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November 2015 | Read this issue and more at www.healthandwellnessmagazine.net |
Depression and Diabetes
When symptoms persist, it is
time to seek professional help
By Dr. Tom Miller, Staff Writer
Some patients
with diabetes live
within the shadow
of a functional depression. That means
the depression is not caused by a biochemical imbalance; it is based on the
belief that diabetes is something you
have to live with and deal with for the
rest of your life.
Most people have felt sad or
depressed at times. Feeling depressed
can be a normal reaction to loss, life’s
struggles or injured self-esteem. But
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when feelings of intense sadness,
including feeling helpless and hopeless
due to your health, lasts for days or
weeks, it is time to take action and seek
professional help.
More than 15 million American
adults experience some form of depression. Among this group are individuals
who have been diagnosed with diabetes. It is also estimated that one in five
youth experience depression at some
point during adolescence, and at any
given time, about 5 percent of children
and teens in the general population are
depressed. Depression is more than just
occasional sadness. According to the
American Psychological Association
(APA), people with depression may
experience feelings of hopelessness;
show a lack of interest and pleasure in
daily activities; and have weight changes
and sleep disturbances. They find it difficult to concentrate and lack energy to
pursue a healthy lifestyle.
Depression is the most common
mental issue. There is no single answer
to the question of what causes it.
Medical and health-related conditions
can play a role in depression. People
with diabetes and depression may need
a multidisciplinary approach to their
care and treatment, which may include
their primary care physician, a psychiatrist, an endocrinologist, a health
psychologist, a registered dietitian and
a diabetic educator, among various
specialists. These professionals will help
them gain the benefits of managing the
complexity of this condition.
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Interventions with most health-related conditions – and specifically for the
patient with diabetes – must address
questions of motivation and intention and focus on self-management.
With diabetes, it is critical to know and
understand your motivators, inhibitors
and triggers.
Motivators are factors that predispose a person to action, such as the
perceived need because you wish to
maintain good health. You have to see
the benefits of treatment, outcome
expectancies, rewards/incentives and
cues to action.
Inhibitors are the barriers to taking
positive action. Barriers can be the
absence of prerequisites for action, such
as funds, skills or support as well as the
presence of a real obstacle to managing
your condition successfully. Intentions
are the primary causes of recognizing
and implementing behavior change
that results in good control of diabetes.
Individuals must have an intention to
change, be ready to change in the present and have a particular goal toward
which they can work.
Triggers are the events that shift
a person from being predisposed to
action into an action state. A person
with diabetes needs to take the steps
for change that result in good control.
Begin by discussing options with your
primary care provider, who can aid in
offering referrals to competent professional help.
Sources and Resources
De Groot, M.; Anderson, R.; Freedland,
K.; Clouse, R.E.; Lustman, P. (2001)
Association of Depression and Diabetes
Complications: A Meta-Analysis.
Psychosomatic Medicine, July/August,
Volume 63, Issue 4, pp. 619-630.
About the Author
Thomas W. Miller, Ph.D., ABPP is a
Professor Emeritus and Senior Research
Scientist, Center for Health, Intervention
and Prevention, University of Connecticut,
retired service chief from the VA Medical
Center and tenured Professor in the
Department of Psychiatry, College of
Medicine, University of Kentucky.
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With diabetes, it is critical to know
and understand your motivators,
inhibitors and triggers.