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.
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.