Diabetes and depression: How one affects the other
One of the challenges associated with diabetes is maintaining a healthy outlook on life. Variations in blood sugar levels can affect mood. According to the American Diabetes Association, people living with the disease that affects 25.8 million children and adults in the United States are at risk for depression, though the reasons aren’t entirely clear.
Some research suggests depression is a risk factor for diabetes because is causes hormonal imbalances that set off neuroinflammatory processes.
Diabetes can cause feelings of isolation. Managing diabetes can cause mounting stresses that sometimes lead to poor self-care and feelings of loss of control.
Depression can make it difficult to think; interfering with medication compliance and exercise goals necessary to keep diabetes under control.
Researchers are exploring the link between poor blood sugar control and how one affects the other.
Satish Garg, MD, Editor-in-Chief of Diabetes Technology & Therapeutics and Professor of Medicine and Pediatrics at the University of Colorado Denver wrote in a May, 2012 press release, "We still do not know which comes first. This needs further investigation, especially using newer technologies such as continuous glucose monitoring."
Variations in blood sugar levels were shown in one study to directly impact mood and quality of life, leading to a vicious cycle of poor self-care related to diabetes. The result can lead to complications including kidney, heart and eye disease, in addition to increased medical costs.
Studies show major depression can interfere with fruit and vegetable intake that is an important component of a healthy diet for anyone and in particular for those living with diabetes.
Exercise that is another essential part of diabetes self-care is less likely when depression is left untreated.
Symptoms include lack of appetite, decreased energy and inability to experience pleasure. Insomnia or oversleeping can interfere with metabolism and weight management, making things worse.
What can you do?
Recognizing symptoms is the first step. Speak with your doctor if your blood sugars are poorly controlled.
Your doctor might prescribe an antidepressant, but it’s important to understand there are side effects that might include weight gain and increased blood pressure. Some antidepressants interfere with sexual function.
Medicines to treat depression take several weeks to work. It may take a second or even third drug to make you feel better.
According to the Behavioral Diabetes Institute, the first antidepressant fails to work in almost half of cases.
Another option that was recently found to help women with diabetes and depression is group therapy.
According to a finding published in the Annals of Behavioral Medicine, depression occurs in twice as many women with diabetes as men.
For the study, women were enrolled in a nurse-delivered group therapy program called SWEEP and compared to patients receiving routine care.
SWEEP is a form of cognitive behavioral therapy. The women were taught how blood sugar affects emotions including depression, anger and anxiety.
Rather than being taught to eliminate stress which is difficult, women in the study learned how to communicate more effectively, recognize feelings of stress and had to think differently to eliminate negative thoughts.
After six months of group therapy fewer women reported feeling depressed, compared to those who received usual care.
Seek help. Speak to your friends and family and ask for help to gain control of diabetes. If you need to lose weight, stop smoking or eat healthier, enlist the help of family and friends. It’s important to remember that diabetes and depression are both manageable.
Diabetes can lead to depression. Conversely, people who are depressed may be at higher risk for developing type 2 diabetes. Speak with your Dr. about which treatment plan is best for you. Medications, cognitive behavioral therapy, talking to other people, joining a support group and group therapy are all shown to help manage depression that can accompany diabetes.
American Diabetes Association
"Relationship of Depression and Diabetes Self-Care, Medication Adherence, and Preventive Care"
Elizabeth H.B. Lin, MD, MPH, et al
Diabetes Research and Clinical Practice
"Diabetes and depression: Global perspectives"
Leonard E. Egede, Charles Ellis
"A psychoeducational intervention (SWEEP) for depressed women with diabetes"
Penckofer SM,, et al.