Diabetes and Depression: Overview
Depression can impact anyone at any time and does not need to be a life long illness. It comes in a wide range of intensities from low-lying depression called dysthymia to the more debilitating, Major Depressive Disorder (MDD). A MDD 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 way. Diabetes tends to complicate the diagnosis of depression, as many symptoms of high blood sugars are similar or identical to the symptoms of depression.
Most people living with depression 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 and function well enough to maintain relationships. Depression is a mood disorder that typically includes feelings of:
It may cause decreased enjoyment of previously enjoyed activities, increased or decreased sleep, increased or decreased appetite and a lack of interest in the world around them.1
According to the American Association of Diabetes Educators, depression is 2 to 3 times more prevalent in people with both Type I and Type II diabetes.2-4
There are several different ideas as to the cause of depression. These include:
- Social and environmental factors
- Neurobiological factors.
One or all of these may play a role.
Regardless of the exact cause, chronic depression is a chemical imbalance, which is commonly seen in those with childhood trauma. Other causes may relate to traumatic life events, which includes being diagnosed with a chronic illness or experiencing a major loss. Symptoms of depression tend to surface with the loss of a loved one. In this case since it follows a loss it would be diagnosed as mourning. However if the mourning period lasts longer than a few months, it would be re-diagnosed as depression.
Depression in People With Type 1 Diabetes
Consistent levels of high blood sugar during childhood can cause symptoms of depression when the brain is at its most vulnerable. After long periods of depressive symptoms, the brain chemically adapts in efforts to lift the depressive symptoms of the child. The brain develops with these adaptations as normal and this sets the stage for increased depression during adulthood.
Research has shown that unstable and low blood glucose during childhood leads to unhealthy brain development in the frontal lobe area of the brain. This area is responsible for many things, including attention, concentration, focus, and the ability to recall as well as retain information. As a result, issues of chemical imbalance, reduced gray matter, and damage in the frontal lobe occur.
Why Depression is More Prevalent in People With Type 1 and Type 2 Diabetes?
Life Style: For many living with diabetes, there is a loss of freedom and spontaneity. You are no longer able to eat what you want or leave your home without thinking about your blood sugar needs. This increases frustration, and for some, may contribute to feelings of depression.
Anger: When a person lives with a chronic illness many things get internalized, usually in the form of self-blame or self-victimization. Depression is anger turned upon oneself, which causes internal thoughts ranging from "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 sugar, take my pill or count the carbs!" or “Why me!”
Family Stressors: When someone is diagnosed with 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. While other’s struggle with family members micromanaging their diabetes.
High Blood Glucose: High levels of sugar in the blood stream causes symptoms that are very similar to depression (for more on symptoms, click here.)