Diabetes and Depression

By Robert Seith
CWK Senior Producer

"It’s just depressing … that’s the best word I can think of."
-Keith Gonyea, 16-

The routine never changes for 16-year-old Keith Gonyea. He inserts the needle from the insulin pump, draws blood 10 times a day to check his blood-sugar levels and carefully watches what he eats.

“It’s unbearable. Obviously, you have to, but it’s hard,” he says.

Still, Keith’s eyesight continues to get worse, and he has circulation problems in his feet.

“It’s just depressing … that’s the best word I can think of. It’s hard,” he says.

Keith suffers from diabetes burnout, which can lead to real depression. According to studies published in the journal Diabetes Care, kids with diabetes are three times more likely to become depressed later in life.

“They spend a lot of time worrying, and some of them get preoccupied with the worries or the feeling different, or just low or just frustrated that it just can’t be easy,” says Paula Bryman, L.C.S.W.

Unintentionally, parents can make matters worse. If they only focus on their child’s disease, their child may begin to think that the disease is the only aspect of life about which his or her parents care.

“A lot of the adolescents say to me, ‘I come home, and instead of my mom or dad saying to me, “How was your day, how are you?” [they ask] “What was your blood sugar?”’ And they feel like their whole identity is about having diabetes,” Bryman says.

According to Bryman, parents need to teach their diabetic child – and remind themselves – that the disease is only part of their child’s life.

Keith teaches this message by working with younger kids at the Juvenile Diabetes Foundation.

“Most adolescents find it very empowering to help somebody,” Bryman says.

Keith agrees: “Just being around them and being able to help them out … knowing people aren’t always going to be around to help me out; I can help people out.”

The Link between Diabetes and Depression

By Tom Atwood
CWK Network, Inc.

“Depression packs a double-punch for those with diabetes. Along with the mental anguish, blood glucose control often slips as well. But there is hope.”

– Diabetes Forecast Magazine, a publication of the American Diabetes Association

The news that diabetics are three to four times as likely to suffer depression is not good for teens who discover they have diabetes. The American Diabetes Association estimates that depression affects 15-20% of those with diabetes, regardless of if they have type 1 or type 2 diabetes because depression affects both groups equally.

Does diabetes cause depression? The ADA says that no one knows for sure why depression is more common among those diagnosed with diabetes. However, both mental and physical factors exist that could aggravate depression for diabetics:

The extra demands of the diabetes regimen itself may put some people at greater risk for depression. (Adjusting to dietary restrictions, blood-testing routines and hospitalizations can be difficult.)
For those whose diabetes has progressed, dealing with the loss of vision, kidney failure, etc., can open the door to depression.
Various physical changes associated with diabetes, including chemical and blood-flow changes in the brain, may also be factors.

The good news? Three recent studies published in Psychological Annals, Psychosomatic Medicine and Diabetes show that depression in diabetic patients can be treated effectively with either antidepressants or a specific form of psychotherapy known as cognitive-behavioral therapy. The studies also found that as depression eased, blood-glucose control improved.

What Parents Need to Know

At any given time, 5% of children suffer from depression. Children with diabetes, as well as children under stress who have experienced a loss or who suffer from other disorders, are at a higher risk for depression. The American Academy of Child and Adolescent Psychiatry (AACAP) lists the following signs of depression:

Frequent sadness, tearfulness or crying
Hopelessness
Decreased interest in activities or an inability to enjoy previously favorite activities
Persistent boredom and low energy
Social isolation and poor communication
Low self-esteem and guilt
Extreme sensitivity to rejection or failure
Increased irritability, anger or hostility
Difficulty with relationships
Frequent complaints of physical illnesses, such as headaches and stomachaches
Frequent absences from school or poor performance in school
Poor concentration
A major change in eating and/or sleeping patterns
Talk of or efforts to run away from home
Thoughts or expressions of suicide or self-destructive behavior

If one or more of these signs of depression persist in your child, the AACAP suggests seeking professional help. Getting an early diagnosis and medical treatment are critical for depressed children.

Treating Teen Depression

Depression is a serious condition, which, if left untreated, can even become life threatening. According to the National Mental Health Association (NMHA), each year 5,000 young people between the ages of 15 and 24 commit suicide. The rate has tripled since 1960. Therapy can help teens understand why they are depressed and learn how to handle stressful situations. Treatment may consist of individual, group or family counseling. Medications prescribed by a psychiatrist may be needed to help teens feel better.

The NMHA cites the following methods for treating depression:

Psychotherapy: This method explores events and feelings that are painful and troubling. It also teaches coping skills.
Cognitive-behavioral therapy: This approach helps teens change negative patterns of thinking and behaving.
Interpersonal therapy: This method focuses on ways of developing healthier relationships at home and school.
Medication: Taking medication relieves some symptoms of depression. It is often prescribed along with therapy.

Resources

American Academy of Child and Adolescent Psychiatry
American Diabetes Association
National Mental Health Association