[shockme]

Kind of Depressed? You May Be Among the Sixty-six Percent of Type 2s Who Are, and It's Probably Affecting Your Self-Care - Diabetes Health

[princesslinda]

Good article! Though personally I don't struggle with depression at this point, it is certainly understandable than someone with EITHER type diabetes would have some component of depression at times. Anything that takes over your life and requires as much time, thought and energy to manage, and has the potential to cause so many other problems would be bound to occasionally cause depression.

I think this is why the forum is such a great idea....we can be ourselves and share our lives, good and bad, with others who truly understand as they've been there themselves.

[Evermont]

A local mental health professional told me that 50% of (all) people walking around in my hometown are on anti-depressants. That may be a bit overstated but it sure surprised me. If true, and you add in all the undiagnosed sufferers of depression then the rates for type 2's isn't different from the general population - at least here, at 45 degrees N. latitude. But those number seem overstated to me.

I do see that depression could lead to worse self-care and so worsened symptoms of D, and so greater depression... clearly a downward spiral.

I'm fortunate not to be caught in this negative feedback loop. One thing that I think may help is my perspective. When I exercise and eat right I'm not doing it to treat my diabetes. I'm doing it because I want to be healthy in general. Diabetes isn't the only reason to exercise and eat right! So I never have thoughts like "Oh, poor me, I have to do all this exercise because I have diabetes..." it's more like "How convenient that my healthy lifestyle happens to be exactly what I need to do to manage my diabetes with no extra effort!"

It's just perspective but it can make a big difference.

[karlf]

I think if we are all honest everybody on the forum will get deprerssed or down at some point

[Penny]

Originally Posted by karlf

I think if we are all honest everybody on the forum will get deprerssed or down at some point

I admit to days of depression, but rarely. I usually can work myself out of it as soon as I realize that is what is happening. I really think some people are just prone to depression, others it just isn't part of their nature. I live with people who suffer from it everyday, and know my short bouts of it are nothing like theirs.

[volleyball]

Feeling depressed to having depression is like having a headache to a full blown migraine. I guess everyone in their life is going to have some sad times. The good with the bad. I don't know if the author differentiated

[MJB]

"...and a shocking 66.5 percent reported at least some depressive symptoms. "

Not so shocking. Probably applies to the general populace not just T2's.

If I ever look like the guy in the picture please shoot me.

[Amethyst]

I am one of the percentages. Although I was diagnosed with depresstion (bipolar)before I was a D. I agree that it caused me not to give a hoot about my health. When on the proper medication, the difference was a miracle for me. I cared if I lived or died. The D part of it for me was the pain of my neuropathy. Some days I couldn't walk across a room. Some days I spent crying in agony and wishing for relief. My family suffered as I did. My husband frustrated cause he couldn't take away my pain. I then had days that I had mild pain, livible. The Dr. put me on some strong medication and it helped so much.
I have a friend who is going through the same thing, depressed because of the pain of side effects, not the disease per say. I guess I am a minority here, but I am glad. Depresstion stinks. BTW good article, thanks for sharing.

[DCaplinger]

I am approaching my diagnosis the same way I would approach any problem I deal with as a cop. Survey the scene for safety, approach with caution, and take control as quickly as possible. Sure, there have been a few moments when I've felt very sad about the fact that I'm now diabetic, however there is a repeating theme that keeps playing in my head: I've been diabetic a for a while, I have only just been diagnosed. In other words... I've been living just fine, not knowing. Now that I know, I can control my diabetic destiny from here.

So, why cry over spilled milk? I'm the one in control of this beast. Sure, it's a challenge, but it's also a choice. People can choose to stay in that sad place, or they can stand up, brush off the dust, and start making positive plans for the future. Wallowing in the sad for too long is destructive, and adds stress to the body. Don't get me wrong. I truly appreciate the need for one to grieve. I also understand the wide range of emotions each newbie will go through. So far this week, I've felt sad, happy, depressed, and of course very, very angry. WHY ME? Well, at least I had an answer to that last one staring me in the face... literally, when I told my dad I was diabetic... because so is he.

Now, I could go around feeling all angry at my dad for passing on bad genes, or I can say, "Well dad, now we have something else we can work on together". We are not alone. Do not isolate yourself if your blues are starting to get to you. I know I'm brand new here, but my background has been in public service, and I will be available for a cheer up anytime anyone needs one.

