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Diabetes and depression: seven things to know and resources to help you take action

By Alexander J. Wolf

Twitter summary: #Diabetes and #depression – we go past A1c and examine the mental burden of diabetes + a list of resources 4 more information.

Short summary: Diabetes is far more than A1c, blood glucose values, and insulin doses – it’s stress, mental burden, and worry. We were glad to see many talks dedicated to diabetes and mental health issues at ADA this year and have gathered our top seven takeaways – learn the stats and signs of distress or depression, talk to your healthcare provider, and take advantages of all the great resources out there.  

Sometimes, diabetes can feel like a total numbers game. What’s my A1c? How many carbs are in my meal? What’s my blood glucose, and how fast is it rising or dropping? The mental burden of dealing with these questions day-in and day-out takes a toll. And the reality is that mental health issues, particularly diabetes distress and depression, are very real for many patients.

We were pleased to see lots of discussion about these topics at the American Diabetes Association (ADA) conference earlier this month. Here are our top seven takeaways about diabetes and mental health:

  1. “Diabetes distress” is much more common than clinical depression and affects up to 39% of people with type 1, and 35% of people with type 2. This term refers to the expected worries, concerns, or threats associated with diabetes. People should be aware that if they are struggling with depression or distress, these statistics make it clear that they are not alone.

  2. The conversation should start early. Parents and health care providers are encouraged to educate adolescents with diabetes about the risks of developing mental health issues at an earlier age. As one presenter framed it, the first conversation a parent has with their child about diabetes and mental health should not be when they are in high school and already showing symptoms of depression or distress.

  3. Mental health screening should be a routine part of diabetes care. According to Dr. Carolyn Thorpe, if physicians could screen their diabetes patients for only one thing, it should be depression. Unfortunately, many healthcare providers are not experienced or trained in mental health issues.

  4. False positives remain an issue when diagnosing depression. When it comes to mental health screening, first impressions aren’t enough. Any initial positive diagnosis for a mental health condition must be followed up with an in-depth screening by a trained mental health professional. Particularly given that many first-stage screening processes only involve shortened surveys of mental health diagnostics, a more thorough follow-up is often necessary.

  5. Several therapies exist for coping with depression and diabetes distress; people need to find the one that works for them: problem-solving therapies, cognitive behavioral therapy, exercise, mind-body therapy, medications, and more. A mental health professional will know what therapies make sense for a particular person, and finding one that understands life with type 1 or type 2 diabetes is key.

  6. Depression and diabetes distress change over time. While living with diabetes is 24/7, depression or diabetes distress are not. Some patients may initially have these issues and then work to control them, whereas others may start out with no mental health complications and only over time develop them. Some days are worse than other days, some weeks worse than other weeks, and some months worse than other months. Just like diabetes, depression is not the same for everyone. For that reason, mental health screenings and awareness should not be a one-time check, but a routine part of diabetes check-ups.

  7. Depression has been linked to poor self-care, poor glycemic control, unemployment, decreased quality of life, and several other negative factors that only make it harder to live with diabetes. In other words, treating depression is equally as important as treating diabetes. If diagnosed with depression or diabetes distress, people should take it seriously and take action immediately.

Behavioral Diabetes InstituteIf you would like learn more about how to take steps towards managing your mental health as it pertains to your diabetes, here are some useful online resources:

Click here for Dr. William Polonsky’s book, Diabetes Burnout: What To Do When You Can't Take It Anymore

For skills and strategies for healthy coping with diabetes, go to: http://www.diabetesinitiative.org/build/hc_healthyCoping.html

For an online assessment of your stress levels and tutorials on how to improve your quality of life, go to: http://www.williamslifeskills.com/

To sign up for a free, online “Better Choices, Better Health” diabetes workshop, see this Stanford University resource: https://diabetes.selfmanage.org/bcbhds/SignUp

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