DEPRESSION, STRESS and DIABETES
Major depression in the UK population at any one time is about 5%, although as many as one person in three may experience an episode of depression in their lifetime. The presence of other illnesses may complicate or worsen depression and vice versa.
Research has shown that depression may occur in:
– Up to 60% of stroke patients
– Up to 40% of people with Parkinson’s disease
– Up to 42% of cancer patients
– Up to 21% of people with irritable bowel syndrome
– Up to 14-18% of people with diabetes
A study by Brazilian researchers, presented at the American Diabetes Association Conference 1998, showed that among a group of people with diabetes those whose HbA1c levels averaged less than 9%, only 21% tested positive for depression according to the results of a standardised test. By comparison of those with HbA1cs over 9%, 42% tested positive for depression. Other research has shown that people with chronic conditions including diabetes are three times more likely to suffer depression than the general population.
The researchers used cognitive therapy to reverse the depression. In those people where depression improved, there was an average HbA1c of 8.3% while those who showed little improvement had an average of 11.3%. While these results show an association between high blood sugars and depression, it remains unclear whether high blood sugars cause the depression or depression causes high blood sugars.
How do you know if you are depressed?
The signs of depression include the following:
– No longer enjoying or being interested in most activities.
– Feeling tired or lacking energy.
– Being agitated or lethargic.
– Feeling sad or low much of the time.
– Weight gain or weight loss.
– Sleeping too little or too much.
– Difficulty paying attention or making decisions.
How does depression affect people with diabetes?
Research [Ref 1] using questionnaires has shown that depression in people with both Type 1 and Type 2 diabetes may have the following effects:
– They are less likely to eat the types and amounts of food recommended.
– Less likely to take all their medications.
– Less likely to function well, both physically and mentally.
– Greater absenteeism from work.
Stress and diabetes This is a very frequently used word and tends to cover a multitude of sins but while it may seem an over-used word, stress can nevertheless be a very real problem and one that needs recognising. Most of us probably know that there is a ‘top ten’ list of things that are stressful – the death of someone close, moving house, divorce, etc. People with diabetes are just as likely to suffer these stressful situations as other people. In addition diabetes, its diagnosis or the diagnosis of complications are stressful for many people. We also have to remember that it may be stressful for close relatives – spouses, partners, parents and siblings. For people with diabetes, stress can affect blood sugars and although much of the medical literature says that stress makes the blood glucose levels rise, my daughter, and many others, maintain that stress makes her blood sugars fall and she has more hypos. May be stress affects people in different ways or may be blood sugars just fluctuate more, whatever is the case, the message has to be learn to know how stress affects you and your blood glucose levels.