Depression following lows


(akoster) #1

I have been having quite a few lows recently (I am currently adjusting my insulin, but avoiding these lows isn't always that simple). Following these lows I find myself becoming very down, even when my levels rise back to normal. I become extremely moody and when my levels are low multiple times in a day it feels as if I can't enoy anything going on around me for fear of going low again. Even after my levels are within the normal range, these periods of depression will stay (even weeks later)- but they are always following a battle with lows over an extended period of time. These lows also take a tole on me because it feels that I am gaining weight with always treating.

This is especially frustrating because I have now developed a fear of lows (or more- a fear of the depression that follows them) and this (I believe) is preventing me from lowering my a1c. I don't quite know how to cope with these moods following lows and I am wondering if anyone else has experienced this. I am not asking for help avoiding these lows; I am more curious about the emotional aspect of it.


(bassoonist1719) #2

Ariana,

I've definitely felt depressed when I'm low and if I ever feel really negative and inadequate I check because I've always been low when I feel that way.  I know that schoolwork and anything involving thinking is hard for me when I'm low/depressed so even though it's impossible to ignore schoolwork for days or weeks (sadly), you could try doing something to take your mind off the depression for an hour or two - maybe listen to music, watch a movie, read, anything that normally distracts you.  Sorry I don't have better advice but I hope that helps you!

Katie


(BrianPQuinn) #3

When I go low, I become quite emotional. More so I would always begin to dwell upon why I feel so miserable i.e. having type one. It annoys me so much. However, the one thing i always try to tell myself is that this feeling is only temporary and I will get around it eventually. Usually after a really bad low, I will read or if my number has recovered enough I do something physical to get over the anger/fear. Having a low and sadness is bad, but shouldn't be something you fear. It can be annoyingly difficult at times but again it is temporary. In trying to get your numbers down you just have to do small changes to move things. If you do big changes that is when you have a greater chance of a low happening. Correcting is not something that happens overnight. Hang in there.


(cab0902) #4

I've been trying to exercise to get healthier and to feel better, but every time that  do, I feel extremely tired and don't want to do anything, no matter how hard I try. I also notice that I get in an irritable mood but I feel almost depressed. Then I get so hungry some days that I can't seem to stop the hunger no matter what I eat. I don't know what is supposed to make me feel better if I can't do anything right for my body.


(Zemus) #5

It's normal to feel down or weird during and after having a low blood sugar. In a clinical sense, depression is a term used to describe a pattern of sadness that lasts weeks, months, or years. Sadness, on the other hand, is a normal emotion that we all go through. So try not to overly worry about being depressed when you might just be sad. I know there is a guy at South Florida that studies diabetes and depression: http://psychology.usf.edu/faculty/wsacco - A lot of that is probably pretty technical, though.

I really don't think there's much you can do about feeling down or weird after being low. The best defense is probably a good offense, meaning that your best bet is to make sure you don't get low in the first place. So just check and adjust, if needed just your lifestyle and insulin intake.


(Gina) #6

Travis that is really great advice. Feeling weird after a low or really mad is definitely something we can all relate to. If you feel down a lot you should talk to your doctor  about it. He may be able to help you.


(sjwprod) #7

Hypos can cause a series of hormone event that will create some uncontrollable emotional responses, particularly if you are a bit down before the low. 

Be patient, it is part of the low BG dance. Try and talk your MD into getting a CGM to try out. It has really helped me with avoiding the lengthly lows and the overcoming emotions. 

If I feel down or emotional, I try and step back and test bg and take my time working it back up w/o panic or frustration. 

Got to go...my cgm is calling...post exercise low management action time.


(system) #8

I wouldn't say I feel depressed after a low, just feel like POOPOO LOL. I get silly when I am low, I get the same way when I drink. Buy him a drink he's funny.


(Tina52389) #9

Hi Cassie

I know exaclty how you feel! This past semester i made myself work out every day- and the first few months were BRUTAL!! But after youve been working out for a while it becomes so much easier and working out has now become my "me time" and i look forward to it now! Even if my sugars are high (which would normally make me want to curl up in a ball and not move) i am able to work through it and still work out. And the excercising has DEFINITLY made my sugars so much easier to manage. Also, now that i am excercising i am more motivated to eat healthier and i just feel better aobut myself. So dont get too discouraged- it really really sucks to push through it- but it will definitly be worth it in the end!

Good Luck!


(kneazle_lady) #10

Hey Ariana,

I have experienced the low/depression thing. It is not fun; it is relentless. Recently, due to tight control and recent weight loss, added to traveling by train w/massive layovers--24 hour trips, by the by...and then ending up in snowy, icy conditions, hauling stuff, and so on...

