Depression and Diabetes


(Kathy-Go-Girl) #1

I've read that Diabetics often times suffer from depression...I find that I do, however 99% of the time my med for depression is fantastic in helping me to feel wonderful - however - some days I feel so very depressed and don't think that I will ever feel happy...and on those days I really don't want to feel happy...today is one of those days...

Does anyone else suffer with this and any ideas on how to feel better? 


(stilledlife) #2

I used to be a lot worse with my depression and anxiety, but there are some changes that really helped. As weird as it was for me, diet really effects my mood- not just the blood sugars making me feel weird, but exactly what I ate. It is unconventional, but keep a food diary and mark your mood, you may find a correlation between certain meals/food and how you feel later or the next day. It only makes sense that food effects your mind as well as body.

[quote user="Kathy"] Some days I feel so very depressed and don't think that I will ever feel happy... on those days I really don't want to feel happy... [/quote]

Just like getting your blood sugars back on track, imagine that you just need to change a little. Not become a perfect diabetic- or in this case- feel perfectly happy. Look to feel just a little better.

To do this I have a sign that I made on the wall that gets me through those ruff days. Written in green says "This moment is just that." with a round dot over top of it. I look at the dot and just try to breath. It does not make me happy, but allows me peace when my anxiety gets out of control. So find a phrase, a photo, a painting, a landscape, or even one of those "hang in there" kitten posters, find what works for you and just look at it and repeat what it says for 10-20 minutes.

I also walk on those days and repeat my phrase while walking so that I don't spiral deeper into depression by thinking about all of the bad thoughts.

Lastly, do you go to counseling to learn tactics for dealing with depression?

 

I hope this helps.

 


(rmeadowsaprn) #3

Depression may be brought on by a significant number of factors. Situational depression is a grief reaction. Clinical depression is a result of an imbalance of chemicals in the brain that affect mood. There are many physiological reasons for a change in the levels of these chemicals at various points in our lives. Physiological disturbances, though seemingly unrelated to mood have a big impact on the imbalances of chemicals. Medications simply help the balance of these chemicals during whatever periods of time we may require them. (FYI these "chemicals" are epinephrine (impacts energy), dopamine (impacts mood balance) and seratonin (impacts sleep.) Behavioral modification (counseling, psychology and psychiatry) help us to adopt healthy responses to sources of stress and grief.

Here is an article from Clinical Psychiatric News Journal if you are interested.

 

 

 

 

BY BRUCE JANCIN

Denver Bureau

KEYSTONE, COLO. — Depression is twice as common in adults with diabetes as in the general population, William H.Polonsky, Ph.D., said at a conference on the management of diabetes in youth. Moreover, coexistent depression and diabetes is associated with significantly greater all-cause mortality risk than either condition alone, hence the need to regularly screen adult diabetic patients for depression and to promote vigilance among patients and their families regarding its signs and symptoms, added Dr. Polonsky of the department of psychiatry at the University of California, San Diego, and president of the Behavioral Diabetes Institute, also in San Diego. Multiple large epidemiologic studies indicate that at any given time, 17%-20% ofadult diabetic patients meet criteria for moderate to major depression, a rate up to twofold greater than that in adults overall. South Carolina investigators recently studied the impact of depression and diabetes on all-cause and coronary heart disease mortality in 10,025 participants in the population-based National Health and nutrition.

Examination Survey–I Epidemiologic

Follow-Up Study.

