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Diabetes and Depression - A Vicious Cycle

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Updated June 12, 2014

Depression and diabetes are two conditions that can sometimes go hand-in-hand. First, diabetes can increase the risk of depression, according to a growing body of research. In fact, having diabetes doubles the risk of depression, compared to people who don't have the disease. Conversely, depression also can increase the risk of Type 2 diabetes, research shows.

It's often a vicious cycle. Depression can get worse as the complications of diabetes get worse, and being depressed can stop people from managing their diabetes as effectively as they need to, which can lead to increased incidence of long-term complications such as retinopathy, neuropathy or nephropathy.

Depression can color everything in a person's life. The ability to do everyday activities can become overwhelming, and this includes taking care of diabetes, such as taking medications, eating right and exercising. Fatigue and lack of enthusiasm can cause people to withdraw from the things they used to like to do. Emotions become flat and thoughts can turn to sadness, anxiety or even suicide.

Unfortunately, a large proportion of people suffering from depression and diabetes never receive help for the depression. Sometimes it's not recognized by healthcare professionals, and sometimes people who are depressed don't communicate to their doctors about their thoughts and feelings or don't realize that they are depressed.

Symptoms of Depression

Recognizing the symptoms of depression is important for getting the help that's needed.

  • Feeling sad for a prolonged period of time.
  • Feeling restless or anxious for no apparent reason
  • Feeling hopeless, helpless or worthless
  • Not being able to concentrate
  • Inability to remember things
  • Fatigue or loss of energy, feeling "dragged out" and tired
  • Lack of appetite, or increased eating with accompanying weight changes
  • No interest in the things that used to bring pleasure
  • Not sleeping at night or sleeping sleeping too much
  • Suicidal thoughts or thinking about death

Treating Depression

Getting help for depression not only improves a person's quality of life, it also can help people manage their diabetes better by giving them more energy and a more hopeful outlook. Talking to a counselor or therapist can be helpful. Most prescription anti-depressant drugs are appropriate for people with diabetes and do not affect glycemic control. Nortriptyline (Pamelor, Aventyl), however, can affect blood glucose levels, so it should be used with caution to treat depression that is complicated by a co-existing diagnosis of diabetes.

SOURCES:

"National Institute of Mental Health." Older Adults and Mental Health. 12 Oct. 2006. National Institutes of Health. 10/30/2006

Goldney, MD, Robert D., Phillips, MA Pat. J., Fisher, BA HONS, Laura J., and Wilson, PHD, David H.. "Diabetes, Depression and Quality of Life." Diabetes Care 27:1066-10702004 1. 10/30/06

Golden, MD, MHS, Sherita Hill, Williams, PHD, MPH, Janice E., Ford, MD, MPH, Daniel E., Yeh, PHD, Hsin-Chieh, Sanford, MSPH, Catherine Paton, Nieto, MD, PHD, F. Javier Nieto and Brancati, MD, MHS, Frederick L.. "Depressive Symptoms and the Risk of Type 2 Diabetes." Diabetes Care 27:429-4352004 1. 10/30/06

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