It's been unrelenting. Manageable, whatever that is, but unrelenting. And get this...I gained three pounds in five stupid days thanks to lows. It makes me want to scream. I hate this.

Such is life. It's not some easily labeled thing, is it? I won't have the arrogance to tell you to just "don't get low," mainly because if it were that easy, well, you'd have done it. Take heart on the A1C as well. I try to notice the little things, like better mental function and focus that come with exercise and better control. I am trying to configure different basal rates without sending myself into DKA or seizures. I take pride in the little victories, hang around with non toxic people, ignore the rest...and commune with cats...and avoid becoming stagnant, mired. That's the worst for me anyway. I can't fall down without a struggle to get back up, if you follow. I avoid lows. It's the best I can do right now...and I swing down more than Tarzan...when I approach consistent 100 levels which is by far the most frustrating thing...but I continue to not stop taking care of myself. And if you are stuck, and you accomplish something you really don't have any motivation to do, it feels great, like a victory. Because it is.

I am nearing the basal change point...I woke up w/a BG of 29 mg/dl. Not good. But I hate, hate highs. I think some people just don't feel them like others do.

When it comes down to psychology, by the by, you can frame it as officially as you would like, but it's still all theory. Medicine is an art, not a science. Educated guesses...here's mine: lows destabilize neurotransmitters...yes, this is obvious...and vague. I think T1 is a smart person's disease. Anyone on here, even the littlest ones, could wade their way through medical jargon. Don't sell anyone else short. Read all you can (and let me know, please :-) Stability in blood sugars affects neurotransmitter levels (cue condescending remark). Like right now. Unable to sleep. Easily irritated.

I hallucinate when low. I also become extremely emotional, like an explosion. Not always, though. Sometimes, I just become lethargic. The thing is that I never want to eat or drink anything when low. No low is the same as another...

Keep on keeping on. I think the cgm would make life much better. I don't have good insurance, though I do chec 10X a day, which doesn't act as a safeguard (arggh).


(Zemus) #11

I hadn't thought about actual neurotransmitter changes that relate to the sadness and/or hallucinations with respect to being low, but that would certainly make sense. When I was young, I visually hallucinated two or three times when I was low. Now, I don't experience any of those symptoms and I haven't for years. I saw on some other boards that some people do, though.

Some people suggest that the body depletes serotonin in order to create a carbohydrate hunger. If this is true, then the lack of serotonin could really alter mood. Serotonin is the key neurotransmitter targeted with medications like Prozac and other SSRI anti-depressants (which increase the amount of serotonin in the synapse by inhibiting the body's mechanism to reabsorb it). This would also make sense because you look for changes in eating behavior from individuals who are experiencing a major depressive episode.

In addition, there is such a thing as Major Depressive Disorder with psychotic features where the person ONLY has hallucinations/delusions when they are experiencing the depression. So, if the hallucinations are only occurring during during episodes of low blood sugar, you could rationally infer that they are related through some other process(es) brought on or co-occurring with the changes in serotonin.

Just something to think about, I guess.


(kneazle_lady) #12

What about other neurotransmitters as well as serotonin? For instance, acetocholine (sp?) which affects movement, I think, as well as dopamine, also related to movement and heightened (from a layman's perspective) stimulation of senses (if dopamine levels plummet, Parkinson's issues emerge, right? My grandmother had Parkinson's)...the shaking/feeling wide awake associated with lows--at least sudden drops--also, norepinephrine...I wish I understood this better.

Maybe the dopamine levels drop, too? Dopamine--is it increased in cycles for people with schizophrenia, I think...? If these levels drop suddenly (or increase?), would hallucinations be the natural result? Until I came on here, I thought all T1 people hallucinated, etc. when low.

When I get very good control, I go through a rough period. I eventually make it through to the other end of if I wait long enough and keep at it.The lows, however, are awful.

I think something about the change from swings back and forth to stability radically changes neurotransmitter function. It "feels" physical in nature, if there is such a thing as what I'm describing.

And insulin...its usage changes greatly during times of good control. It isn't wielded to put out fires. It's used more subtly, and it becomes much more potent (not that the insulin is changed, but the context has changed). Does insulin, all by itself, cause neurotransmitters to fluctuate, depending on how much is used and how often--boluses, etc.--and maybe the high/low swings actually, from a neurotransmitter perspective, send out more comfort than stable blood sugar levels?

Maybe some people who swing up and down are actually self medicating?

Sorry for the diversion...I hope you are doing better...I hate the moment where insulin has to be lowered, even this is, technically, a good sign...because it could have unpleasant consequences...