Having any chronic disease increases the risk for depression. Diabetes is no exception. According to some estimates, about one in five diabetes patients experiences persistent bouts of the blues. That means depression is three times more common among people with diabetes than it is in the general population.


 

Studies show that depressed diabetes patients tend to have worse glucose control than their more-optimistic counterparts, possibly because persistent despair and gloominess make it harder to deal with the many responsibilities of managing diabetes. So it's not surprising that they also tend to have more complications. For instance, a 2005 study in Diabetes Care found high rates of depression among patients with diabetic neuropathy. Some researchers believe that a common hormonal imbalance may be linked to both mood problems and difficulty controlling blood sugar.

Symptoms of depression can include:

  • disturbed sleep patterns (either insomnia or oversleeping)
  • loss of interest in hobbies and favorite pastimes
  • a change in appetite
  • lack of energy
  • feelings of worthlessness, hopelessness, or helplessness
  • self-loathing
  • feeling guilty for no reason
  • difficulty concentrating
  • irritability
  • low self-esteem
  • suicidal thoughts

If you have several of these symptoms for an extended period, your doctor may diagnose depression. There are two primary methods of treatment: counseling and medication. These can be used on their own or in combination, depending on the severity of the depression and its source.

Talk to your doctor if you feel that your outlook on your health or treatment is spiraling into depression.
Talk to your doctor if you feel that your outlook on your
 health or treatment is spiraling into depression.

Mental Health Counseling

If all you know about psychotherapy comes from TV and movies, you may think psychotherapy involves lying on a couch and talking endlessly about your tortured childhood to a bearded man who is taking notes. But talk therapy needn't be long-term (though there is certainly a place for that, too). Short-term, focused psychotherapy can help you address your diabetes-related problem head-on. In fact, some research suggests that a form of counseling known as cognitive-behavioral therapy (CBT) may be particularly beneficial. In CBT, a therapist helps the patient identify and replace negative, inaccurate, and destructive thoughts and behaviors with healthier, more constructive thoughts and actions

Medication

When you have depression, brain chemistry is out of balance. Modern antidepressant medication simply adjusts levels of neurotransmitters, the chemical messengers that deliver signals from one neuron (brain cell) to another. These are not "happy pills," as ill-informed skeptics sometimes suggest. There are several categories of antidepressant drugs, but the most commonly prescribed today are known as selective serotonin reuptake inhibitors, or SSRIs. Serotonin is a neurotransmitter believed to help regulate mood. SSRIs appear to work by keeping serotonin at work longer. Fluoxetine, better known by the brand name Prozac, is one of the most widely prescribed SSRIs. Others include paroxetine (Paxil), sertraline (Zoloft), and citalopram (Celexa).

Eating Disorders and Diabetes
Given the central role diet plays in controlling blood sugar, it's not surprising that many diabetes patients become preoccupied with food. However, that preoccupation can morph into unhealthy practices. Studies suggest, for instance, that young women with type 1 diabetes have a heightened risk for food bingeing and bulimia (vomiting or using laxatives to avoid weight gain). Furthermore, one-third to one-half of young women with type 1 disease may engage in a practice known as "insulin purging." Because injected insulin allows the body to burn glucose as fuel and store the leftovers as fat, these women reduce their usual insulin dose to avoid gaining weight.

Reducing the dose causes the body to get rid of excess glucose in the urine instead of storing it as fat. It also allows blood sugar to rise because there isn't enough insulin, increasing the risk of complications.

Treatment options for eating disorders also include therapeutic intervention and medication.

Counseling

Experts say that treating eating disorders requires a team approach. A psychotherapist can help the patient cope with underlying emotional problems that contribute to self-destructive eating habits. A dietitian can offer education and counseling about healthy nutrition. And, of course, the patient's physician treats and controls the effects of elevated glucose.

Medications

Doctors sometimes prescribe antidepressants to treat eating disorders.

For more on diabetes and depression, and how to manage both conditions, try the following articles:

ABOUT THE AUTHOR:

Timothy Gower is a freelance writer and the author of several books. His work has appeared in many magazines and newspapers, including Prevention, Health, Reader's Digest, Better Homes and Gardens, Men's Health, Esquire, Fortune, The New York Times, and The Los Angeles Times.

ABOUT THE CONSULTANTS:

Dana Armstrong, R.D., C.D.E., received her degree in nutrition and dietetics from the University of California, Davis, and completed her dietetic internship at the University of Nebraska Medical Center in Omaha. She has developed educational programs that have benefited more than 5,000 patients with diabetes. She specializes in and speaks nationally on approaches to disease treatment, specifically diabetes.

Allen Bennett King, M.D., F.A.C.P., F.A.C.E., C.D.E. is the author of more than 50 papers in medical science and speaks nationally on new advances in diabetes. He is an associate clinical professor at the University of California Natividad Medical Center and cofounder and medical director of the Diabetes Care Center in Salinas, California.

This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.