Depression appears to have a higher rate in people with diabetes than the general public. Diagnosing depression in a person with diabetes can be tricky. Most mental health professionals do not rule out diabetes before making a diagnosis. When you put the symptoms for depression next to high blood sugars, they are virtually identical. Food for thought, when going to the psychiatrist for the first time, make sure you advocate for yourself by informing the diagnosing mental health professional you have diabetes.
The most recent statics of the prevalence of psychiatric issues in people with diabetes show that depression is 2–3 times more common in both type I and type II diabetes. One of the reasons that living with a chronic illness like diabetes increases depression is the loss of lifestyle. However, as I was just explaining, the symptoms of high blood sugars can be misdiagnosed as depression and may be a confounding factor in the present statics.
There is a wide range of psychiatric medications available for most psychological issues. While it is not a magic pill and will not make all your problems go away, it may be needed. Especially when the psychiatric illness is impacting your ability to manage your diabetes.
I am neither for nor against psychiatric medication. People have preconceived notions as to what it means to be on a psychiatric medication. Some think that the big pharmaceutical companies are plotting to get everyone on some kind of medication. I admit that with all the commercials it would seem that way. However, not all medications work for everyone and without all the options these companies provide, life for people with diabetes who have psychiatric illnesses would be 10x harder.
One of the things that cause problems is that a lot of people go to their primary care physicians and ask for medication or are given medication when they feel depressed. That is like going to an oral surgeon for Lasik eye surgery. Sure they are both doctors but with vastly different skill sets. Because so many general practitioners are giving out psychiatric medication, the wrong people are put on medications that may not need it while others are not on medications but need to be.
Only a mental health professional like a psychotherapist or psychiatrist can diagnosis a psychiatric illness and if you are on medication but not seeing a psychiatrist and a psychotherapist ask your doctor for a referral. Only a psychiatrist has the knowledge base needed to prescribe psychiatric medications.
Psychiatric medication is a way to balance the chemical equation in the mind. It allows for individuals who struggle with focusing on their diabetes to become more attentive to their diabetes-related needs.
It takes time to figure out which medication will work for an individual but once the right combination of medication is found. The person with diabetes will have an easier time processing information needed for management tasks.
Unfortunately, Attention Deficit Disorder (ADD) is common in Type 1 diabetes and research has shown that people who were diagnosed prior to age 17 have some level of ADD. Once an individual with diabetes and ADD gets on the correct medication to resolve the attention issues, they will be able to focus better.
However, that is just part of the problem that needs addressing. Once on the medication, the person needs to adjust how to focus attention and additional training is needed for healthy focusing to occur. Motivation to manage their diabetes is still needed.
Once the individual is on the correct medication and dose, it is important to follow up with talk therapy. Psychotherapy is helpful in resolving what is blocking a person living with diabetes from proper management. In many cases, the psychological issues need to be resolved before education can take hold.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Prior to making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.