Managing Low Moods and Depression
Depression is a common, but often overlooked, problem.
Life with diabetes can be tough. In the busy setting of the diabetes clinic, discussions about managing diabetes can often focus solely on the medical and physical aspects. However, it is common to have a whole range of emotions toward diabetes. You may experience anger, frustration, guilt, hopelessness, shame, rage, bitterness, irritability, despair, fright, fear, and worry, among others. These difficult feelings can easily be overlooked.
Along with the obvious physical impact, diabetes affects our:
- Emotions—moods and feelings
- Thinking—about ourselves, others, and the future
- Behaviors—the things we do or don't do
- Our relationships with other important people in our lives
Experiencing difficult emotions connected to diabetes is very common and depression can be an often-overlooked problem. Depression has been found to be very prevalent among people with diabetes. In fact, individuals with diabetes are twice as likely to experience it as the general population. Furthermore, despite findings that people with both diabetes and depression are far more likely to have poor blood glucose management, the report, "Diabetes: State of the Nations" (2005), published by Diabetes UK, highlighted the lack of recognition and psychological support for people with diabetes.
What is Depression?
Depression is different from feeling "a bit down" or "low." Depression is diagnosed when:
- five or more of the following symptoms are present every day for more than two weeks, and
- they interfere with daily routines, such as work, diabetes self-care, childcare, or social life:
- persistent sad, irritable, or "empty" mood
- loss of interest in activities once enjoyed, including sex
- significant change in appetite or body weight (gain or loss)
- difficulty sleeping, waking very early (feeling sad), or oversleeping
- feelings of worthlessness, helplessness, guilt
- decreased energy, fatigue, feeling "lackluster"
- restlessness and irritability
- difficulty concentrating and remembering
- recurring thoughts of death or suicide.
Why Do People with Diabetes Become Depressed?
Depression is caused by a combination of biological, psychological, and social factors. This means that some people are more predisposed to developing depression due to family background and early experiences, but factors such as thinking styles, coping styles, and the level of social support available are also crucial. The daily requirements of managing diabetes can be a huge challenge—juggling medication, injections, blood glucose monitoring, and regular clinic visits, along with all the usual stresses of life can put people with diabetes at real risk of developing difficulties with low mood.
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Many people say that depression is a side effect or complication of diabetes. Without discounting the association of the psychological condition with the physical one, I'm not convinced that our high and/or unstable glucose levels are directly responsible for that change in our mental state. My belief is that the unrelenting need for self-care, for following the sort of care schedules that can drive licensed, professional caregivers crazy, is what overwhelms us...