Diabetes and Depression

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06/04/2017

 

Diabetes and Depression

 

Author: Dr Sunil Kumar Kota

 MD (Medicine), DNB (Endocrinology), Consultant Endocrinologist

 DIABETES & ENDOCARE Clinic, Berhampur

 Email: This email address is being protected from spambots. You need JavaScript enabled to view it., Ph: +91-7749804401

 

Posted by;Odishabarta 

Depression is the most common psychiatric disorder witnessed in the diabetic patients. People with as diabetes are 3 times more likely to be diagnosed with depression than people without it. Depression can have a serious impact on a person's well being and their ability cum motivation to self-manage their condition. People with diabetes suffering from depression are at greater risk of suffering from an episode of diabetic burnout which collectively can have adverse effects on physical health and potentially instigate more long term complications.

 

Link between Diabetes and Depression: 

It’s thought that alterations in brain chemistry tied to diabetes may be related to the development of depression. Some researchers suggest that this could be due to diabetes' metabolic effect on brain function as well as the toll that the day-to-day management can take. For example, damage resulting from diabetic neuropathy or blocked blood vessels in the brain may contribute to the development of depression in people with diabetes. Conversely, changes in the brain due to depression may cause an increased risk for complications. Symptoms of depression can make it more difficult to successfully manage diabetes and prevent diabetes-related complications. It’s also possible that people with depression are more likely to develop diabetes. Because of this, it’s recommended that people who have a history of depression be screened for diabetes. Type 2 Diabetic patients who experience symptoms of depression often have higher blood sugar levels. Additionally people who have both conditions are 82 percent more likely to experience a heart attack. 

What is depression (?). 

Depression is the perception of life situations as undesirable. Often, when individuals are faced with adverse events or conditions, they spend huge amounts of effort trying to escape or deny such circumstances. Depression is the term given when an individual experiences a number of symptoms including:

 

Persistent sadness or anxiety, a feeling of hollowness, lethargy.

Feeling anxious or nervous all the time. 

An overriding feeling of hopelessness and negativity. 

Feeling helpless and powerless to change your situation. 

Loss of interest in activities or pleasures- no longer finding pleasure in activities that you once enjoyed. 

Lower energy and increased fatigue. 

Insomnia, oversleeping, awakening early in the morning. Sometimes sleeping too much. 

Concentration problems, memory problems and indecisiveness. 

Feeling isolated, sad in the morning. 

Restlessness, self mutilation (harming self) or suicidal thoughts. 

Weight change and decreased or increased appetite

 

A diagnosis of depression is made if many of these symptoms are present, continuously, for a minimum of two weeks. For people with diabetes, dealing with a lifelong condition and managing the risk of complications can seem like an overwhelming task, particularly for newly diagnosed patients. Many diabetics struggle to cope with the requirements, feeling overwhelmed and unmotivated. If diabetes is not faced with an attitude of perseverance and defiance, often depression will prevail. Avoiding unpleasantness and expending energy trying to minimize discomfort can cause symptoms of depression.  

What causes depression in people with diabetes(?). 

It's possible that the demands of managing a chronic disease such as type 2 diabetes lead to depression. This may ultimately result in difficulty managing the disease; 

The rigors of managing diabetes can be stressful and lead to symptoms of depression. 

Diabetes can cause complications and health problems that may worsen symptoms of depression. 

Depression can lead to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain — all of which are risk factors for diabetes. 

Depression affects one’s ability to perform tasks, communicate and think clearly. This can interfere with the patient’s ability to successfully manage diabetes. 

It seems likely that both diseases are caused and affected by the same risk factors. They include: family history of either of the conditions, obesity, hypertension, inactivity, coronary artery disease. However depression makes it more difficult to manage diabetes physically as well and mentally and emotionally. Depression can affect all levels of self-care. Diet, exercise, and other lifestyle choices may be negatively impacted with depression leading to poor blood sugar control. 

Poor diabetes management can also prompt symptoms similar to those of depression. For example, people with too high or too low blood sugar may experience increased feelings of anxiety, restlessness, or low energy. Low blood sugar levels can also cause feelings of shakiness and sweating, which are symptoms similar to anxiety.

Diagnosing depression in people with diabetes. 

Consultation with a doctor can let you determine whether the symptoms are the result of poor diabetes management, depression, or tied to another health concern. It starts with assessment of medical profile, family history of depression followed by psychological evaluation to learn more about symptoms, thoughts, behaviours, and other related factors. Sometimes physical exam is needed. In some cases, a blood test may be needed to rule out other underlying medical concerns, such as thyroid disorders. 

Treatment of Depression in Diabetes

Depression is typically treated through a combination of medication and therapy. Certain lifestyle changes may also help relieve your symptoms and promote overall wellness.Medications: There are many types of antidepressant medications. Selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) medications are most commonly prescribed. These medications can help relieve any symptoms of depression or anxiety that may be present. If symptoms don’t improve or worsen, a different antidepressant medication or a combination plan may be instituted. One should also discuss with the doctor about the potential side effects of these medications. 

Psychotherapy: Also known as talk therapy, psychotherapy can be effective for managing or reducing symptoms of depression. There are several forms of psychotherapy available, including cognitive behaviour therapy and interpersonal therapy. Overall, the goal of psychotherapy is to: recognize potential triggers, identify and replace unhealthy behaviours, develop a positive relationship with oneself and with others to promote healthy problem-solving skills. Sometimes for severe depression, participation in an outpatient treatment program may be recommended until symptoms improve. 

Lifestyle changes: Regular exercise can help relieve symptoms by boosting the “feel good” chemicals in your brain. These include serotonin and endorphins. Additionally, this activity triggers the growth of new brain cells in the same manner as antidepressant medications. Physical activity can also assist in diabetes management by decreasing body weight and blood sugar levels and increasing energy, stamina. Other lifestyle changes include: eating a balanced diet, maintaining a regular sleep schedule, working to reduce or better manage stressors, seeking support from family and friends.

The Vicious Cycle of Depression

 

 

 

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2018-02-22 17:53