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Diapression: Diabetes + Depression
It is one of my passions to support patients in the management of diabetes. It takes time for a diabetic to learn how diet, lifestyle, medications, and supplements can all be a part of improving blood sugars. However, even when we are doing it all correctly, the daily adherence can get exhausting and repetitive. Frustratingly, diabetes does not take a day off. When the family is taking a “cheat day” from their diet and enjoying Sunday football food, if you join in your blood sugars might be significantly altered. Eating a good diet can be especially challenging around a holiday when everyone is preparing delicious foods to enjoy with family. Eventually, diabetics often get fatigue from careful blood sugar management and have days, weeks, or even months where we stop taking care of ourselves the way we know we should by neglecting checking blood sugar values or struggling to take medication as often (or even at all). This process of diabetes leading to depression is a real thing and is often referred to as: “diapression”; diabetes plus depression. And it happens to more diabetics than you might think.
Research shows that 20%-40% of people with diabetes have significant depressive symptoms. Additionally, among people with diabetes, 12% have major depression – this is a whopping two times the prevalence in the general population. When you are both diabetic and depressed, data shows that you can have reduced self-care and treatment adherence, glycemic control, and increased morbidity and mortality. In short, the data show that diabetics are at higher risk for depression, can have more severe depression, and serious physiological complications as a result. While not all of us may experience major depression, at some point in our health journey, many diabetics will feel small bouts of diabetic fatigue and this can negatively affect our long-term health.
What can be done?
While my wonderful counterparts in allopathic medicine sometimes struggle in this area, providers in naturopathic medicine shine. A cornerstone of naturopathic care to take a wholistic approach to ensure that we take into account the physical, mental, emotional, and even spiritual sides of our patients.
I like to start by telling my diabetic patients to give themselves grace. Sometimes enjoying holiday food with our family fills our soul and is more important that a perfect A1c. Finding balance, support, and self-acceptance with our diabetes can be just as important as careful blood sugar management. In my humble experience, I find that loving ourselves, diabetes and all, is a huge part of giving ourselves the long-term care we deserve and preventing diabetes related fatigue.
Another aspect of treating “diapression” is directly discussing emotional health with my patients and not avoiding emotions like some doctors may do. I’ve been trained in counseling techniques so that I can support my patients in their challenges beyond just managing the physical aspects of diabetes alone. I also work closely with my colleagues in counseling and mental health so that I can provide a cohesive team for creating a network of support. You do not have to do it alone!
Additionally, I talk with my patients about vitamins and nutrients that can be depleted with long term diabetes medications. Did you know that long term use of metformin, one of our first line treatments for type 2 diabetes, can result in a decrease in vitamin B12? This vitamin is vital for metabolism and as a cofactor for the synthesis and breakdown of our neurotransmitters, which help stabilize and regulate mood. Other nutrients like chromium are essential for allowing glucose to be optimally taken into the cells and can improve diabetes numbers with the correct dosing. While some of this can be accomplished with a great diet, other patients may need to supplement especially when our diet is lacking. This balance is where I step in to help educate and provide the best supplemental advice tailored to each specific patient and their individual needs.
This is just a starting place of the options available to diabetic patients that I love to provide. As a naturopath, the wholistic care that we provide can make a meaningful difference in the emotional and physiological impact of diabetes. Because diabetes is something that we live with every day I encourage every patient to keep their emotional health a strong priority; your body will appreciate the care and your diabetes will likely also see improved blood sugar results.
Just because no one else can heal or do your inner work for you, doesn’t mean you can, should, or need to do it alone. -Lisa Olivera