How is Depression Treated?
If you recognize yourself in the list of depression symptoms above then you are not alone. Although depression doesn't just go away by itself, it can be successfully treated. Antidepressant medication can be useful, but research indicates that therapy, particularly Cognitive Behavioral Therapy (CBT), either alone or in combination with antidepressants, is very effective in tackling the symptoms of depression.
What is Cognitive Behavioral Therapy?
I touched on CBT in my previous column, Managing Your Diabetes Diagnosis. CBT was developed by the psychiatrist Aaron Beck in the 1960s. It proposes that there are four interrelated aspects to depression:
- Thoughts and thinking styles ("cogntions")
- Emotions and feelings
- Behaviors—what we do or don't do
- Physical symptoms
The theory of CBT recommends that by changing any of the components above, particularly our thinking patterns, we can begin to make changes to our mood.
Unhelpful Thinking in Depression and Diabetes
Everyone, with diabetes or not, has thoughts that are sometimes unhelpful. When you feel depressed or low, you might like to try to get into the habit of becoming aware of the thoughts you are having when you notice your mood changing. Writing down your thoughts may feel like a lot of effort, but it can really help you to capture and explore your styles of thinking, and see which are helpful and which are less so.
To use the process of Cognitive Behavioral Therapy to assist you in dealing with your thoughts, notice what situation or event prompts the thought(s), and focus on what is happening in your body and what you do. Notice your:
- Body sensations—low energy, feel sick, dry mouth
- Behaviors—snapped at my partner
Then further battle unhelpful thinking with the 3 steps to using CBT:
- Notice—What do you tell yourself? What are the thoughts you notice running through your mind?
- Challenge your thoughts
- Come up with an alternative, balanced thought
You're Not Alone
When you first begin to examine your thinking styles, it is likely to feel unfamiliar. However, like any skill you have learned, with practice it will feel easier until you are naturally having more supportive, constructive thinking styles. Many people also gain from the support of a psychologist or counselor, so you might like to talk to your doctor about a referral or investigate seeking a private therapist for yourself.
Other Ways to Manage Your Thinking
In addition to CBT, there are other way you can help yourself through depression. Becoming more physically active can have a positive impact on your diabetes control as well as your mood. Finding time to relax can be very helpful. But equally important is that you find ways to increase your pleasurable activities—life with diabetes can be hard work so make sure you have time to inject a bit of fun into your life!
Dr. Jen Nash is a clinical psychologist who has lived with diabetes for more than 20 years. She runs www.PositiveDiabetes.com, an education, therapy and coaching service that supports people with type 1 and 2 to manage the emotional and psychological impact of day to day life with diabetes.
NOTE: The information is not intended to be a replacement or substitute for consultation with a qualified medical professional or for professional medical advice related to diabetes or another medical condition. Please contact your physician or medical professional with any questions and concerns about your medical condition.
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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...