About Depression

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With people with diabetes being at a greater risk of developing depression than those without diabetes, it is imperative to recognize the signs of depression. Failing to recognize and/or treat this disorder can impact how you or your loved one chooses to manage diabetes. Treatment for depression helps people manage symptoms of both diseases, thus improving the quality of their lives.

Several studies suggest that diabetes doubles the risk of depression compared to those without the disorder. The chances of becoming depressed increase as diabetes complications worsen. Research shows that depression leads to poorer physical and mental functioning, so a person is less likely to follow a required diet or medication plan. Treating depression with psychotherapy, medication, or a combination of these treatments can improve a patient's well-being and ability to manage diabetes.

Causes underlying the association between depression and diabetes are unclear. Depression may develop because of stress but also may result from the metabolic effects of diabetes on the brain. Studies suggest that people with diabetes who have a history of depression are more likely to develop diabetic complications than those without depression. People who suffer from both diabetes and depression tend to have higher health care costs in primary care.

Despite the enormous advances in brain research in the past 20 years, depression often goes undiagnosed and untreated. People with diabetes, their families and friends, and even their physicians may not distinguish the symptoms of depression. However, skilled health professionals will recognize these symptoms and inquire about their duration and severity, diagnose the disorder, and suggest appropriate treatment.

Treatment for Depression

Depression Facts
Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. NIMH-sponsored studies estimate that 6% of 9- to 17-year-olds in the U.S. and almost 10 percent of American adults, or about 20.9 million people age 18 and older, experience some form of depression every year. Although available therapies alleviate symptoms in over 80 percent of those treated, less than half of people with depression get the help they need.

Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person's level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or other environmental factors. Whatever its origins, depression can limit the energy needed to keep focused on treatment for other disorders, such as diabetes.

Symptoms of Depression
Symptoms of depression most commonly include:

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Restlessness, irritability

If five or more of these symptoms are present every day for at least two weeks and interfere with routine daily activities such as work, self-care, and childcare or social life, seek an evaluation for depression.

SOURCES:

1 - Anderson R, Freedland K, Clouse R, Lustman P. (2001). "The Prevalence of Comorbid Depression in Adults with Diabetes." Diabetes Care 24(6).
2 - Goldney R, Phillips P, Fisher L, Wilson D. (2004). "Diabetes, Depression, and Quality of Life." Diabetes Care 27(5).
3 - National Institutes of Mental Health. Depression. http://www.nimh.nih.gov/health/publications/depression/complete-index.shtml. (Accessed 1/2012).
4 - National Institutes of Mental Health. Statistics. http://www.nimh.nih.gov/statistics/index.shtml. (Accessed 1/2012).