Depression is more common in people with diabetes compared with the general population.
Symptoms of depression affect 30% of people with diabetes, while 10% of them experience major depression. A depressive mood leads to poorer physical and mental functioning, making it more difficult to manage diabetes leading to:
Poorer blood glucose management;
Diabetes-related health problems;
Decreased quality of life;
Increased family problems; and,
Higher health-care costs.
The association between depression and diabetes is unclear. Depression may develop because of stress and anxiety related to managing diabetes. Depression often goes undiagnosed and untreated. Individuals with diabetes should be regularly screened by their health-care provider for psychological distress and psychiatric disorders (e.g. depression and anxiety).
Treatment of depression
Treating depression with psychotherapy (“talk” therapy), medication or a combination of these treatments can improve a patient’s well-being and ability to manage diabetes. In people who have diabetes and depression, scientists report that psychotherapy and antidepressant medications have positive effects on both mood and blood glucose management. Prescription antidepressant medications are generally well tolerated and safe for people with diabetes. Specific types of psychotherapy can also relieve depression However, recovery from depression takes time. Antidepressant medications can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted.
Therefore, treatment for depression in the context of diabetes should be managed by a mental health professional, such as a psychiatrist, psychologist or clinical social worker who is in close communication with the physician providing diabetes care. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided.
In some cases, a mental health professional who specializes in treating individuals with depression and co-occurring physical illnesses, such as diabetes, may be available. People with diabetes who develop depression, as well as people in treatment for depression who subsequently develop diabetes, should make sure to tell any physician they visit about the full range of medications they are taking.
Use of herbal supplements of any kind should be discussed with a physician before they are tried. Recently, scientists have discovered that St. John’s wort, an over-the-counter herbal remedy promoted as a treatment for mild depression, can have harmful interactions with some other medications. It is important to remember that depression is a disorder of the brain that can be treated in addition to whatever other illnesses a person might have, including diabetes. If you think you may be depressed or know someone who is, don’t lose hope. Seek help for depression.