Diabetes and Mental Health
Factors that could lead to depression and ways to combat it
The May 2014 American Mental Health Month theme is ‘Mind your Health' and is all about how physical health and mental health impact each other. We know that physical and emotional well-being are closely interlinked, which means living with diabetes, with all its daily self-management tasks, can put our emotional well-being at risk. People with diabetes are 2-3 times more likely to be diagnosed with depression as those without the condition, and other emotional difficulties are also very common, for people with both type 1 and type 2:
• Low mood and depression
• Anxiety (including needle phobia, fear of hypos, anxiety about long-term complications)
• Eating issues, including emotional/binge eating, omitting insulin for weight loss
• Grief reactions affecting diabetes self-care
The World Health Organization suggests that almost fifty percent of the world's population are affected by mental illness and the USA has the highest yearly prevalence rates (26 percent) for mental illnesses when compared with 14 developing and developed countries. Mental illness can impact self-esteem, relationships and ability to function, including, for people with diabetes, being motivated to deal with all the self-care tasks necessary for good health. Someone's emotional well-being can also affect their physical health and we know that people with diabetes can get ‘burned out' with all the demands and their health can deteriorate.
What causes emotional difficulties?
Whilst there is no single cause, there are a number of risk factors that predispose people to difficulties with emotional well-being. These include biological, psychological, and social factors.
• A family history of depression (especially parents and siblings) are more at risk of developing emotional difficulties
• Some brain chemicals can be deficient in people with depression
• A tendency toward thinking styles that are unhelpful
• Emotions such as anger that aren't safe or able to be expressed
• Loss of a loved one
• Loneliness and isolation
• Relationship conflict
• Stress – family, work, money worries
• Early traumas e.g. abuse, bullying
So how do you know if you are ‘mentally healthy'? There are a number of signs:
• you can feel and express a range of emotions
• you are relatively self-confident and self-accepting
• you are productive and feel you are contributing to something/someone beyond yourself
• you have good relationships with others
• you can cope with the inevitable stresses of life.
Smith and Segal, two experts in the area of emotional wellbeing, expressed it well in their quote, "People who are emotionally and mentally healthy have the tools for coping with difficult situations and maintaining a positive outlook in which they also remain focused, flexible, and creative in bad times as well as good". (2011)
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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...