Diabetes is a serious disease that may have an impact on mood. People with diabetes are 2 times more likely to develop depression than those without diabetes.
Depression is a problem in itself and makes it hard for patients to take care of themselves, which can cause high blood sugar and diabetes complications.
Tell your doctor if you think you may have depression. There are steps your doctor can take to make you feel better.
The link between diabetes and depression
Depression is a complex disease, and the underlying causes may be related to genes, environment, and mood. And managing diabetes can be both stressful and time-consuming, with lifestyle and diet-related restrictions that can make life less interesting and, in turn, exacerbate depression.
Symptoms of depression
The following are symptoms of depression.
- Sadness;
- Anxiety;
- Irritability;
- lack of interest in things once enjoyed;
- disengagement from social life;
- Inability to concentrate;
- Insomnia (difficulty falling asleep and staying asleep);
- Insomnia (difficulty falling asleep and staying asleep);
- feeling of guilt or self-denial;
- Loss of energy or fatigue;
- Changes in appetite;
- Observable mental and physical retardation;
- Thoughts of death or suicide.
If you have diabetes and show signs of depression, seek prompt medical attention.
How is depression diagnosed?
Doctors will diagnose depression based on the symptoms they know and laboratory tests are not used to diagnose depression.
How is depression treated?
The doctor will work with the patient to manage the depression and may prescribe one or more of the antidepressants described below.
- Selective 5-hydroxytryptamine reuptake inhibitors (SSRIs): affect the brain’s use of a chemical called 5-hydroxytryptamine, and changes in the balance of this chemical can help brain cells receive information better and boost mood. Such antidepressants include citalopram, escitalopram, fluoxetine, paroxetine, and sertraline.
- 5-hydroxytryptamine norepinephrine reuptake inhibitors (SNRIs): block both 5-hydroxytryptamine and norepinephrine reuptake. Like SSRIs, they can improve the way the brain sends and receives messages. Antidepressants in this category include desvenlafaxine, duloxetine, and levomilnacipran.
- Tricyclic antidepressants: Can raise levels of certain chemicals in the brain that help nerve cells communicate with each other. If these chemicals are out of balance or not working properly, messages may not pass through the brain correctly, causing depression. Common tricyclic antidepressants include amitriptyline, desipramine, doxepin, promethazine, and nortriptyline.
- Norepinephrine and dopamine reuptake inhibitors (NDRI): This is another class of reuptake inhibitors, but there is only one representative drug, bupropion. Many patients with diabetes and depression benefit from this drug.
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The side effects of each type of antidepressant usually go away or become more manageable over time. To help patients until they adjust to the medication, doctors may start treatment with a small dose and then slowly increase to a higher dose.
While research is inconclusive, some evidence suggests that the combination of tricyclic antidepressants and SSRIs may actually increase the risk of developing diabetes, possibly as a result of weight gain from tricyclic use. However, there is also evidence that antidepressants may help control blood glucose levels in people who already have type 2 diabetes.
Counseling or psychotherapy
Getting counseling or psychotherapy, especially when combined with medications, can help manage depression, or meeting with a support group can be beneficial. Consult your doctor about where you can seek more help.