For the Depressed
Feeling down once in a while is normal. But some people feel
a sadness that just won’t go away. Life seems hopeless.
Feeling this way most of the day for two weeks or more is
a sign of serious depression.
At any given time, most people
with diabetes do not have depression. But studies show
that diabetics are at a greater risk of depression .
There are no easy answers about why this is true.
The stress of daily diabetes management can build. You may
feel alone or set apart from your friends and family because
of all this extra work.
If you face diabetes complications such as nerve damage,
or if you are having trouble keeping your blood sugar levels
where you’d like, you may feel like you’re losing
control of your diabetes. Even tension between you and your
doctor may make you feel frustrated and sad.
Just like denial, depression can get you into a vicious cycle.
It can block good diabetes self-care. If you are depressed
and have no energy, chances are you will find such tasks as
regular blood sugar testing too much. If you feel so anxious
that you can’t think straight, it will be hard to keep
up with a good diet. You may not feel like eating at all.
Of course, this will affect your blood sugar levels.
What to Do?
Spotting depression is the first step. Getting help is the
second. If you have been feeling really sad, blue, or down
in the dumps, check for these symptoms:
1. Loss of pleasure. You no longer take interest in doing
things you used to enjoy.
2. Change in sleep patterns. You have trouble falling asleep,
you wake often during the night, or you want to sleep more
than usual, including during the day.
3. Early to rise. You wake up earlier than usual and cannot
to get back to sleep.
4. Change in appetite. You eat more or less than you used
to, resulting in a quick weight gain or weight loss.
5. Trouble concentrating. You can’t watch a TV program
or read an article because other thoughts or feelings get
in the way.
6. Loss of energy. You feel tired all the time.
7. Nervousness. You always feel so anxious you can’t
sit still.
8. Guilt. You feel you "never do anything right"
and worry that you are a burden to others.
9. Morning sadness. You feel worse in the morning than you
do the rest of the day.
10. Suicidal thoughts. You feel you want to die or are thinking
about ways to hurt yourself.
If you have three or more of these symptoms, or if you have
just one or two but have been feeling bad for two weeks or
more, it’s time to get help.
Getting Help
If you are feeling symptoms of depression, don’t keep
them to yourself. First, talk them over with your doctor.
There may a physical cause for your depression.
Diabetes that is in poor control can cause symptoms that
look like depression. During the day, high or low blood sugar
may make you feel tired or anxious. Low blood sugar levels
can also lead to hunger and eating too much. If you have low
blood sugar at night, it could disturb your sleep. If you
have high blood sugar at night, you may get up often to urinate
and then feel tired during the day.
Other physical causes of depression can include
 alcohol
or drug abuse
thyroid
problems
side
effects from some medications
Do not stop taking a medication without telling your doctor.
Your doctor will be able to help you discover if a physical
problem is at the root of your sad feelings.
If you and your doctor rule out physical causes, your doctor
will most likely refer you to a specialist. You might talk
with a psychiatrist, psychologist, psychiatric nurse, licensed
clinical social worker, or professional counselor. In fact,
your doctor may already work with mental health professionals
on a diabetes treatment team.
All of these mental health professionals can guide you through
the rough waters of depression. In general, there are two
types of treatment. One is psychotherapy, or counseling. The
other is antidepressant medication.
Psychotherapy with a well-trained therapist can help you
look at the problems that bring on depression. It can also
help you find ways to relieve the problem. Therapy can be
short term or long term. You should be sure you feel at ease
with the therapist you choose.
If medication is advised, you will need to consult with a
psychiatrist (a medical doctor with special training in diagnosing
and treating mental or emotional disorders). Psychiatrists
are the only mental health professionals who can prescribe
medication and treat physical causes of depression.
If you opt for trying an antidepressant drug, talk to the
psychiatrist and your primary care provider about side effects,
including how it might affect your blood glucose levels. Make
sure that the doctors will consult about your care when needed.
Many people do well with a combination of medication and psychotherapy.
If you have symptoms of depression, don’t wait too long
to get help. If your health care provider cannot refer you
to a mental health professional, contact your local psychiatric
society or psychiatry department of a medical school, or the
local branch of organizations for psychiatric social workers,
psychologists, or mental health counselors. Your local American
Diabetes Association may also be a good resource for counselors
who have worked with people with diabetes.
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