What's the connection between diabetes and depression? How can I cope if I have both?
Answers from M. Regina Castro, M.D.
If you have diabetes — either type 1 or type 2 — you have an increased risk of developing depression. And if you're depressed, you may have a greater chance of developing type 2 diabetes. The good news is that diabetes and depression can be treated together. And effectively managing one can have a positive effect on the other.
How they're related
Though the relationship between diabetes and depression isn't fully understood:
- The rigors of managing diabetes can be stressful and lead to symptoms of depression.
- Diabetes can cause complications and health problems that may worsen symptoms of depression.
- Depression can lead to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain — all of which are risk factors for diabetes.
- Depression affects your ability to perform tasks, communicate and think clearly. This can interfere with your ability to successfully manage diabetes.
Managing the two conditions together
- Diabetes self–management programs. Diabetes programs that focus on behavior have been successful in helping people improve their metabolic control, increase fitness levels, and manage weight loss and other cardiovascular disease risk factors. They can also help improve your sense of well-being and quality of life.
- Psychotherapy. Similarly, participants in psychotherapy, particularly cognitive behavioral therapy, have reported improvements in depression, which has resulted in better diabetes management.
- Medications and lifestyle changes. Medications — for both diabetes and depression — and lifestyle changes, including different types of therapy coupled with regular exercise, can improve both conditions.
- Collaborative care. New research shows that treatment supervised by a nurse case manager that steps up therapy when needed helps improve both depression and diabetes. This type of care may not be available in most health care systems.
If you have diabetes, watch for signs and symptoms of depression, such as loss of interest in normal activities, feelings of sadness or hopelessness, and unexplained physical problems like back pain or headaches.
If you think you might be depressed, seek help right away. Your doctor or diabetes educator can refer you to a mental health professional.
M. Regina Castro, M.D.
July 24, 2014
- American Diabetes Association. Standards of medical care in diabetes — 2014. Diabetes Care. 2014;37(suppl):s14.
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- Atlantis E, et al. Collaborative care for comorbid depression and diabetes: A systematic review and meta-analysis. BMJ Open. 2014;4:e004706. http://bmjopen.bmj.com/content/4/4/e004706.abstract. Accessed May 10, 2014.
- Depression. National Institute of Mental Health. http://www.nimh.nih.gov/health/publications/depression/index.shtml. Accessed May 11, 2014.