Diabetes & Depression: All in your head

It’s estimated that as many as 30% of diabetics also suffer from clinical depression. While the “which came first”/”which causes which” argument hasn’t been settled at this point, it’s clear that treatment and care plans for diabetes should make provision for the complicating factor of doing what needs to be done to avoid diabetic complications while simultaneously managing a serious mental illness.

For me, I believe the depression came first although the very nature of that disease – the distorted thinking, the lack of desire to do much of anything, the belief that I’m not worth the effort it will take to keep me happy and healthy – make it difficult to say for sure. I’m pretty sure that I was depressed in college, possibly even as early as my teens, and I wasn’t diagnosed with diabetes until age 29, so it’s likely that the depression pre-dates the diabetes for me. Given that I use(d) food to soothe myself when l’m in the middle of a bout with depression and that nearly all physical activity other than chewing and breathing used to stop when I was depressed, I would even call depression out as one of the “causes” of my diabetes.

Regardless of how and when they started, I deal with both diseases regularly: diabetes every minute of every day, depression at least once a month – every month – without fail. As exhausting as it is to keep my diabetes management mojo going on a good day, when I’m depressed it’s a whole lot tougher.

bigstock Sadness And Happiness 50402351 300x200 Diabetes & Depression: All in your head

Over the last 19 months, as I’ve focused on Project: Happy/Healthy Me, I’ve learned a few things that help me deal with my depression more effectively. Tactics that work for me include:

  • Recognizing that it’s back and that I’m depressed again is a great first step. When it’s really bad, this can take me anywhere from a few days to a week or more. If you have never experienced it, it’s tough to explain how that happens but remember that depression means that my own brain is working against me, creating thoughts that aren’t true but feel completely valid. Once some part of my brain breaks free to see that it’s just the disease talking, I can implement better coping techniques.
  • Keeping up my healthy daily routines as much as possible. I get quite a lot of physical activity and track my food intake every day, so I try to keep those habits going even when I’m dealing with the crazy thoughts that would have me stay in bed and eat simple, starchy carbohydrates for the rest of my life. That’s not nearly as simple as it sounds but it’s easier now that I make natural and planned physical activity so much a part of my everyday life. When the depression hits, I still go out before work each day but I might take a simple walk instead of incorporating jog/walk intervals. Both diabetes and depression benefit from exercise and walking is such an easy way to get my day off to a healthy start. Once I have a walk under my belt, it’s much easier to continue making good choices for my health even as I put up with my depression symptoms.
  • Calling myself out when I start giving small things more importance than they deserve. I overreact on a good, non-depressed day and it only gets worse when you add in the disordered thinking that accompanies depression. Suddenly, the fact that I haven’t completed any of my duathlon training planned workouts in a week means that I’m a terrible person and am destined to re-gain every pound I’ve worked so hard to lose. The truth is that I’ve been very active in ways other than running or biking and my fitness level will carry me through the event next month even if I never follow through on another workout from the training plan. (Not that I plan to skip another month of workouts, but with depression, anything is possible.)
  • Treating myself kindly, as I would a friend who was suffering with a chronic illness; skip the self-abuse. While it’s easier said than done, taking excellent care of myself while I’m depressed pays off almost immediately with improved mood and cognitive function. For me, this could mean going to bed a little early, using a favorite body wash with my shower, or scheduling a massage. If I pretend that it’s a friend who is suffering, this becomes more natural and less awkward.
  • Incorporating more mindfulness into my daily activities. Whether it’s yoga, quiet meditation, focused breathing, or simply focusing intently on my surroundings with each of my senses, the more I am present in the here and now, the easier it is to keep an even keel.

Even with these strategies, there is no “cure” for depression. Some months the symptoms are worse than others and at those times I call my therapist for a check in – somehow just talking with her brings a better focus on what’s real and what is not.

If you suffer from depression, know that you’re never alone, no matter what your brain might be telling you to the contrary. You are lovable and loved more than you know, so when things get scary, reach out and find help.

  • To find a therapist in your area, use this helpful website
  • Psych Central hosts an online depression support group which includes both message boards and weekly chat sessions. Depression tries to isolate us so being around others – even virtually – is a great way to put the disease back in its bottle
  • If it’s all too much and you just can’t bear another minute of feeling this way, please call the National Suicide Prevention Hotline at 1-800-273-TALK (8255) – it’s staffed 24/7/365 with trained professionals who will help you. Nothing – absolutely nothing! – gets better if you hurt yourself so don’t let this stupid disease win!

Just as with my diabetes, I know I’ll need to continue refining my depression self management plan for the rest of my life. There is no cure for my diseases but with careful planning, strong partnerships with medical professionals, and a little bit of luck, I’m confident I will live a long, healthy life.

Gaining weight and self knowledge

On June 14, before starting a 10 day trip to the southeast followed by a 5 day trip to Seattle, I stepped on my scale to find that I’d officially dropped belong 150 pounds and 26% body fat, representing a loss of 95 pounds and a 50% reduction in how much of my body is composed of fat since starting this journey in February 2013.

