What Is Depression?
Depression is more than feeling a little down or having a sad day. It’s a persistent state of being that can interfere with thoughts, behavior, health and daily activities like sleeping, eating and working. The chance of being diagnosed with a depressive disorder is twice as high for people with diabetes.Symptoms of Depression
Depression is diagnosed based on several symptoms occurring at the same time for longer than two weeks. These symptoms interfere with day-to-day activities.Symptoms of depression can include:
- A feeling of sadness, emptiness or anxiety
- Feeling guilty, helpless or worthless
- Feeling hopeless or pessimistic
- Having far less energy than normal
- Feeling irritable or restless
- Thinking about death or suicide
- Loss of interest in what once provided pleasure
- Trouble remembering, making decisions or concentrating
- Physical ailments that don’t respond to traditional treatment
- A health care provider
- An employee assistance program at work
- A community mental health center, or a university- or medical school-affiliated program
- Hospital clinics or emergency rooms, psychiatry departments or mental health outpatient services
- Private clinics or mental health professionals, including counselors, psychologists, social workers and psychiatrists
- Community or family service agencies
- Local clergy
Is There a Link Between Diabetes and Depression?
Although they are not entirely able to explain the reasons for the connection, many experts see a link between diabetes and depression. While some have found that having diabetes can make people more susceptible to depression, others believe that depression can lead to type 2 diabetes.“There are two general theories,” explains Lawrence Fisher, Ph.D., a professor in family and community medicine at the University of California at San Francisco. “One says that depression hits people with diabetes more often than the general population because they get burned out managing their disease. They get upset, gloomy and hopeless and many feel that they can't control what's going on.
“The second theory looks at the links between glucose metabolism and the physiological response to stress, distress and depression. All of these factors are linked through the neuroendocrine system in ways that are not well-documented. It is thought by some that high, chronic levels of depression influence glucose metabolism over time through these interlocking physiological systems.”
Regardless of the reason, people with diabetes are at high risk for depression; Fisher puts the rate at about 25%. According to a study published in The Diabetes Educator, the rate of depression in women with diabetes is double that of men with the disease.
Sue Penckofer, a registered nurse and professor at the Marcella Niehoff School of Nursing at Loyola University, has spent a significant portion of her life studying the connections between diabetes, women and depression.
“Part of the problem is that some women don’t make their self-care a priority,” says Penckofer. “Instead, they continue to care for their families, do their jobs and all else, and little time is left for them to take care of themselves.” This can lead to problems with managing their diabetes, in turn leading to guilt and depression.
