February 17, 2015

Do You Understand Depression - Part 1

Although the article is written for all people and about depression, I will be limiting my discussion to people with diabetes. About two-thirds of people with diabetes develop depression and about 19 percent of these develop severe depression. We are more susceptible to depression because diabetes is a chronic disease, there is no vacation, and we must battle it 24/7/365. Then add stress and other variables and it is easy to understand why depression can affect us.

Then because of the stigma attached to depression and it is easy to understand why many people with diabetes refuse to talk about or even see a doctor for depression. Yes, I have had ignorant doctors say it's all in your head and tell me I was just too lazy to deal with it. I could not leave that doctor fast enough – never to return. Then some people write me about getting help because when the subject was mentioned in a meeting with a certified diabetes educator, the educators all seem to want to end the session and leave the room. These examples are not the way to treat depression in people with diabetes.

What is depression and what causes it? These are often the questions people with diabetes want to know and they often start with their primary care doctors. In diabetes patients with severe depression, many visit their doctor the week before committing suicide. Yet many doctors do nothing to help people with diabetes and won't deal with depression, mild or severe.

Some people with diabetes attribute their depression to personal weakness or lack of will power. This stigma often becomes a barrier to seeking help. Not seeking help can often make those who suffer from depression feel worse. Now if doctors would understand the importance of helping those with depression, both mild and severe. This may only be a dream with the numbers of doctors that either ignore the patients' pleas for help or ridicule them for being weak.

Depression can be a feeling and often a feeling that is difficult to explain or describe. Doctors that are knowledgeable about depression do try to educate, when possible, their patients and work to dispel the stigma associated with depression. Some of the better doctors will prescribe a medication to help and other doctors will refer them to people that are knowledgeable about the different levels of depression.

Most people experience a “down” or a “blue” period every so often, but these normally resolve after a few hours or days. These are a normal part of living and life and should be expected. It is when these or feelings of sadness last for more than two weeks that we should seek help. A doctor that expresses empathy, concern, and a supportive environment can lift a large part of the burden and this can be very therapeutic.

Some of the problems associated with diabetes can bring on depression. These can include hypoglycemia, diabetic ketoacidosis (DKA), and hyperglycemic hyperosmolar nonketotic coma (HHNKC). The last two require immediate medical intervention and hypoglycemia may require immediate medical intervention if the blood glucose levels become too low.

In addition, just the fact that diabetes requires attention 24/7, can lead to mild or severe depression depending on other circumstances in a person's life.

3 comments:

Jane said...

Thanks for this article. I do forget that I am susceptible to depression.

Denise Elliott said...

I am fortunate indeed to live in San Diego with easy access to the wonderful Diabetes & Depression programs offered by the Behavioral Diabetes Institute (headed by Drs. Polonsky & Guzman). Until I participated in one of their two-month programs, I truly thought I was just weak-willed and lazy, instead of understanding how my diabetes and depression worked together to make things just a bit more difficult for a week or two every month. I don't know which disease came first for me - and I suppose it doesn't matter - but I deal with them together because that's the only way to keep myself on a healthy path.

Bob Fenton said...

Yes, we can all be susceptible to depression. Much depends on how long it hangs around.

There have been several articles about diabetes and depression and which came first, but none were conclusive. The one I like was written back in 2011 and was not concerned about which came first, but that if neither is managed, the cycle can be our undoing and both can ruin our health.