Clinical depression is a very common disorder in both children and adults, affecting approximately 7% of the population each year. In individuals with diabetes, the likelihood of co-existing clinical depression is much higher. It is estimated up to 15% of patients with diabetes suffer at least one episode of severe depression in any given year.
The combination of diabetes and depression is particularly problematic. For example, many symptoms of depression (hopelessness, decreased motivation, poor concentration, appetite disturbances, etc.) complicate the treatment of diabetes. Compliance with following a diabetic diet, regular exercise, blood glucose monitoring, insulin injec-tions, and periodic visits to the doctor become more difficult when a person is depressed. Careful blood sugar control decreases the likelihood of long-term complications in the eye, kidney, and nervous system. You can see how the vicious cycle of depression and diabetes can affect people in the “here and now” and in the future.
My advice to individuals with diabetes who may be depressed is straightforward. Get an evaluation, and if you are clinically depressed, get treatment. First off, the evaluation process is quite simple and even available on the Internet. The National Mental Health Association (NMHA) offers a brief 10- question scale for detecting clinical depression. The Internet Web site (www.depression-screening.org) does not require registration, is free of charge, and completely confidential. Or, you can arrange an evaluation through your doctor or directly from Health New England by calling the mental health line at 787-4000 ext. 5020. Treatment for depres-sion usually consists of either (or both) antidepressant medication or psychotherapy. About half the time your primary doctor will prescribe the medication. In more complicated situations, the treatment will be done in the office of a psychiatrist, psychologist, or psychiatric social worker. The sooner you get treated the better—both for the mind and the body.
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