It’s known that if you have either type 1 or type 2 diabetes, you have an increased risk of developing depression. The good news is that there is light at the end of the tunnel, and people should know that both conditions can be managed and treated.
According to Amanda Kirpitch, a diabetes educator at the Naomi Berrie Diabetes Center at Columbia University, depression is common in patients with both type 1 and type 2 diabetes, however, research statistics vary on the actual prevalence.
“Some studies show up to 30% of patients with diabetes have concurrent depression, while others show a two-fold increase in depression with type 2 diabetes and a 3-fold increase in depression in type 1 diabetes,” Kirpitch says.
She indicates there is also research to show that the incidence of diabetes and depression is bidirectional, particularly with respect to patients with type 2 diabetes.
“People may also experience diabetes distress in certain aspects of their diabetes self-care but this can overlap with depression as well,” she explains.
How is depression treated?
Depression is treated through psychotherapy, which can be either through insight-oriented psychotherapy or cognitive behavioral therapy.
Insight-oriented psychotherapy relies on conversations between the therapist and the patient.
Cognitive behavioral therapy takes a different, short-term approach where treatment takes a hands-on approach and uses problem-solving to change patterns of thinking or behavior.
If your depression is too severe, you may have to consider anti-depressant medication.
The caveat, according to the Diabetes Council, is that antidepressant medication may be associated with an increased HbA1C level, which is the main indicator of glycemic levels. Use of antidepressants may actually result in suboptimal blood sugar levels in people with diabetes.
Kirpitch stresses anyone who is exhibiting signs or symptoms of depression should seek help from their healthcare provider.
“Healthcare providers can help clarify the diagnosis for a patient and offer resources for further assistance,” she says. “Seeking the support of family and friends is also beneficial and can help with the isolation one may feel.”
Other options for managing diabetes and depression involves diabetes self-management programs. These types of programs are successful at getting patients to look at their lifestyle, manage their blood-sugars, and their exercise levels.
Kirpitch points out that diabetes is a self-managed disease and is best supported with a team approach. “All members of the team should be aware and mindful of the patient’s depression, as it can impact all aspects of one’s self-care.”
She says having a psychologist, psychiatrist, and/or social worker as part of patient’s care team is important to fully support and manage the depression as well as the other aspects of diabetes that may be neglected. “It’s valuable to have team members that understand diabetes and the impact a chronic disease can have on mental health.”
Problem Areas In Diabetes (PAID) and Diabetes Distress Survey (DDS) provide validated screening tools available to providers.
Kirpitch offers the following tips to someone who is suffering from both diabetes and depression:
- Diabetes is a self-management disease and is best supported with a team approach.
- All members of the team should be aware and mindful of the patient’s depression, as it can impact all aspects of one’s self-care.
- Having a psychologist, psychiatrist, and/or social worker as part of patient’s care team is important to fully support and manage the depression as well as the other aspects of diabetes that may be neglected.
- It’s valuable to have team members that understand diabetes and the impact a chronic disease can have on mental health.
It’s important for people with diabetes to look out for symptoms of depression. The common mnemonic used by residents and medical students is SIGECAPS:
S: Sleep: Either increased or decreased sleep patterns
I: Interest: Loss of interest in things that you once found interesting
G: Guilt: Feeling guilty about everything and a feeling of hopelessness.
E: Energy: Lack of energy and feeling of fatigue.
C: Poor concentration and inability to focus on tasks
A: Appetite: Either an increase or decrease in appetite
P: Psychomotor: You become either super agitated and restless or you become docile and listless
S: Suicidal ideas
To meet the diagnosis of major depression, a patient must have four of the symptoms above plus depressed mood for at least two weeks.
If you answer yes for any of the above symptoms, seek the help of your doctor, a mental health professional or a diabetes educator right away. If you have thoughts about suicide, contact your healthcare professional immediately.
Sources:
- Papelbaum M, Moreira RO, Coutinho W, Kupfer R, Zagury L, Freitas S, Appolinário JC. “Depression, glycemic control and type 2 diabetes.” Diabetol Metab Syndr. 2011 Oct 7;3 (1):26. doi: 10.1186/1758-5996-3-26. Retrieved from https://www.ncbi.nlm.nih.gov/pubmed/21978660
- Carlo Carandang, MD, FAPA. “Diabetes and Depression: How to deal with it.” The Diabetes Council. Retrieved from https://www.thediabetescouncil.com/diabetes-depression-how-to-deal-with-it/
- “Diabetes and depression, Coping with the two conditions,” Retrieved from https://www.mayoclinic.org/diseases-conditions/diabetes/expert-answers/diabetes-and-depression/faq-20057904