Diabetes and Depression - What's the Connection
Understanding link between diabetes and depression key in maintaining emotional health
By Richard Rubin, PhD, CDE
It's been a while since I talked with you about depression and diabetes, but it is such an important topic I wanted to discuss it again, especially because we have recently learned important things about the connections between these two conditions.
People who have diabetes are more likely to be depressed
In the US, about one adult in ten (10%) has major depressive disorder (MDD), the most serious form of depression; among people who have diabetes MDD is twice as common. About one person in 5 (20%) who has diabetes also has MDD, and researchers estimate that almost half of all people with diabetes have MDD or milder forms of depression. That's a lot of people!
Why are people with diabetes more likely to be depressed?
Are people with diabetes more likely to be depressed because of the daily challenges and frustrations of the disease? Or is it the long-term burden of complications? It turns out both of these contribute to the higher rates of depression among people with diabetes.
But recently researchers raised another possibility – could depression be causing diabetes, instead of the other way around? There is some evidence for this notion, at least when it comes to type 2 diabetes.
Once you think about it, the idea is not that outlandish. Being depressed can lead to a less healthy lifestyle – eating more and exercising less, for example. In people at high risk for type 2 diabetes, that could push blood sugar levels up high enough for a person to have diabetes. Depression can also trigger stress hormone release, and that can also raise blood sugar levels.
Regardless of how the double whammy of diabetes and depression comes into your life, you need help to relieve your depression. Depression can ruin your emotional health, and it can wreck your physical health as well, by sapping your motivation to take good care of yourself. The problems maintaining a healthy lifestyle that can lead to developing diabetes in the first place have the same bad effect on your health once you have diabetes. So it's no surprise that research shows people with diabetes who are depressed have higher blood sugar levels and are more likely to have diabetes complications.
That's the bad news. The good news is there are effective treatments for depression that help improve your emotional health and lower your blood sugars. I'll tell you more about these treatments in a moment, but first, how can you tell if you are depressed?
Signs of depression
Depression is different from the occasional bout of the blues almost everyone experiences. Depression goes on for weeks, with almost no time when you feel right. When you are depressed you feel sad and hopeless, or you lose interest in things you generally enjoy, or both. You also have other symptoms. You might eat or sleep much more or less than usual, your energy level might be very low (one patient of mine said she felt like she was walking through molasses), you might have trouble concentrating, and you might feel really bad about yourself, as well.
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