel like you're in complete control of your disease and your life. Other days, you may feel like the disease is calling the shots. At these times, simply checking your blood sugar or counting your carbohydrates can seem like a monumental task.
Don't be surprised when you have an off day. It happens to everyone, diabetes or no. But when an off day turns into an off month, it's time to take a closer look at your mood. Although few people realize it, depression is a common complication of diabetes. According to Mental Health America, 30 percent of people with diabetes are depressed.
The two diseases often form a vicious circle. Many patients sink into depression when their diabetes worsens. Then the depression makes them more likely to have trouble managing their disease. As their diabetes gets further out of control, their mood darkens as well.
Spotting the problem
You can stop this chain reaction before it ever has a chance to start. There are many effective treatments for depression, including medications and counseling. In addition to improving your mood, these treatments will make it much easier to control your diabetes. But before you can get help, you have to spot the problem, and the sooner the better.
It may not always be easy to tell the difference between a run-of-the-mill bad mood and depression. According to the National Institute of Mental Health, people who are depressed have symptoms that interfere with work, daily activities, or social life. The symptoms to look for include:
- Lingering feelings of sadness, emptiness, or anxiety
- Hopelessness and pessimism
- Loss of pleasure in previously enjoyable activities, such as seeing friends or having sex
- Trouble falling asleep, waking up too early in the morning, or sleeping much more than usual
- Irritability or restlessness
- Loss of energy or feeling "rundown"
- Changes in appetite or weight
- Persistent pains or digestive problems that don't get better with treatment
- Feelings of worthlessness or persistent guilt
- Trouble concentrating, remembering, or making decisions
- Thoughts of death or suicide or attempted suicide
Physical sources for depression
If these symptoms apply to you, schedule an appointment with your general doctor or your diabetes specialist (If you are feeling suicidal, you should call a crisis center right away. You should also try to see your doctor as soon as possible.)
Your doctor can look for possible physical problems that can affect your mood, such as the side effects of medications or poorly controlled blood sugar. If necessary, he or she can also refer you to a psychologist, psychiatrist, or other mental health expert who can help you get back on track. Psychiatrists and other doctors can also usually prescribe medication for depression, if needed.
Sometimes depression just can't be prevented, but there are things most people can do to reduce their risk of the disease. Follow your health plan carefully and build a support network of family, friends, and health professionals. In addition, exercise has been shown to improve mood in the case of depression -- regardless of whether someone has diabetes. (It also helps you keep your diabetes under control.) And, even when depression can't be prevented, it can usually be treated successfully if you work closely with your health care team. Communication and teamwork with your doctor and/or therapist are very important to ensure you have a full recovery and avoid a relapse.
National Institute of Mental Health. Depression and Diabetes.
American Diabetes Association. Coping with bad feelings.
Blumenthal, J.A., et al. Effects of exercise training on older patients with major depression. Archives of Internal Medicine, Vol. 159:2349-56
Lane, A.M. and D.J. Lovejoy. The effects of exercise on mood changes: The moderating effect of depressed mood. Journal of Sports Medicine and Physical Fitness. Vol. 41(4):539-45.
Chen, J. and W.J. Millar. Health effects of physical activity. Health Rep. Vol. 11(1):21-30.
Mental Health America. Factsheet: Co-occuring Disorders and Depression. http://www.nmha.org/go/information/get-info/depression/co-occurring-disorders-and-depression
National Institute of Mental Health. What are the signs and symptoms of depression? http://www.nimh.nih.gov/health/publications/depression/what-are-the-signs-and-symptoms-of-depression.shtml