any health care professional
a trusted friend or family member
or a suicide or crisis helpline. The Canadian Association for Suicide Prevention’s website - www.casp-acps.ca/crisiscentres.asp - has a Canada-wide list of crisis centres and contact numbers.

What is depression?

Although symptoms of depression differ for everyone, they include any of the following:

constant sadness or anxiety
hopeless, negative thoughts
loss of interest or pleasure in things that were once enjoyable
low energy and tiredness
feeling stressed and overwhelmed
changes in sleep, such as sleeping more often or difficulty sleeping
trouble concentrating and lack of motivation
constant irritability
changes in eating, such as eating more or less than usual
thinking about suicide or death more often.

Depression can strike anyone at any age. It happens for a variety of reasons. Genetics, prolonged stress and anxiety, or a combination of causes may be involved. Even some medications can cause symptoms of depression.

If you have diabetes, you are at higher risk for depression. Dealing with diabetes can cause high levels of stress and frustration. It is easy to become overwhelmed when trying to get the disease under control.

Evidence suggests that individuals with type 2 diabetes are 30 per cent more likely to have been depressed than those without diabetes. It is hard to say whether a history of depression makes someone more at risk for developing diabetes or if diabetes leads to depression.

Depression can also cycle. If you have been depressed once, you are more likely to experience it again in future.

How does depression affect my diabetes?

Being depressed can make it harder for you to take good care of yourself. Eating poorly, not exercising, gaining weight and less medication control can all make diabetes worse. Depression can also result in social isolation and unhealthy activities like smoking and drinking alcohol. Depression itself can worsen sugars.

Not taking care of yourself can lead to uncontrolled blood glucose levels, health complications, family problems, and higher health care costs. If your diabetes stays out of control, complications can include heart disease, stroke, blindness, and death.

It can be difficult for people with diabetes to recognize their depression, since some symptoms look like uncontrolled diabetes. Blood glucose changes can make an individual with diabetes feel tired, grumpy, anxious, and cause sleep disturbances.

What should I do if I think I might be depressed?

Having symptoms of depression does not necessarily mean you are depressed. However, if these feelings and warning signs do not go away, they can start to affect your ability to care for yourself and your diabetes. If this is the case, seek help from a health care professional as soon as possible. The sooner you get help, the better your chances of avoiding complications related to uncontrolled diabetes.

How is depression treated?

A trained professional will usually help treat your depression, either privately or with a support group. Treatments, often called therapy, help figure out the cause of depression and devise ways to manage it.

Your therapist needs to communicate with the other health care professionals that make up your diabetes care team. This is especially important if you are taking antidepressant medication, as it may affect blood glucose levels. Talk to your pharmacist or doctor when starting a new medication so that you know what to expect.

Do not try to treat depression without help. Always talk to a pharmacist or doctor before trying any over-the-counter or herbal remedies, as these may interfere with blood glucose control.

What can I do to prevent depression?

Depression cannot always be prevented. It may occur without cause in spite of your best efforts. Living a healthy lifestyle may be the best way to protect yourself. Exercise regularly, eat a healthy diet and control your blood glucose. Try to manage stress before you become overwhelmed. Reducing stress should be a part of your overall diabetes management program.

Ways to relieve stress

Join a diabetes support group, where you can talk about problems and find ways to cope with them.
Continue to exercise and eat healthy food.
Create time for relaxation.
Establish rituals for relaxing. Try yoga stretches, a scented warm bath, tea and a magazine, or calling a family member or friend.
Keep your sleep patterns regular and get enough sleep.
Try to identify and remove things that may be causing stress.

Remember, poor blood glucose control can also cause anxiety. If you have been feeling anxious for a while, let your health care team know so that they can review your treatment plan. If the anxiety is not relieved with an adjustment to your diabetes treatment, some prescription medications may help.

When it comes to controlling diabetes, your mental health is as important as your physical health. If you think you may be depressed, getting help is essential. Talk to a trusted friend or family member, clergy member, health care professional, or call a helpline.

Diabetes and Depression Dealing with a double whammy

Diabetes is a complex condition. Dealing with it can be overwhelming, especially when first diagnosed. If you are struggling with feelings like sadness, loss or hopelessness, you may also be experiencing depression. People with diabetes are two or three times more likely to become depressed.