The Other D-Word, Depression and Diabetes.
Clare Venus
August 20, 2008

As if it were not enough of a daily struggle to manage diabetes, many people also have to deal with the additional burden of clinical depression. Distressingly prevalent in populations across the world and more so in individuals with chronic illness, depression is too often unnoticed and untreated. Since depression is usually cloaked in a variety of vague physical symptoms, very real to the patient, but dismissed by many busy medical practitioners, it is not surprising that the subtle indicators of depression are often overlooked. In individuals with diabetes, depression is of particular concern because it undermines motivation and leads to neglect of diabetes self-management. People who suffer from depression and diabetes often lack the energy or the will to follow their treatment plan, placing them at much greater risk for complications and disability Tasks such as blood glucose monitoring and taking medication may be performed sporadically or abandoned altogether. Routine activities such as exercise and meal preparation may be experienced as too difficult or simply not worthwhile.

Depression is sometimes confused with simply feeling blue, sad or unhappy, normal emotions that we all experience from time to time. But real depression is a demoralizing and crippling condition that causes tremendous suffering. Only last year, the World Health Organization drew attention to the seriousness of depression as a major disabling illness across the globe, with greater health implications than many other illnesses, including diabetes.

We don’t always know what causes depression or what makes one person more vulnerable than another. From a biological perspective, we know there are genetic factors that underlie many illnesses, including depression. Having diabetes is itself a risk factor for depression and being depressed also increases the likelihood of developing type 2 diabetes. Someone who has been raised in an abusive or emotionally-deprived environment may be at greater risk for depression. People with no family history of depression can become depressed following a serious illness, personal loss, accident or traumatic event.

If you have symptoms of depression which are affecting your everyday functioning, don’t hesitate to seek professional help. Depression warrants intervention in just the same way as a torn ligament or persistent cough would require medical care. Most cases of depression respond well to treatment. Evidence-based treatment options include psychotherapy and medication or a combination of both. Beyond mood improvement, psychotherapy may have the added advantage of strengthening emotional resilience, building coping skills and reducing the risk of relapse.

The importance of enlisting social support from friends, family and/or support and self-help groups cannot be over-emphasized. Diabetes support groups are a good place to receive encouragement and to share coping strategies. A diabetes education group may help with getting back on track with diabetes care. A full night of sleep on a regular schedule is vital, since irregular patterns of sleep and sleep deprivation will only impede recovery. Minimizing stress and setting moderate, realistic goals will help pave the road to restoring emotional health and well being.