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July 7, 2014

Diabetes and Women: Preventing and Overcoming Depression with Chronic Illness

July 7, 2014

Molly Barnes, MS, RD, LDN
Cooley Dickinson Medical Group Diabetes Center

Diabetes and Depression
If you have a chronic disease, such as diabetes, you are at greater risk of developing depression and if you are currently experiencing symptoms of depression, you are not alone. People with diabetes and other chronic diseases are more likely to have depression than people without diabetes.  Managing any chronic condition adds a lot of stress and strain to one’s daily life. Additionally, many people with a chronic disease feel alone and isolated in managing their diagnosis and, specifically with diabetes, one can easily feel out of control if you are having trouble keeping your blood sugar in your target range.

Dealing with both depression and diabetes can feel like you are stuck between a rock and a hard place because depression also makes it difficult to find the motivation and energy to follow your diabetes self-care plan, including preparing and eating healthy meals, exercising regularly, taking medications consistently, and regularly checking your blood sugar.

Diabetes and Stress
Similarly to depression and diabetes, stress and diabetes as well as stress and depression are often linked. Stress of any kind – both emotional and physical – initiates the “fight or flight” response, resulting in a cascade of hormones, which raise blood sugar, blood pressure, and heart rate. The body releases stored glucose from the liver and muscles to provide the energy to cells to prepare the body to “fight or flee.” However, in people with diabetes, insulin may not be readily available to effectively utilize the additional sugar in the blood, so this sugar remains in the blood.

Recognizing Depression
Depression moves in slowly and if we do not know how to recognize the signs and symptoms it can settle in and stick around for a long time before we even know it is there. Identifying the signs and symptoms early can help to prevent depression from feeling insurmountable. Ask yourself if you have been feeling any of the following symptoms for more than a few days at a time:

• Loss of pleasure in things you used to enjoy
• Trouble sleeping or sleeping more than usual
• Eating more or less than usual, resulting in unintentional weight gain or loss
• Difficulty focusing or paying attention
• Low energy, fatigue, chronically tired
• Anxiety or nervousness
• Feeling like you are a burden to others or feel an overwhelming sense of guilt
• A preoccupation with death and/or feeling like you want to die or end your life

If you feel that you might be experiencing any of the above-mentioned symptoms, help is available and there are numerous treatment options for depression. The first step is to talk to your health care team – it is important to tell them how you have been feeling and let them know that you are seeking support and help with managing your depressive symptoms.

Strategies to Prevent and Manage Depression
Always discuss any concerns you are having with your healthcare team – they are there to
support and guide you on your path to health and this includes mental health!

Ask for and seek out support with diabetes, life stressors and depression – consider joining a
support group and/or meeting with a therapist or another mental health professional to feel less isolated and to process any issues as they arise.

Incorporate exercise and physical activity into your daily routine – this stimulates the
production of “feel good” hormones to help regulate mood, lower stress and lower blood sugar levels.

Incorporate mindfulness/active awareness into your daily routine – practicing mindfulness
helps to raise awareness in all areas of one’s life.

Replace negative thoughts with positive thoughts as you notice them arise – each time you notice a negative thought (such as, “I can’t get my blood sugar under control”), try to find a more positive replacement (such as, “my blood sugar may not always be on target with my goal, but my last reading was close!”).

Incorporate relaxation exercises/techniques into your day – breathing exercises, progressive relaxation, body scan, guided meditation, gentle yoga, and/or positive visualization exercises.

If you ever feel an overwhelming sense of desperation in managing your depression or you are considering suicide, please contact your health care provider, a 24-hour crisis hotline (phone numbers listed below), or call 9-1-1 immediately.

• Crisis Services: 586-5555 or toll free 800-562-0112
• Samaritans Statewide Hotline: 1-877-870-HOPE (4673)
• National Suicide Prevention Hotline: 1-800-273-TALK (8255); press #1 if you are a veteran
• The Trevor Helpline: 1-866-4-U-TREVOR (488-7386) – specifically for lesbian, gay, bisexual and transgender youth and young adults

The Diabetes Center  offers free monthly support groups for people living with Type I and Type II diabetes.

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