Depression is present in a quarter of the adult population worldwide, but it is estimated that half of people with diabetes will develop it. It is a condition distinguished by a persistent feeling of sadness without a specific reason, which affects daily life by impeding enjoyment of activities that previously were entertaining, added to feelings of guilt and concern. Difficulty concentrating, inadequate rest or lack of sleep, appetite loss or overeating due to anxiety or even suicide thoughts can also be present.
Diabetes is a disease that involves time and attention, which may exert pressure on those affected. Diet changes, need for physical activity, daily medication and constant monitoring may be stressful factors in the long-term. This may cause anxiety or depression, or detonate it if additional risk factors are present. These include lack of family or social support and low socioeconomic and education levels. Besides, having a poor glycemic control and presence of diabetes complications predisposes to depression and vice versa.
But why is it important to detect depression and provide treatment? It has been proven that people with diabetes that also have depression maintain inadequate levels of blood glucose, have lower adherence to treatment, less quality of life and an increased risk of complications from diabetes, increasing mortality risk.
Having depression may discourage patients with diabetes to the point of discontinuing or neglecting treatment. This is due to decision making being affected and it is harder to comply with healthy habits, such as eating well or make physical activity, by lack of energy or motivation. Moreover, depression and anxiety may affect immune system, making it more vulnerable to infections and illness.
Treatment must be comprehensive, covering diabetes control and depression symptoms, including psychological therapy, habits and medication changes. Depression tends to be recurring so it must be prevented and treatment should be provided each time.
If you have diabetes and think you might have depression or anxiety, the following recommendations might be helpful:
- Recognize that your feelings need attention, even if you cannot describe them completely.
- Ask for help, which reflects you are giving equal importance to physical and mental health.
- Talk to family, friends and health professionals about how you feel.
- Follow the treatment prescribed by health professionals.
- Look for support groups for people with diabetes.
- Maintain contact with friends and family, avoiding isolation and ask for support if you need company for doctor’s appointments.
- Practice physical activity outside: Walk your pets, go for a walk or try a new activity.
- Enjoy food. Try preparing tasty meals, adapting them to a proper diet.
- Learn to relax: rest properly, identifying those activities that relieve stress. Moreover, avoid tobacco and alcohol in excess, because they worsen diabetes complications.
If you think that a relative or friend is being affected by depression or anxiety, offer your help. Be open and respectful in your concerns and wait for them to be prepared to talk. You can also offer your company and support in the changes they are experimenting.
Depression and anxiety need to be taken seriously. Both are diseases with a high prevalence in patients with diabetes and may have serious complications that affect quality of life and diabetes control. Due to these reasons, an annual psychological evaluation and constant support on diabetes care are important to those who suffer from diabetes.
American Diabetes Association. Mitos sobre la diabetes. Available from: http://www.diabetes.org/es/informacion-basica-de-la-diabetes/mitos/
American Diabetes Association. Blood glucose and exercise. Available from: http://www.diabetes.org/food-and-fitness/fitness/get-started-safely/blood-glucose-control-and-exercise.html
Harvard Medical School. Understanding the stress response. Available from: https://www.health.harvard.edu/staying-healthy/understanding-the-stress-response
INEGI. Principales causas de mortalidad por residencia habitual, grupos de edad y sexo del fallecido. 2015
University of California. Blood sugar and stress. Available from: https://dtc.ucsf.edu/types-of-diabetes/type2/understanding-type-2-diabetes/how-the-body-processes-sugar/blood-sugar-stress/
WebMD. Plain truth: Diabetes myths debunked. Available from: https://www.webmd.com/diabetes/features/diabetes-myths-truth#2