There is a wide range of treatments for depression from psychotherapy to medications. For individuals with diabetes, Self Management Education has therapeutic value, because better control reduces some symptoms of depression and builds self-esteem.

 

Since, there are various reasons a person may be depressed, not all forms of treatment will resolve any one persons depression. Every individual is different and that means treatments need to be tailored to your specific needs. Just because someone you know was put on Zoloft does not mean that it will work for you.

 

First step is to seek the help of a Mental Health Professional where you can get an initial assessment. Keep in mind that high or out of control blood sugars during your assessment or over the past few weeks to years will impact the diagnostic process.

 

The cause of your depression, once known, usually defines treatment. For more information on the various causes see the “Depression Etiology” section.

 

Treatment Types

Treatment is based off the initial assessment discussed in the “Depression Diagnosis” section. I would recommend meeting with a certified diabetes educator while seeking emotion help from a psychotherapist. It is important to rule out the diabetes with the help of a CDE and/or your psychotherapist.

 

Certified Diabetes Education helps people get their diabetes management under better control, which may alleviate some symptoms of depression depending on cause. Best when used in conjunction with Cognitive Behavioral Therapy or Psychodynamic Therapy.

 

Psychotherapy helps reduce various life stressors and symptoms of depression, while increasing self-esteem. It helps people resolve personal issues and manage painful feelings like anger, sadness, hopelessness and frustration, to name just a few.

 

• Cognitive Behavioral Therapy is considered most effective and research has shown good result in alleviating depression.
• Psychodynamic Therapy focus many aspects of an individual and tends to be more client centered.
• Psychoanalytical Therapy has value for seasoned therapy goers, but I do not recommend till you have mastered diabetes management. Psychoanalytic techniques tends to focus less behavioral change and more on resolving past issue that are still negatively impacting an individual in the here and now.

 

Once you have been assessed and extrinsic factor like your diabetes has been ruled out, your psychotherapist may refer you to a psychiatrist for further evaluation. For some people medication will be needed to resolve some of the symptoms of depression that talk therapy wont resolve.

Medication Therapy helps reduce or resolve some of the symptoms of depression that may be interfering with your diabetes management. Some symptoms of depression make it difficult or even impossible to manage diabetes.

 

• Selective serotonin reuptake inhibitors (SSRIs) are used to reduce symptoms of moderate to severe depression and cause minimal side effects.
• Monoamine oxidase inhibitors (MAOIs) are also used to reduce symptoms are a second line of defense due to increased side effects and need for diet restrictions.MAOIs can cause sever high blood pressure due to interactions with certain foods and medications. Generally not recommended to people living with diabetes, but in some cases when all else fails, they maybe prescribed.

Before starting any medication, over the counter medication or herbal alternative to medication, please inform both your endocrinologist and psychiatrist of the medications you are already on. As some psychiatric medications may negatively impact both diabetes and non-diabetes medications you already take and vise versa. For example, some psychiatric medication may lower or raise blood sugar levels.

 

Electroconvulsive therapy (ECT) is a last resort, when all else fails. It is much safer then it used to be with minimal side effects. It is a process where electrical currents are used to induce a small Seizure. It causes rapid changes in brain chemistry, reversing the symptoms of depression.

 

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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