During 8 years of follow-up there were 1,925 deaths, including 522 caused by coronary heart disease. Compared with subjects who were nondiabetic and nondepressed, adjusted all-cause mortality was increased by 20% among those who had depression but not diabetes, by 88% in subjects who had diabetes but not depression, and by 150% in participants with both diabetes and depression. Coronary heart disease mortality was increased by 29% in individuals with baseline depression, by 126% in those with diabetes but not depression, and by 142% in subjects with both conditions (Diabetes Care 2005;28:1339-45). Several studies also have shown threefold greater rates of new-onset coronary artery disease and retinopathy over a 10-year follow-up period in depressed diabetic patients compared with nondepressed diabetic patients, Dr. Polonsky said at the conference, sponsored by the University of Colorado and the Children’s Diabetes Foundation at Denver. Other studies have demonstrated that depression makes it tougher to initiate and maintain constructive behavioral change. In persons with diabetes, depression is associated with worse glycemic control as reflected in hemoglobin A1c levels 2.0%-3.3% higher than in nondepressed patients, along with an increased hospitalization rate, more lost work days, and greater functional disability. Screening diabetic patients regularly for depression is a simple matter even in a busy office practice. Many screening questionnaires are available that patients can fill out in the waiting room. Or the physician can simply ask two straightforward questions:_During the past month, have you felt down, depressed, or hopeless? _Have you had no interest or pleasure in doing things? A yes response to either screening question warrants further inquiry. By far the most widely used tool for this purpose in adults is the Patient Health Questionnaire–9. A Google search for “PHQ-9” will provide the scale itself for free, as well as the history of the test instrument, how to score the PHQ-9 properly, and other useful information. Antidepressant therapy in diabetics is as effective as in nondiabetics. But if baseline glycemic control is good, antidepressant therapy will have little impact on diabetes specific outcomes, Dr. Polonsky said. That was shown in a preplanned subgroup analysis involving 417 depressed elderly patients with type 2 diabetes in the Improving Mood–Promoting Access to Collaborative Treatment (IMPACT) trial.This analysis compared usual antidepressant therapy in the primary care setting with enhanced care given in collaboration with a depression care manager who provided patient education, problem-solving treatment, and intensification of antidepressant medication as needed. After 1 year, patients in the collaborative care arm were significantly less depressed and had better overall function than did those assigned to usual care; however, HbA1c values in the groups didn’t differ (Ann. Intern. Med. 2004;140:1015-24). Dr. Polonsky, who works chiefly with adults, said the data regarding depression in diabetic adolescents are more limited and equivocal. “It’s not clear that their depression rates are as high as in adults,”he noted.

 

 

 


(kah1605) #4

Hi Kathy! I totally know what you mean!!!! I actually found a fabulous therapist(she's actually a licensed clincial social worker)! She is amazingly talented at what she does! i've been seeing her for about 2 years now and although I have made a huge turn around I still feel better seeing her once a week! I was on cymbalta for awhile and it helped...but things started to change because I worked at it with her guidance!!!!! I still have my moments and days where I could just dig a hole and never come out again but for the most part I'm doing really well! I do a lot of meditation, exercise, reading ( as well as workbooks), writing, etc. I rediscovered some favorite hobbies, talk to my friends more about stuff, etc. It can get better as long as you're willing to work at it!


(Dylan404) #5

I certainly know what you mean. I was pretty severely depressed from grade 8-10, and depressed from 11- to first year university. Although I currently feel better than I have in a long time, I still think I am depressed, I'm just used to it. It's funny how you talk about some days just being awful; I totally notice that. For example, last night and day I felt excellent all day. I woke up this morning and it just wasn't there, I felt like shit. The thing is I don't really know what caused it. I think a key to staying mentally healthy with diabetes is avoiding too much stress by setting realistic goals and practicing de-stressing activities like exercise or meditation.  I'm currently talking to someone about social anxiety and it's been helping a lot, although I'm not sure thats the only thing that needs fixing. Do you talk to someone specifically about your diabetes, and if so does it help? 


(Dylan404) #6

Hmm, I took the PHQ-9 test and apparently I'm not doing that bad though. 


(Gina) #7

I went through a really bad depression in 05'. I thought that I would never come out of it... and i think you never really do come out of it totally I don't think. There are some days that I get so mad about having diabetes and I honestly feel like I can't take another day of this crap. Today I felt like that after I had a blood sugar of 356. The whole day was in the mid 100's. I think that higher blood sugars just make me feel bad and automatically I feel depressed. When my blood sugars are better I am in a great mood and want to keep having great blood sugars but it is never the same and that can really get you down also.

