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We’ve all felt sad or down from time to time. It’s a simple fact of life that challenges and hardships come to us all. And part of the coping process involves dealing with emotions.
However, if this becomes a regular pattern in you life and begins to interfere with your daily activities, there may be a more serious issues at stake. Depression is one of the most common mental disorders, not only in diabetics but in the general population, too.
Depression has been increasing in both adults and children in recent decades. It seems depression can result from a combination of genetic, biological, emotional and psychological factors.
Depression and Diabetes
Clinical depression is twice as common in people who suffer from diabetes. Think about all the conditions encompassed: diabetes increases risk of many complications (damage to feet, eyes, kidneys, heart, nerves etc), requires major lifestyle changes to adapt (diet, exercise etc), and often results in added expenses (diabetic supplies).
To further complicate things, with ongoing poor blood sugar control, the complications themselves, often painful and debilitating, combined with feelings of guilt and shame for past decisions, is enough to overwhelm the strongest of us.
Interestingly, while there is a clear link between diabetes and depression, it is not clear if diabetes causes depression or vice versa. In other words, it may be accurate to say that sometimes diabetes and related complications are a result of depression. While sometimes diabetes causes depression due to the load and pressures people have to deal with.
In any case, being aware of the signs is important, so you can seek treatment if you need it.
Signs of Depression
- Persistent sad, anxious or “empty” mood
- Feelings of hopelessness, pessimism or guilt
- Irritability, nervousness, or restlessness
- Loss of pleasure in former hobbies and activities
- Change in sleep patterns
- Changes in appetite or weight
- Decreased energy
- Trouble concentrating
- Sadness on waking up
When to Seek Help
If you have been experiencing any of these symptoms for 2 weeks or longer, it is wise to seek medical attention.
The longer you wait, the more rooted depression can become and the more ingrained the depression cycle will be. It may be the case that if treatment is begun early on, less treatment will be needed and symptoms will be easier to overcome or control.
Coping with Depression
One of the first things to remember about depression is you aren’t alone. It is estimated that up to 20% of people suffer symptoms of depression and it is likely under diagnosed due to people not seeking help.
There is nothing wrong with you and there is no shame in feeling down. Living life is difficult and living with diabetes can be incredibly challenging. So please, go easy on yourself.
When it comes to coping, there are several non-medical interventions and skills you can use to help you deal with depression. Many of these are similar to those we discussed when dealing with stress, as the chemical imbalances are similar in some ways.
First let’s review some UNHEALTHY, yet common coping techniques
Isolation
We generally don’t want to be around people when we’re sad. We can feel as if we’re a burden, not wanting to bring others down with us. However, fight the urge to isolate yourself as being around others who can support and help you is very beneficial.
Bingeing
Psychological disorders often manifest in impulsive behaviors, in seeking instant gratification through illogical or irrational decisions that are self-sabotaging. Don’t let all your hard work go to waste by splurging–whether it is food, alcohol, or other substances. You know you will feel guilty afterward and you’ll also make yourself worse physically, too.
Ignoring
Ignoring the problem won’t make it go away. Denying it’s existence doesn’t make it fail to exist. That said, there is an element of truth to the strategy: that is, focusing on things that are positive, encouraging, self-empowering, and motivating while trying to avoid thoughts that bring you down is certainly helpful…as long as you’re not denying the reality of a true problem and avoiding seeking help if you need it.
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Now let’s look at some HEALTHY coping techniques
Exercise
This is one of my favorites because we’ve already hammered the many benefits of exercise and here is just one more to tout.
Exercise results in a release of multiple endorphins (ie. serotonin, dopamine etc) that are well known to improve mood, help with mental clarity and are calming.
Most antidepressant medications are working on these same systems, increasing the levels of serotonin or dopamine in the brain. But, since science shows antidepressants are not as effective as once thought, why not incorporate something natural that gives you all the benefits without the side effects!
Not to mention, exercise helps improve glucose control and sleep, and increase weight loss etc.
Surround yourself with people who can love and support you
This is in contrast to the tendency to isolate. Remember that there are people who care about you and want to help you. And while they may do it imperfectly, spending time with people who are positive and uplifting is better than being alone with depressing thoughts snowballing through your mind.
Find people you can trust and share your struggles with them. Talking and processing through difficulties is very therapeutic.
