Depression and Diabetes

Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. Depression results from abnormal working of the brain.

Depression can affect anyone, but people with diabetes can get easily. Also, people with depression may be at greater risk for developing diabetes. Treatment for depression helps people manage symptoms of both diseases, thus improving the quality of their lives.

Studies suggest that diabetes doubles the risk of depression compared to those without diabetes. The chances of becoming depressed increase as diabetes complications worsen. Research shows that depression leads to poorer physical and mental functioning, so a person is less likely to follow a diet or medication plan. Diabetes can also affect important aspects such as the social and sex life. Treating depression with therapy, medication, or a mixture of these treatments can improve a person’s well-being and ability to manage diabetes.

Causes of and the link between depression and diabetes are unclear. Depression may happen because of stress but also may result from the effect of diabetes on the brain. Studies suggest that people with diabetes who have a history of depression are more likely to develop diabetic complications than those without depression. Despite progress in brain research in the past 20 years, depression often is not diagnosed or treated. People with diabetes, their families and friends, and even their doctors may not see the symptoms of depression.


Symptoms of Depression

• Persistent sad, anxious, or "empty" mood
• Feelings of hopelessness, pessimism
• Feelings of guilt, worthlessness, helplessness
• Loss of interest or pleasure in hobbies and activities that were once enjoyed, including sex
• Decreased energy, fatigue, being "slowed down"
• Difficulty concentrating, remembering, making decisions
• Insomnia, early-morning awakening, or oversleeping
• Appetite and/or weight changes
• Thoughts of death or suicide, or suicide attempts
• Restlessness, irritability

If five or more of these symptoms are present every day for at least two weeks and interfere with routine daily activities such as work, self-care, and childcare or social life, seek an evaluation for depression.


Treatments

In people who have diabetes and depression, scientists report that psychotherapy and antidepressant medications have positive effects on both mood and blood sugar control.2 Additional trials will help us better understand the links between depression and diabetes and the behavioral and physiologic mechanisms by which improvement in depression fosters better adherence to diabetes treatment and healthier lives.

Treatment for depression in the context of diabetes should be managed by a mental health professional—for example, a psychiatrist, psychologist, or clinical social worker—who is in close communication with the physician providing the diabetes care. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as diabetes may be available. People with diabetes who develop depression, as well as people in treatment for depression who subsequently develop diabetes, should make sure to tell any physician they visit about the full range of medications they are taking.

Other mental disorders, such as bipolar disorder (manic-depressive illness) and anxiety disorders, may occur in people with diabetes, and they too can be effectively treated.

Depression is a treatable disorder of the brain. Depression can be treated in addition to whatever other illnesses a person might have, including diabetes. If you think you may be depressed or know someone who is, then call your doctor for advice