For me the thing that depresses me the most are the inconsistent highs and lows and that I never can keep the numbers in the middle. It frustrates me so much that instead of striving for better numbers I sometimes give up. This doesn't happen all of the time but it happens and I just try and tell myself this: Tomorrow will be better it is the only thing you can do.

Just know that if you feel depressed for a long period of time that you can seek out professional help. I recommend it highly. When I was really bad I went to see someone and it felt good to talk to someone that really didn't know me or could pass judgement on me.

Kathy, maybe if you try writing your feelings down in a journal maybe that can help to get your feelings and frustrations out. And also you always have us to vent to the people that know how you feel the most!

If you ever need anyone to talk to privately you can always send me a private message by going to my profile page.


(Dylan404) #8

Gina, I don't want to sound preachy but I notice that when I get high (say, 288 like I was earlier today) I find the best thing to do is not get frustrated. Getting frustrated triggers a stress response, releasing adrenaline which releases more sugar into our blood. I find the best thing to do when I'm high is give my correction then find a way to relax. I find deep, diaphragmic breathing helps (basically, breath through your nose, try to expand your stomach as you breath, and do this for about 5-10 minutes) and basically just thinking about how stress only hurts helps me relax too. Also, I think trying to look at things logically and creating a plan, like "well I did get high because I did this, so next time I will not do this" really helps, as I think getting depressed about the high only makes it more difficult to make the change you need. I also do not agree with your views on depression, I think it can be treated to the extent that you are no longer depressed. I think Mental health functions on a continuum (here is a picture of a continuum - http://www.camh.net/education/Resources_teachers_schools/Drug_Curriculum/Grades_11-12_Mental_Health/13883wellness_diagram12.jpg), so if you can get from a high level of depression to a low level of depression, you can also get to a level without depression. 


(BrianPQuinn) #9

I used to let things like this bother me. I mean while I never was great with my numbers and testing I hated being a diabetic. I had always thought that it made life harder and ruined things I wanted to do. I think part of the anger was that I was running low often with the NPH-Humalog combo and never realized it. I think the thing that made the biggest difference for me, was finidng the one person that I could talk to about this. Ask the stupid questions, learn about the pump, and just have someone understand what I felt. I truly feel that we should all try to find our "diabetic buddy" to support us when we are down and out. That really helped me. I know that since I found my "buddy" my outlook has changed and while I don't want the disease I no longer loathe it.


(system) #10

I went to my doctor last year for some anti-depressants and came out with a prescription for some and valium(because i didn't think i could stop drinking, even tho you can't on anti-depressants). Personally though, I didn't really want to be drugged out of my mind and my mom had bad reactions when she went on some a few years earlier..so it was likely I would too.

Instead though, I started taking "Happy Sense" which is a herbal mood enchancer. It has had no side effects on my blood sugar, it's all natural and it helps -a lot-. You take them three times a day when you eat, takes about two weeks to fully kick in though depending on the person, and it also helps with PMS and cramps!

We all go through ups and downs, whether we are diabetic or not, and sometimes we need some help on certain days to feel better..and personally this has helped me feel a lot better when I'm depressed about diabetes, or anything going on.

Remember, they aren't there to make you feel better..they are there to help you make yourself feel better. On days you aren't wanting to be happy, you know what..that's okay. We all have those days and it's totally fine to have those days. When they become more frequent, then that's something you need to seek counselling for, because drugs alone aren't going to help.


(ehalv000) #11

I suffer from depression anyway...then my daughter of two was just dx.  Now I'm really going lower into depression.  I'm trying to up my meds to see if it will help.


