In general, depression can impact anyone at anytime and does not need to be a life long illness. Depression comes in a wide range of intensities from a low lying depression called dysthymia to more debilitating, which may be diagnosed as a Major Depressive Disorder. A Major Depressive Disorder can be an acute or a recurrent problem impacting all areas of life.

 

Depression is a complex issue that is difficult to define as it comes with many symptoms and no one person presents the same. Most people are not the stereotypical individual that society has presented in movies, who lives on their couch all day, unable to function at any level. Most people living with depression work a job and function well enough to maintain relationships.

 

Depression is a mood disorder that typically includes feelings of: detachment, loneliness, isolation, depression, hopelessness and sadness. It may cause a decreased enjoyment of activities that were previously enjoyed and a lack of interest in the world around them.

 

According to the American Association of Diabetes Educators as well as the American Diabetes Association, depression is 2-3 times more prevalent in people with both Type I and Type II diabetes.

 

Depression Etiology

There are several different ideas as to the cause of depression that have been identified. These include genetics, social and environmental factors, and neurobiological factors. One or all of these may play a role. Regardless of exact cause, depression is a chemical imbalance predominantly seen in those with childhood trauma.

 

Other causes may relate to traumatic events in life that have a devastating impact on an individual. Like people who experience a traumatic loss may develop symptoms similar to depression. When the loss is the death of a love one the symptoms although the same as depression it would be diagnosed as mourning, unless it last longer then 2 months at which time it would be considered depression.

 

Reasons it is more prevalent in individuals with Type 1 diabetes:

• Unstable Blood Glucose: Having unstable blood sugar during childhood can lead to brain issues such as developing a chemical imbalance, reduced gray matter and frontal lobe damage. Reasons it is more prevalent in individuals with Type I and Type II diabetes:
• Life Style: For many it’s a loss of freedom, to live life free of constrictions and without having to worry about management of an illness. No longer being able to eat what you want or leave your home without thinking about your blood sugar needs.
• Anger: When a person lives with a chronic illness many things get internalized usually in the form of self-blame. Depression is anger turned upon oneself. Everything from internal statements of “I did this to myself. I caused this!” to “This shouldn’t be that hard so, why am I always messing this up! I am stupid because I should have remembered to test my blood, take my pill or count the carbs!”
• Family Stressors: When someone gets diabetes, family members start acting differently, which can cause relationships to fall apart while causing extreme levels of anxiety and arguments within the family. The person with diabetes may take on the family stress and blame themselves for everyone’s behaviors and see it as their fault.
• High Blood Glucose: It mirrors the symptoms of depression (see symptoms below.)

 

Depression Symptoms

The symptoms of depression are vast but the issue is not the complexity of the symptoms but that many of the symptoms of high blood glucose levels are similar to depression. This is important when diagnosing depression in an individual living with diabetes, as high blood sugar needs to be ruled out.

 

Major Depressive Disorder and High Blood Glucose Levels Symptoms:

• Depressed mood
• Loss of interest or pleasure
• Weight loss
• Increase or decrease of appetite
• Hypersomnia (excessive sleep) or Insomnia (trouble falling asleep)
• Fatigue or loss of energy
• Diminished ability to think or concentrate, or indecisiveness
• Self-Blame/Guilt

 

Other Major Depressive Disorder Symptoms:

• Weight Gain
• Psychomotor agitation or retardation
• Recurrent thoughts of death, suicidal ideation or suicide attempts

 

Other High Blood Glucose Symptoms:

• Dehydration
• Blurred vision
• Increased thirst and frequent urination

 

If you believe you might be depressed and would like some help. Please contact Eliot LeBow LCSW, CDE at 917-272-4829 to schedule your first Diabetes-Focused Therapy Session.

 

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