Set Realistic Expectations
Depression is often gradual, both in its onset and as it subsides. I like to think of depression kind of like an onion. There are lots of layers and sometimes it takes a while to peel them back. Some causes of depression involve surface issues, while others are much deeper and take a while to uncover. Depression is much easier to treat when underlying causes are exposed and dealt with.
Avoid Making Major Life Decisions
This is wise counsel during any time of emotionally vulnerability. We have a tendency to make irrational and impulsive decisions when we are hurting or suffering. Decisions we often later regret.
Be intentional about putting things like moving, changing jobs, large purchases, or majority changes on the back burner and continue to consider the long term implications for a few months before acting. It also helps to get the advice of people you trust.
Pray, Journal, Meditate and Reflect
Have you noticed that news has changed over the years?
No longer is it simply disseminating information, but rather uses many fear tactics that are much more effective at drawing people in and information recall.
In other words, reading dramatic scary headlines causes people to click on links and passively tune into programming. The media has learned to twist events and report selectively in order to sell their product. Learn a bit of what is going on in the world, then leave it at that.
Choose, to engage your mind in activities such as prayer (which cultivates thankfulness), keeping a journal (which draws out emotions), meditation (which calms the mind), and reflection (training ground for learning to cope with underlying emotions).
Eat a Healthy Diet
This is only saved for last because we cover it again and again on this blog. But remember that a poor diet will impact more than just your blood sugar and weight, it plays a huge role in emotional health.
There is a lot of evidence to support what we know to be true: healthy diet can reduce symptoms of depression and other mental illness. And poor food choices will increase risk of mood instability.
Multiple key nutrients including omega-3 fatty acids, B vitamins, amino acids and many others have been shown to improve psychological health.
It’s common sense really. Think: Garbage in, Garbage out.
What you put into your body will dictate how you feel to a large degree.
Finally, learn more about depression. The more you understand your condition–it’s causes/ triggers, signs, symptoms and treatment options, the better equipped you will be to face the challenges ahead.
Medical Treatment
Treatment for depression will vary from person to person, but may include medications, supplements, psychotherapy (or counseling), cognitive behavioral therapy, or electroconvulsive therapy (brain stimulation).
Keep in mind that some antidepressants can have side effects, which may include weight gain and glucose elevation, so it’s important to discuss these concerns with your physician.
Depression is a real challenge for a lot of people. You may feel alone, but you’re not. There is an enormous support network available to you if you’re willing to reach out and seek help.
And remember, there is help here. Join our email list, get our weekly updates with great information, and chime in to the conversations we have via the blog. We’re always here to listen and provide a helping hand when we can. 🙂
Have you suffered with depression? What have you done to overcome it? Leave your comments below, I’d love to hear your story and no doubt sharing it will help others, too.
jim
What a huge topic. I have been struggling for ever trying to loose weight. I spent several nights reading your weight loss blogs and wasn’t finding what I really wanted. Last night and tonight I have been looking at your emotional eating blogs I can relate in some way to all you say about depression, stress and anxiety. I think they are all related.
I think for me, I have been morbidly obese for so long (they used to just say I was fat), that I fear what it is like on the other side of some arbitrary goal I have set for my self. I have now seen it many many times where I will lose weight to just above a goal number and then I will start to put it back on. I don’t usually gain back to a place I previously was but it just takes for ever to cross that goal number. Have you written about or could you recommend a reading that could help get past this? I have set very modest goals and I think it could help me to actually get past one!
Elizabeth
Hi Jim, sounds like some interesting introspection. I can’t think of an article specific to your particular situation, but know that relapse is very common and self-sabbotage can be something we do even subconsciously for various reasons. Another thing we see is that our bodies often have ‘set points’ in which we regulate various factors and sometimes we hit plateaus for a time and this can be frustrating. Keep on plowing through and try to set behavioral goals rather than just outcomes based–goals YOU have control over. For example, setting a goal of 5# weight loss in the next month might be hindered by fluid retention, hormonal cycles, medication etc and you may be doing everything right and still come away defeated. However, if you set a goal to limit your carbs to 40 grams per meal and exercise every day, you have full control over that! Regardless of your weight you can look at what you are doing and make gradual progress. So set goals which will help you accomplish your desired outcomes, but focus on the things you are doing day to day rather than just the weight itself.
jim
Thank you Elizabeth, you sound very wise. Today I mowed the lawn, about a 2 hour process. Beside avoiding flowers about the only thing to do is think. This topic was on my mind most of the time. Then I sat down with my wife and discussed this particular topic. Conclusion 1: I know pretty well what to eat – EAT IT!