(Kathy-Go-Girl) #12

Hi Ella, just try to do your best...that is really all that any of us can do...and if we are doing our best, we can feel good.  Keep your heart open and pray that God will help you thru...I will keep you in my thoughts and prayers.


(TinaTenn) #13

My son has a hard time from time to time dealing with bouts of depression and he is only 8...it breaks my heart that he has to deal with this...there are times he just cries and cries about it.. I had my cry after the first time I heard Nick Jonas' "A Little Bit Longer"...now I am ready to FIGHT TO FIND A CURE..hints the name of MY message board "Fighting To Find A Cure".


(Kathy-Go-Girl) #14

Hi Dylan, I have not talked to very many people about my D...the main person being my husband because he is always wanting to know what is happening...but never anyone professional.  A lot of my depression, which I am now finding out, is caused by me and my reaction to other people's actions or my perceived actions of other people.  Probably close to the social anxiety you mentioned.  It was actually an al-anon meeting that has helped me the most to figure out what is happening with me...they have great steps to help you to look at yourself and to help you keep your side of the street clean so to speak.  I'm also reading several books, one by Laura Schlessinger, that is really helping to see what I have been doing...probably causing most of it myself - imagine that! 

I don't think any of it has to do specifically with D although it is certainly warranted with all that is involved in taking care of it.  I probably would have still suffered from it even I wasn’t a diabetic.

 


(nopainn0game) #15

im kinda a new type one and i dont know how im going to handle these mood swings for the rest of my life. one day im just fine the next ill be in love with a girl then the next day i may be so sad i dont want to get out of bed. before i was diabetic  i guess i was kinda a jock and played football and was not this way at all , the sudden change has been alot to take on i guess. i guess my reason for posting this is to see if anyone has any advise on what i should do to help control it.


(Gina) #16

Hey Jacob,

When were you diagnosed?

We all feel the way you have described the key is to not let diabetes get you down. You have to work it into your schedule without letting it get in the way of your everyday life as much as you can.Yea, I know what you are thinking it is always on your mind 24/7.

For me I started getting more active. What are things you like to do? Maybe write down a list of things you like to do and start doing them. It may help to get you motivated! When I started to feel just like you I started taking art classes to get my mind going into another direction. I was an  art student and do graphic design for a living so i figured it was a good way to get me back into hand drawing again and you know what I started feeling better.

Are you not playing football anymore? If you aren't playing anymore just because of having diabetes you should start up again. There are football players with type 1. Such as Jay Cutler and Jonathan Hayes probably more but, I would have to look it up.

Maybe for you it can be going out with your buddies for some football on the weekends? Its a good way to keep your blood sugars in good range too. If you do play just make sure you bring fast acting carbs and your blood meter and if you wear a pump just turn down your basal rate so you can play the whole game without going low. If you are prepared and watch your blood sugars you will be fine.

You control the diabetes, don't let diabetes control you. I know that sounds easier said then done. But, you can do it.

Regarding your mood swings, if your blood sugars are running higher you are more likely  to have a depressed state. This can be why you are more tired and don't want to get out of bed as well. Are you running a little bit higher?

Hang in there it gets better.

 

 

 


(nopainn0game) #17

Thanks Gina,

I was diagnosed about three months ago and all this mood swing/ depression stuff has just recently started within like the last two weeks. thanks for the advise , the only person i knew that had type one that i could talk to  is going to college so ill be the only one in my school this year. im pretty sure im going to go out for football this year still even though it might be a little harder than before. i have been staying active since i was diagnosed just last week i ran in an 8k and im doing another in about two weeks. i guess the whole thing with depression is pretty common with us diabetics so at least i know now im not sick or something. And about my BG lvls i am usually somewere 70-90 i run lower than usual for some reason. Also another weird thing that has happened since i was diagnosed is that my appetite has decreased like to half of what it was before. If im lucky i will eat two decent meals per day, and im not a small guy 5'9 184lbs. i was wandering if there was a reason for this or if im just going crazy lol.