When I weighed myself last Thursday, seven weeks later, I saw 154.1 pounds and 28% body fat on the display; I have regained 7 hard-fought pounds and that weight is pure fat (as opposed to increased muscle mass). Given the way I’ve been eating lately, this was not a surprise to me, but it was – and still is – difficult to accept. One thing I’ve realized in the last 18 months, though, is that the lessons I learn when the path becomes bumpy are those that stick with me and form the structure of a healthier, happier life if I focus on finding the lesson in the experience rather than beating myself up for not being perfectly perfect.

So what will I do differently going forward?

  • Stop mindlessly eating sweets before bed – I convinced myself that I could have hundreds of calories of dessert every night because it was all low-glycemic and wouldn’t affect my blood sugar. While that’s absolutely true, extra calories add up over time and they aren’t doing my body fat percentage any favors. I’ll focus on fruit and nuts after dinner instead and see where that gets me.
  • Stop watching television with Mick after dinner – school starts back up in a couple of weeks anyway, so I need to get into the habit of reading and/or writing before bed anyway. Mindless eating while doing something mindless doesn’t align with my goal to live a happier, healthier life, so it needs to be replaced.
  • I’ve started taking one yoga class a week – anxiety is a regular part of my life that I’ve used mindlessness to “treat” for most of my life. Yoga encourages being present in my body and observing myself without judgment; I need more of that.

I’ve also been giving a lot of thought lately to what my goals are in terms of a happy, healthy weight and when to shift from weight loss to weight maintenance. At a Fitbloggin’ session this year, I was confronted by these questions as well as this troubling (for me) thought: what needs to happen inside my body for me to feel satisfied with where I am physically? I still haven’t wrapped my head around that one yet and it feels like a great topic for a session – or several – with Dr. Jennifer, my therapist; let me make an appointment to find out what wisdom she has for me.

Look, I wrote a whole post in MS Word without getting overwhelmed – perhaps there’s hope for this blog yet!

Giving it a go

I compose blog posts in my head while I walk in the mornings. While they never seem to make it to the screen here, trust me when I tell you that they're filled with angst and wisdom, and would probably make great reading. The process of getting them from my brain to the blog just seems like too much effort most days, in a life where every decision about what … [Continue reading...]

Project Happy/Healthy Me: June Review and Goals for July/August

My goals for June (and half of July) were: Work back up to run/walk workouts three times a week - Done. I'm jogging 3/5 of a 5K three times a week and it isn't totally awful most of the time. We'll call that a win! Continue to concentrate on clearing out one quarter of the garage, by myself, for 30 minutes per week - Umm, not much was accomplished on … [Continue reading...]

Project Happy/Healthy Me: March review and goals for June

My goals for March were: Keep up the run/walk workouts three times a week - I was doing well with this one until the training rides for the American Diabetes Association's Tour de Cure bike event started getting longer and more intense. I found that my hip flexors were very painful when I tried to combine running with the high intensity and/or long … [Continue reading...]

Dear Comrades: It’s been a little while since last we spoke

Way, way back, so long ago that it hardly seems real now when I think about it, I used to write blog posts as naturally as if I were casually checking in with a friend every day. Heck, I sometimes posted more than once a day if I had a particularly interesting - at least to me! - day. I didn't worry about what anyone wanted to read, or about how it all came … [Continue reading...]

Creating a new habit

post-5K 9/3/2011

I never used to walk anywhere if I could drive. I never used to bring my own food - healthy or otherwise - to work with me. I never used to walk a 5K every morning before work so that I could start my day off with 8,000 steps on the pedometer (that I didn't own). I never used to do anything about it when I had worrisome medical symptoms. ...but I do … [Continue reading...]

Not an athlete

post 4 miles, 4/26/14

I was in a Weight Watchers meeting this morning when I had one of those annoying "a-ha" moments. It wasn't my normal, early Saturday morning meeting because I walk/jogged a 4 mile event to honor Pat Tillman, an American football player who quit the NFL to enlist in the Army after the events of September 11, 2001. I was feeling pretty good because I was down … [Continue reading...]

Just Write

"I need to include at least one picture with every blog post, for SEO, Google+, and Pinterest." If you don't write anything, there's nothing for a search engine to fine and nothing to be shared on Google+ or pinned. "I need to finish that major project on the blog before I write any new posts." The project isn't as massive as you're making it out to be in … [Continue reading...]

Three things I’m grateful for this week: March 27

Making lemonade from lemons!

Our vacation to Phoenix for Spring Training. Oh my gosh, it was so good to get away and relax for a few days - I'm so grateful to my husband for organizing everything (and doing all of the driving) so that I could focus on the enjoyment of it all. Gentle rain. Last month's gully-washing rain in San Diego were awful because so much moisture came down so … [Continue reading...]