Patients being treated for type 2 diabetes are at a much higher rate for developing symptoms of depression than the general population, and experts recommend treating both conditions at the same time. Even diabetics with mild to moderate symptoms should be wary of developing depression, and anyone with a history of depression should be screened for diabetes. According to the Centers for Disease Control & Prevention (CDC), just having diabetes doubles your risk of developing depression. It remains unclear exactly why this is—the CDC posits that this could be due either to the psychological stress of dealing with depression, or due to diabetes' metabolic effect on brain function. Alternatively, there is the possibility that people with depression may be more likely to develop diabetes—a chicken-and-egg type situation that may be difficult to unravel.
There are numerous reasons why the diabetes-depression connection is so urgent. Symptoms of depression can often make it more difficult to successfully manage diabetes, and studies suggest that people with diabetes who have depression symptoms often have consistently higher blood glucose levels than non-depressed patients. Additionally, according to a 2011 study published in Diabetes Care, patients who have both conditions are 52 percent more likely to suffer a heart attack or stroke.
Causes of Depression With Diabetes
At this time it remains unclear whether depression leads to poor dietary choices (and higher blood glucose), or if the demands of managing a chronic disease such as type 2 diabetes leads to depression, and ultimately, more difficulty managing the disease. It seems likely that both diseases are caused and affected by the same risk factors, such as family history, obesity, hypertension, inactivity, and coronary artery disease.
Recent research even shows a link between non-diabetic children with depression symptoms and their development six years later of insulin resistance, regardless of weight or body mass—in other words, having depression has been isolated as an independent risk factor for type 2 diabetes.
Most recently, researchers have begun to search for a closer link between diabetes and depression, and whether decreased blood volume to the brain (possibly due to damage from diabetic neuropathy and/or blocked blood vessels) is a contributing factor. Recent studies investigated this theory, including a 2008 study published in the American Journal of Geriatric Psychology that found that "diabetes is related to an increase in brain atrophy and poor motor function in 60- to 64-year-olds, independent of depression, vascular risk factors, and small vessel disease of the brain."
What experts do know for certain is that poor management of diabetes can mimic symptoms of depression, and actual depression symptoms result in poorer outcomes for diabetic patients. For instance, blood glucose that is too high or too low may cause increased anxiety, restlessness, or low energy. Low blood sugar can also cause you to feel very hungry and have the tendency to overeat.
Symptoms of Depression
Just trying to cope with and properly manage a chronic disease like diabetes and its complications can feel overwhelming. If you feel depressed and your sadness isn't relieved within a few days, you may be suffering from depression. Keep the following symptoms of depression in mind when speaking with your doctor:
- no longer finding pleasure in activities that you once enjoyed
- experiencing insomnia or sleeping too much
- loss of appetite or binge eating
- inability to concentrate
- feeling lethargic
- feeling anxious or nervous all the time
- feeling isolated and alone
- feeling sadness in the morning
- feeling that you "never do anything right"
- having suicidal thoughts
- harming yourself
If you are suffering from symptoms of depression, you should contact a mental health specialist, or your primary care doctor, who can then put you in touch with a mental health professional.
Treating Depression With Diabetes
Recognizing your risk for depression is the first step to getting treatment. First, discuss your situation and symptoms with your primary healthcare provider. He or she will refer you to a mental health professional for consultation. Treatment usually involves psychotherapy or some form of counseling and/or antidepressant medication.
In the meantime, there are things that you can do to help improve your depression symptoms, such as increasing your physical activity. Any form of exercise will likely make you feel better, at least in the short term, due to the release of endorphins in the brain. This "feel good" brain chemical has been proven to help alleviate depression symptoms. Increasing your physical activity also has plenty of health benefits for diabetics, too, such as decreasing your weight and body mass, decreasing blood glucose levels, and increasing your energy and stamina.
Other measures that may help improve depression include being more proactive about your management of diabetes. Get educated about your disease. Increase your monitoring of blood glucose levels. Seek additional support from family and friends. Finally, avoid caffeine, recreational drugs and alcohol, and maintain a regulated sleep schedule.