Diabetes and Depression
Identifying and treating diapression
By Wil Dubois
The blues. Down in the dumps. The blahs. Heavyhearted. Gloomy. Dispirited. Low. Melancholy. Sad. In a dark space. And my personal favorite: In a blue funk.
If I ever start a rock & roll band, we'll call ourselves the Blue Funks.
The fact our society won't call it what it is tells us a lot. I'm talking about depression—the misunderstood disease. Yep, that's what I said: Depression is a disease. And that's actually a good thing, because diseases can be treated.
So why does depression freak people out so much? Why all the cloak-and-dagger nicknames to belittle and marginalize a serious medical condition? Why the fear of talking about depression openly and honestly? Why is this disease so stigmatized?
I think it's because brain stuff wigs people out. Our stiff-upper lip, show-some-backbone culture is doing us no favors when it comes to depression. No amount of "just being a man" can fix high cholesterol, so why do we think it will cure depression? Because while depression ultimately affects our psychology, depression actually starts in our physiology. It's not in all in your mind, it's in your blood. Depression starts at the biological level.
And diabetes and depression are linked in a powerful way. People with diabetes are twice as likely to be afflicted with depression than sugar-normals, and some studies suggest as many as one-third of all people with diabetes suffer from depression.
Worse, more than half of us don't get proper treatment for our depression. I think your doctor has some unkind words for you when your sugars are out of control. And your lipids. And your blood pressure. And your thyroid. Or if you're late getting your dilated eye exam. So how come he's not treating your depression?
Good question, and I don't have an answer for you. But it might be that whole stigma thing we mentioned above. Or, in his defense, we've only recently come to grips with just how common depression is in diabetes, and the inter-relationship between the two diseases.
Welcome to the squirrel cage
Here's the problem. Diabetes causes depression. And what does depression cause? Well, depression gets in the way of life, so among other things it causes you to not take proper care of your diabetes.
But guess what? It doesn't stop there. The worse the diabetes gets, the greater the depression gets. And when the depression gets worse, efforts at blood sugar control drop even more. And then that turbo-charges the depression further, and… Well, I think you can see where this is going. The tail-chasing tiger of depression and diabetes can leave you very sick indeed.
And let's not mince words here. Depression is deadly. This biologically based disease can so fog your thinking that you can end up harming yourself—either by direct or indirect action.
Am I depressed?
I'll be the first to admit it: Sometimes having diabetes really sucks. It gets old. It gets frustrating. It gets isolating. Keeping it in check is an unrelenting effort, with no break, and the only reward— to quote my favorite diabetes and depression expert, Dr. Bill Polonsky of the Behavioral Diabetes Institute— is that, "Nothing bad happens." Plus, even when you do everything right, sometimes your body rebels and you get bad results anyway. It can be vexing beyond words.
I'm getting depressed just thinking about it.
But, seriously, where do we cross the line between vexation and outright depression? How do you know if you are depressed and in need of treatment?
The symptoms of depression
If you feel sad, anxious, or empty for more than two weeks, you might have depression.
If your sleep patterns are messed up, and you are either unable to sleep, or are sleepy all the time for more than two weeks, you might have depression.
If your normal eating patterns are messed up, if you are eating tons more or hardly eating at all for more than two weeks, you might have depression.
If you can't get interested in things that used to make you happy for more than two weeks, you might have depression.
Remember you're much more at risk for depression than almost anyone else on the planet because of your diabetes. Remember that depression is an illness. This is nothing to be ashamed about. You didn't cause it. You can't prevent it. But you can make sure you get treatment for it. This is a medical problem that needs a medical intervention.
But to do that, you have to tell your doctor about your symptoms.
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