I believe in the power of positive thinking. It's pulled me through situations that were so bleak, that no one in my life thought would ever get better. However, somehow... they always do. I choose to be positive. I choose to do what is necessary to beat this. I choose to live. Not just for me, but for my boys and my beautiful wife.

Depression is real. Overcoming depression is hard, but it can be done. It all starts with a choice. And hey, if you are a long time diabetic, if you can survive diabetes... you can survive anything.

God bless everyone here, and I hope everyone a very Merry Christmas. May God grant us all solice this time of year, and bless us in 2008.

Regards,

Darian

[verynicebecky]

I was diagnosed with a low level depression called dysthymia last November. I dont know if it can be fully attributed to diabetes though.

[notme]

Wow.....this is all very depressing isn't it?

[Harold]

Bet a large percentage of the 66% were already depressed before Diabetes.

[ant hill]

when I was diagnosed I was concidered late diagnosis as I was thin enough and the deteriation of mussel mass as I was too lite and so with that the complications are now apparent.
So may I suffer depession with the knowlage that I may have a stroke and eye problems wich I now have and other things that may happen. Will this stop??

[REDLAN]

Bet a large percentage of the 66% were already depressed before Diabetes.

this is one of the reasons I dislike these kind of articles - they are intended to convey a point - in this case diabetes is a really depressing disease. Note the use of sensationalised comments

a shocking 66.5 percent

AND...

Only 14.2 percent claimed to be free of depressive symptoms

Unfortunately the study shows nothing of the sort.

The study used the HANDS screening tool - this was developed by Harvard Psychiatry department to identify individuals who might be depressed.

it's a self administered questionaire, where you tick either none of the time, some of the time, most of the time, all of the time. to 10 different questions. such as "had difficulty falling/staying asleep", or "been feeling low in energy/slowed down".

I defy anyone not to tick some of the time to at least 1 of the boxes - and you can take the test here online...



anyway after you've done the test it is marked 0-3 for each of the categories - all of the time gets a 3, none of the time gets a 0 - so you can score 0-30 points on the test.

if you score 9-16 it is likely that you might be depressed and it is recommended you are assessed by a health professional.

above 16 it is very likely that you are depressed and it is strongly recommended you are assessed by a health professional.

this is how the screening tool is to be used - it does not diagnose depression - it actually has a very high False Positive rate.

from the study cited in the article only 54% of those who scored more than 9 points on the HANDS screening scale were actually being treated for depression.

translated into English this means that getting more than 9 points on the test only gives you around a 50/50 of actually being depressed - the authors themselves of the HANDS tool admit that has low specificity (i.e. a high False Positive rate).

the study actually shows the following....

people who scored over 9 points had poorer self-care scores (which was expected), but it also showed that the more points you scored on the test then the lower your self-care score.

they concluded that interventions aimed at alleviating symptoms of depression could improve self-care, even in those not diagnosed with depression, but with some depressive symptoms.

in other words in English...

people who are unhappy are worse at looking after themselves than people who are happy - genius.

the actual prevalence of major depression among people with Type 2?

about 8% - which is considered to be high.

(this is from a study that looked at 18,000 individuals - it did use a telephone survey though, and is in line with the prevalence reported by our HANDS study - which was around 10% - it most certainly isn't the 66% that the article suggests)

links are here so you can check my assertions for yourself...

Depression, Self-Care, and Medication Adherence in Type 2 Diabetes: Relationships across the full range of symptom severity -- Gonzalez et al. 30 (9): 2222 -- Diabetes Care

Prevalence of Depression among U.S. Adults with Di...[Diabetes Care. 2007] - PubMed Result

[DonnaB]

There's a big difference between clinical depression and just feeling depressed from time to time. Our "Prozac Nation" is taking waaaayyyy too many antidepressants. We take a pill for everything - the medicalization of society. I think I can speak to this because I work for a psychiatric clinic. Of course it seems like that to me because all of them are on antidpressants but I think not all of them have to be medicated - it's just what the docs are taught in medical school..... push the drugs. There was a recent study that showed the same results could be obtained by just getting moderate exercise....the exercise gave the same benefit as the antidepressant and there are no side effects, only positives.