A social worker discusses diabetes and depression
Depression is serious mental health concern that goes far beyond general unhappiness. According to the Centre of Addiction and Mental Health (CAMH), depression is the leading cause of disability globally. Those with severe depression find it difficult to function in their everyday lives, and fifty per cent of those diagnosed with clinical depression will experience a relapse at some point in their lives.
When you have diabetes, your risk of depression increases. The Canadian Diabetes Association (CDA) says depression is twice as common for individuals with diabetes, as compared to the general population. And, major depression is found in at least 15% of people with diabetes.
If you or someone you know has diabetes, be alert to the signs and symptoms of depression. To help you learn more about depression and the treatment options available, KRAFT Living Well with Diabetes recently spoke with Claudia Tindall, an advanced practice mental health clinician and registered social worker with more than 25 years of experience.
Just as diabetes must be carefully managed on an ongoing basis, the same goes for depression. If left alone, it can get worse. But when treated properly, you can regain the quality of life you once enjoyed.
Signs and symptoms of depression
For a number of reasons, depression often goes undiagnosed and untreated. Depressed individuals may feel ashamed or embarrassed to talk about their problems. They might think things will improve on their own. Or, they might be in a state of denial and not even realize they're suffering from depression.
Unfortunately, if depression is left untreated, it can fester for many years and take a heavy toll on an individual's personal and professional life. When someone experiences five or more of the following symptoms, it can be a sign of depression:
Feelings of sadness and despair that are present almost every day, last throughout the day
Impaired performance at school, work or in social relationships
Changes in appetite or weight
Loss of interest in work, hobbies, people or sex
Withdrawal from family members and friends
Feelings of uselessness, hopelessness, guilt, pessimism or low self-esteem
Feelings of agitation, sluggishness or fatigue
Difficulty concentrating, remembering things or making decisions
Crying easily, or feeling the urge to cry but not being able to
Having thoughts of suicide (these should always be taken seriously)
Feeling out of touch with reality – this may include hearing voice or having strange ideas
While the signs and symptoms of depression can vary widely from person to person, the onset of a depression often coincides with a major life change. For example, receiving a diabetes diagnosis, or adjusting to the major lifestyle changes associated with diabetes, can be enough to trigger periods of depression.
The good news is that professional help is available, so you don't have to deal with depression alone.
The earlier a person is treated for depression, the more positive the outcome. If you or someone you know is experiencing any signs of depression, there's no time like the present to seek help. A number of resources are available – including mental health professionals who can provide effective forms of therapy, support groups and self-help strategies.
Start with your family doctor
General practitioners can make referrals to mental health professionals – including psychiatrists, psychologists and psychotherapists – who in turn can verify the diagnosis and offer counseling to help develop coping strategies. Depending on the severity of the depression, your family doctor or a psychiatrist may also prescribe antidepressant medication to help you cope with the symptoms.
If someone other than your main healthcare provider is treating you for depression, it's important to ensure they're in regular communication with one another. This is especially important for people with diabetes since depression is associated with poorer blood glucose management, health complications and a decreased quality of life.
It's also important to note that if you're taking antidepressant medication, you should always follow your doctor's instructions. If it appears your symptoms are lifting, that doesn't mean stopping your medication. Rather, it could be a sign the medication is working. The same goes for any medication you may be taking. Always consult a healthcare provider before stopping a medication. Otherwise, you could jeopardize your health and risk a relapse.
Three effective forms of therapy
Cognitive Behavioural Therapy (CBT)
CBT is a form of psychotherapy that helps people deal with depression by showing them how negative thought patterns can contribute to feelings of sadness and despair. Over time, individuals learn how to turn negative thoughts into more balanced ones.
Interpersonal Therapy (IPT)
IPT looks at depression from an interpersonal perspective. Personal experiences – such as the loss of a loved one or a change in role, such as retirement – can alter a person's support system and trigger a depression. IPT aims to treat the depression by finding ways to cope with and improve interpersonal relationships.
This form of therapy helps people stay mentally healthy after they've recovered from an episode of depression. Unlike CBT, mindfulness meditation does not attempt to change thought patterns. Instead, it helps individuals focus on the here and now, and accept their feelings without judgment.
Support groups for individuals and families
Research shows when a depressed person has positive family support, they're less likely to experience a relapse. Yet, often families simply don't know what they can do to help the depressed individual. They're afraid of saying or doing the wrong thing for fear of making the situation even worse.
Learning about depression, and the issues surrounding it, can help family members be more supportive. Many mental health organizations offer education groups and programs that teach families about depression, what they can do in a crisis situation and how to effectively communicate with a depressed individual.
Ways you can help yourself
Just as you plan your meals, it can help to plan your day in much the same way. Making time for activities – like exercise, hobbies and socializing – can add important structure to your day and help you find enjoyment where there wasn't any before.
Many individuals find it helpful to discuss their problems in a safe environment with others who are experiencing similar emotions. That's the premise of self-help groups. They remind you that you're not alone. The Canadian Mental Health Association
(CMHA) lists local chapters across the country with programs and services to help those in need.
What to do in a crisis
If you have suicidal thoughts, or someone you know has talked about suicide or self-harm, it's extremely important to seek help quickly. The Centre for Suicide Prevention
lists crisis centres across Canada and people can also access the closest emergency room of their local hospital.
Look for books on depression in the General Health section of your local bookshop. Plus, these online resources can help you learn more about depression and what you can do about it:
(Centre for Addiction and Mental Health)
Canada's leading addiction and mental health teaching hospital aims to help those affected by addiction and mental illnesses, such as depression.
Confidential Depression-Screening Test
This quick, easy and anonymous questionnaire can determine if you're experiencing signs of clinical depression.
Mood Disorders Society of Canada
This national, non-profit organization is committed to improving the quality of life for those affected by mood disorders, such as depression.
This quarterly Canadian publication aims to improve quality of life for individuals who suffer from mood disorders and mental illnesses.