2: I pretty well what not to eat – do my best NOT to eat it.
3: Don’t get on the scale. I see a Dr. for something at least every other month, that should be enough. Besides, the blood glucose knows and my belt knows and I can’t avoid them.
4. GIVE MYSELF A BREAK. It took 60 years to get this way so it will likely take several months to change.
I do like the way you say it better. Thanks!
vickie
hi im vickie .i have diabetes 2 and now my dr says i have a fatty liver .i dont drink nor smoke .i have no family support nor friends only a few on facebook .i do my shopping in line .red cross take me too my appointments .i live in hobart tasmania australia .im 57 years old and i have a lovely cat who is 3 years and 8 months old his name is tiger .hes a good boy and my best friend .he is a short furred tabby .he has a gorgeous sister named random .as she does random things and eats random foods ..they are both funny cats .i have no motivation ..no one too help me improve my health .im scared about death .of dying .i take my diabetes 2 meds and other tablets .i have too make my self today too plug the device into my exercise bike for 10 minutes a day .my dr told me i have too go on a diet .and i have too loose weight and get the fat off of my liver ..thankyou
aNNIE
a vERY TIMELY ARTICLE, THANK YOU. iT SEEMED TO TAKE ME A FEW YEARS TO NOTICE HOW I’VE BEEN DISTANCING MYSELF FROM FRIENDS & FAMILY, HOW MY JOB WAS BRINGING ME DOWN, HOW EVEN CLIMBING A SINGLE FLIGHT OF STAIRS WAS TOO MUCH WORK. i DON’T COOK REAL MEALS ANYMORE AND i FORGET MY MEDICATIONS MORE OFTEN THAN i REMEMBERED THEM.
i FINALLY DECIDED TO MAKE SOME BIG CHANGES, BUT i MADE THEM AFTER TALKING TO MY FAMILY. qUITTING MY JOB, MOVING TO THE CITY MOST OF MY FAMILY RESIDES IN TO BE CLOSER TO PEOPLE i LOVE. tHE PACKING UP & MOVING IS GETTING ME MOTIVATED TO DO THINGS INSTEAD OF SITTING & EATING.
i STILL FEEL VERY STRESSED. wHERE WILL THE MONEY COME FROM TO MOVE. wHAT WILL HAPPEN TO MY HEALTH INSURANCE WHEN i LEAVE MY JOB. i REALIZED i CAN’T ANSWER THESE QUESTIONS ON MY OWN, BUT TALKING THEM OUT WITH OTHERS HAVE HELPED A GREAT DEAL WITH STRATEGIES & IDEAS.
i AM STILL RELUCTANT TO LABEL MYSELF AS “DEPRESSED”, BUT AS i LEARN MORE ABOUT IT, IT SEEMS CLEAR THAT IS WHAT i AM REALLY FIGHTING HERE. sO i AM NOW FOCUSED ON CLOSING THIS CHAPTER OF MY LIFE AND STARTING A NEW ONE. sCARY & VERY DIFFICULT, BUT i’M FINDING IT’S DOABLE!
Elizabeth
Annie,
Sounds like you’ve really been struggling for quite some time now. I would really encourage you to discuss what you’ve been going through with a professional. Getting help may be of great benefit–sometimes there are a few basic steps people can take by way of being more intentional, but sometimes there are actual chemical or hormonal disruptions in the brain that can be helped with medication or working through issues with a psych professional that may save quite a lot of time and energy….a good investment for your health!
Amy
Great article, thanks for posting.
I have had my ups and downs that’s for sure but I have learned that it doesn’t help to sabotage yourself by coping in unhealthy ways – probably learned that lesson the hard way. I do keep a journal on a regular basis, which I have found helps a lot. And just focusing on the everyday things – diet, exercise, being nice to yourself – though sometimes a struggle, it really does make all the difference.
Elizabeth
You bring up a very good point Amy–the ‘hard way’ is an unpleasant, but usually very impacting teacher. I suspect everyone makes poor decisions during times of emotional distress (our emotions are usually not rational), but the important thing is that you learn from it. Sounds like you’ve come up with some excellent strategies & making progress in the right direction!