We all experience sadness in our lifetime. Career disappointments, relationship problems, or just the reality of “life on life’s terms” – everyone has ups and downs. If we’re fortunate, the sad feelings subside and before long we’re enjoying life again. But if gray feelings latch on and interfere with your everyday activities, you may be suffering from depression. Depression is actually a common disorder. In fact, worldwide, approximately 340 million people suffer from depression, including 18 million in the United States.

As far back as 300 years ago, doctors saw a connection between depression and diabetes. Numbers vary according to gender and type of diabetes, but some modern medical studies report as many as 33 percent to 45 percent of patients experience both diabetes and depression. In patients with type 2 diabetes, for instance, the incidence of depression is significantly higher compared to individuals who don’t have diabetes.

The Vicious Circle

Though the physiological relationship between diabetes and depression is not fully understood, it seems clear that the two conditions can impact each other.

When you are depressed, higher levels of the stress hormone is produced, which may reduce the sensitivity to insulin and cause an increase in blood sugar levels. Also, if you are depressed, you have a greater risk of being overweight and leading a sedentary lifestyle, two factors linked to type 2 diabetes.

Conversely, if you are diabetic, the chronic nature of the illness may increase your risk of developing depression.

Identifying depression can be the first step to getting help. Anyone with three or more of the following symptoms, or if you have felt “down” consistently for two weeks or more may be suffering from depression; it may be time to get help.

• Loss of interest in activities that you used to enjoy

• Changes in sleep habits

• Loss of concentration  

• Change in appetite

• Fatigue

• Feelings of anxiety or irritability

• Feelings of inadequacy

• Feelings of sadness

• Thoughts of suicide

• Unexplained aches and pains, or headaches

Depression in diabetes is a critical issue. Diabetics who experience depression may have difficulty following the diet and treatment regimens that control blood glucose levels. Depressed diabetics may isolate themselves, limiting access to important support systems and impacting their ability to self-manage their disease. 

Without good self-management, chances for serious medical complications from diabetes increase. For diabetics, these complications may mean damage to kidneys, the heart, and eyes, as well as foot and leg ulcers that can result in amputation – or even death.

A positive attitude is very important for anyone coping with a chronic illness. For diabetics, treating depression is a vital component of your care.

Treating Depression

If you are diabetic and depressed, talk to your doctors. They might have a psychiatrist, psychologist, or counselor who specializes in diabetes on staff. If not, they will be able to refer you to someone in the community who focuses on helping diabetics.

Talk to your doctor about antidepressants. Ask what effects medication might have on your blood sugar levels. If you are already on medication for depression, report any troubling side effects that might signal the need for change in dosage or a new medication.

Ask

Talk to your doctor. If you find yourself unable to make that phone call, ask a trusted friend or relative to make it for you.

Be informed

Read books, articles, pamphlets, and Web sites. Gather as much information about your illness, its treatment, and medications as you can. 

Communicate

Forget “putting on the brave face.” Be honest about how you are feeling. Your treatment team wants to know. Especially if the medications you are taking are making you more depressed. So, speak up!

Coping with Chronic Illness and Depression

Diabetes is a chronic illness. The World Health Organization defines this as a disease “of long duration and generally slow progression.” So, it is not surprising that the most common complication of chronic illness is depression; or that roughly one-third of the individuals who suffer from chronic illness have depression symptoms.

Chronic illness can cause significant lifestyle changes including decreased independence and mobility. For some, in addition to the physiological changes brought on by the illness itself, certain medications used to treat a chronic illness can cause depression, as well.

Depression can make good self-care difficult, if not impossible. It helps if you can stay engaged in the activities that you enjoy most. Doing something you love can boost your self confidence and morale. Understanding the physical effects and limitations that the illness may bring, and adjusting your life and lifestyle accordingly, is essential.

Diabetes and depression is a heavy load for anyone to manage, especially alone. Reaching out to others can help alleviate stress, fears, and frustrations, and help give you the strength to keep up the good fight. Building a support system is vital to good self-care. Ask your doctor, nurse, or therapist about support groups in your community.

You Are Not Alone

If you suffer from diabetes, especially Type 2, the risk of becoming depressed is high. Becoming aware of the symptoms of depression, and its impact on your work and daily life, can be the first step.

Coping with one chronic illness is hard enough. If you’re dealing with depression and diabetes, ask for help. Look for support groups and other helpful resources in your community and online. If you can just reach out, you’ll see that you aren’t alone in this fight.