Is your diabetes causing depression?

An estimated 29.1 million Americans have diabetes and 14.8 million suffer from major depression. The two may not seem related, but it’s well known that depression and diabetes do share a link. Unfortunately, researchers are still unsure exactly what brings the two together – the link is considered to be similar to the chicken and the egg conundrum.

What is known is that chronic illnesses can increase the risk of depression, but there may be something specific about diabetes which increases a person’s risk. One thing is for certain: Although a specific link is unknown, researchers are confident that there is something in particular about diabetes which can increase a person’s risk for depression.

Diabetes linked with depression

Researchers in St. Louis, Missouri reviewed 42 different studies and uncovered that individuals with diabetes were twice as likely to be depressed in comparison to those who did not have diabetes. Additionally, women were more likely to develop depression if they had diabetes, compared to men.

Researchers believe the link may be a combination of psychological and physical factors. They report that diabetes can trigger feelings of failure, which in turn leads to depressed feelings.

Although there is an apparent link between diabetes and depression, it is not normal. What has been seen is that individuals with more complications related to diabetes are more likely to be depressed. In one study, major depression was seen in individuals who had diabetes along with other chronic conditions in comparison to those who only had diabetes. Worse yet, diabetics combined with depression has a higher mortality rate, but with proper treatment the risk of death can be cut in half.

Symptoms of depression

If you have diabetes, especially in combination with other chronic conditions, it’s important to recognize the symptoms associated with depression to receive treatment early on. Symptoms of depression include:

• Loss of pleasure in once enjoyed activities and hobbies
• Changes in sleeping patterns – this can often be confused with diabetes
• Waking up earlier than normal
• Changes in appetite
• Trouble concentrating
• Nervousness
• Feeling immense guilt or as if you are a burden on others
• Morning sadness
• Suicidal thoughts

Mental Health America reports that a diagnosis of depression is disregarded nearly 50 percent of the time because doctors expect such reactions to occur as a result of being diagnosed with a chronic illness like diabetes. Furthermore, depression still holds a strong stigma, causing people to feel “weak” if they seek out help or to believe it’s just a phase which they can snap out of. Lastly, many people are ashamed to talk about feelings of sadness, so they don’t report the symptoms in the first place.

How to improve depression in diabetics

A study published in the Journal of General Internal Medicine revealed that individuals with diabetes, along with other chronic illnesses, could improve their depression through Pathways collaborative care intervention.

A group of 329 diabetic patients with depression were treated with a collaborative care model. The intervention used individualized stepped-care treatment which was provided by a nurse and a doctor. The treatment involved either antidepressant therapy or problem-solving therapy. If, after eight to 12 weeks of the initial stage of treatment, the symptoms did not decrease by at least 50 percent, patients were moved to stage two of the intervention which involved one of the following:

1. 1. Change of antidepressant medication
2. 2. Change from medication to problem-solving therapy – or vice versa
3. 3. Consult a psychiatrist

If stage two did not reduce symptoms or the patient was dissatisfied, they would be admitted to long-term follow-up care.

The results revealed those who had diabetes and one or more other chronic illness improved their depression with the help of the Pathway collaborative intervention. Additionally, improvements were seen over the long-term as well. The study goes to show that a stepped-plan is most beneficial for improving depression among those with diabetes and other chronic illnesses.

In order to improve depression in those with diabetes the individual must be willing and open to seek out treatment. Being able to openly talk about feelings can better help the condition and improve depression. There are many modes of treatment in regards to depression, but a doctor can only offer them if the patient speaks-up about how they are feeling.

In order to improve health and chronic illnesses patients must be willing to express changes in mood and be open to treatment options, which in turn can work to combat the stigma which is associated with depression.

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Sources:
http://www.ncbi.nlm.nih.gov/pmc/articles
http://www.dbsalliance.org/site/PageServer?pagename=education_statistics_depression
http://www.health.com/health/condition-article