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Depression and Diabetes

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I know this week’s column may be a bit of a surprise to you because, as I recall in SVG, we don’t like to talk about depression, at least not in a serious way. We can all throw hands to the sky and say: “My nephew stole my last golden apple and got me SO depressed!” That’s obviously not what I am talking about. And I am also not talking about normal sad feelings, like after losing a job, or a loved one dying.{{more}} This is a normal human response, and it only gets very worrisome when it goes on for a long time or is very severe (you stop eating, feel like hurting yourself etc).

There are specific criteria for diagnosing major depression, but for our purposes, the World Health Organization defines depression as a condition “with depressed mood, loss of interest or pleasure, feelings of guilt or low self-worth, disturbed sleep or appetite, low energy, and poor concentration.” As you can see, sad mood is only a part of this. A longer list of symptoms includes:

  • Loss of interest in normal daily activities
  •  Feeling sad or down
  • Feeling hopeless
  • Crying spells for no apparent reason
  • Problems sleeping
  • Trouble focusing or concentrating
  • Difficulty making decisions
  • Unintentional weight gain or loss
  • Irritability
  • Restlessness
  • Being easily annoyed
  • Feeling fatigued or weak
  • Feeling worthless
  • Loss of interest in sex
  • Thoughts of suicide or suicidal behavior
  • Unexplained physical problems, such as back pain or headaches

Why on earth am I bringing this up in a diabetes column? Older people with diabetes, and folks with diabetes in general, are at higher risk of having depression. Some studies estimate that about 40% of folks with diabetes will have depression at some time, as compared to people without a chronic disease. In those people over the age of 75 with depression and diabetes, they have a 36% chance higher risk of dying than those the same age without depression. (And no, this is not taking into account suicides, which is the most extreme manifestation of depression.)

The reasons for having a higher risk of depression with diabetes are many, the most obvious being that having diabetes does put a degree of burden on individuals—there is a lot of care involved, and many complications when diabetes runs wild. That’s a lot of stress. And no one wants to see themselves as “sick”, so that adds to the issue.

Once depression takes hold, it puts you at a higher risk of not doing well because depressed people do not take as good care of themselves-this is called lack of self care or loss of self interest. And this can fool you, maybe just seem as if someone doesn’t want to be “bothered” and is “fed up.” You can understand those feelings from time to time, but if it goes on for weeks and months, start thinking about possible depression.

Depression is most often successfully treated with a combination of counseling and medicines. As always, talk with your doctor about your concerns—do not think your doctor “will think you are crazy.” Depression is not a reason to be ashamed. It is a medical condition that, if left untreated, can truly destroy someone’s life, and those close to him or her. Please take it seriously.

Until next week, stay safe and healthy, Vincies.

Anita Ramsetty, MD
[email protected]
Medical Director Endocrine Care Group
Tel: 843-798-4227