Diabetes and depression

Depression is common amongst people with diabetes

Managing diabetes can seem like an overwhelming task, particularly for the newly diagnosed patient. Many diabetics struggle to cope with the requirements of the disease and the complications that it causes.

As a result, many diabetics suffer from depression.

Depression is the most common psychiatric disorder witnessed in the diabetic population.

I am worried that I might be getting depressed because of my diabetes, what would my symptoms be?

The symptoms of depression are numerous, and will be different in each individual case. However, the following symptoms can be consistent with depression caused by diabetes.

Persistent sadness or anxiety, a feeling of hollowness
An overriding feeling of hopelessness and negativity
Feeling helpless and powerless to change your situation
Loss of interest in activities or pleasures
Lower energy and increased fatigue
Insomnia, oversleeping, awakening early in the morning
Concentration problems, memory problems and indecisiveness
Dwelling on death or suicide
Restlessness
Weight change and decreased or increased appetite

Each of these symptoms by themselves does not necessarily mean that depression is present. Also, if the feelings are inconsistent or only occurring rarely, this may be quite normal. If you have these symptoms consistently, and they begin to interfere with the management of your diabetes, your relationships or your social work it could be sensible to seek an evaluation of depression.

Am I more likely to have depression as a diabetic?

Many experts believe so, but depression can strike at anyone. Furthermore, individuals who suffer from depression may also be a greater risk of developing type 2 diabetes. Studies have shown that the risk of depression increases when diabetes has developed. When depression is well treated, it can improve the patient’s ability to self-care and manage their diabetes. Scientifically, the links are unclear. Depression often goes undiagnosed and untreated, both amongst diabetics and the general population.

What exactly is depression, and how could it affect my diabetes?

Depression is a common but serious medical problem that affects the victim’s ability to function in their everyday life.

Depression can occur at any time, at any age. Depression occurs because of family history and life history – the genetic precondition is sparked off by life events- although this may not always be the route. Depression can occur due to stress, environmental factors, and even the side effects of medication.

Depression can affect a patient’s capacity to deal with their diabetes, including managing blood glucose levels appropriately. Tight glucose control has been proven to be the best way to prevent the serious complications that diabetes can cause. Depression could influence your life in the following ways:

Reduced quality of life and social functioning
Low levels of physical activity
Reduced ability to adhere to treatment regimen
Worsen diet
Increase likelihood of unhealthy behaviour such as smoking
Increase macro and micro-vascular complications.

How can I treat my depression in tandem with my diabetes?

A qualified professional should prescribe individual treatments for depression. Because depression is a mental illness, the treatment parameters are not so clearly defined. Your depression may need to be treated through the prescription of antidepressant medication, which are generally safe for diabetes sufferers.

Psychotherapy can also be useful in relieving depression. However, different people will react to medications in different ways. Studies have shown that amongst diabetics, both antidepressants and psychotherapy can be useful in terms of mood improvement and glycaemic control.

When it comes to treating depression amongst diabetics, the process should be managed by a mental health professional in close communication with your diabetes care team or physician. This is essential when antidepressants are prescribed, to limit the chances of harmful drug interactions. Some herbal supplements do have an application in the treatment of depression, but these should be closely discussed with a physician before being tried.

What conflicts could there be between diabetes and antidepressant drugs?

Although this list is by no means comprehensive, and it is essential to seek medical guidance from both your doctor and your diabetes healthcare team, the following are known drug-related conflicts.
Tricyclic drugs can have significant hyperglycaemic effects, and their side effects can cause problems for people with diabetes. These can include sedation, cardiotoxicity and weight gain.
SSRIs (Serotonin Specific Reuptake Inhibitors) can also cause hypoglycaemic episodes in type 2 diabetics. Side effects caused by these drugs can also be mistaken for hypoglycaemic episodes.
MAOIs (Monoamine oxidase inhibitors) can decrease serum glucose levels and other antidepressants such as lithium can reduce hyperclycaemia and even increase insulin sensitivity.

Are there other mental health hazards for diabetics?

Mental disorders are numerous, and any of them can affect diabetes sufferers. Often they will hinder the effective management of the disease, meaning that the patients find themselves in a vicious circle. Bipolar disorder (manic depression) and other anxiety disorders can occur in people who have diabetes.