Depression/Diabetes/Stress Links

[Guest guest]

GREETINGS --

The following is the introductory portion of a piece from Northern

County Psychiatric Associates that offers some good insights to those

diabetics affected by depression. The full document can be found at

www.ncpamd.com/dmdepression.htm

wambo1941

Diabetes, Depression and Stress

Carol E. Watkins, MD

Northern County Psychiatric Associates

Depression is not generally listed as a complication of diabetes.

However, it can be one of the most common and dangerous

complications. The rate of depression in diabetics is much higher

than in the general population. Diabetics with major depression have

a very high rate of recurrent depressive episodes within the

following five years. (Lustman et al 1977) A depressed person may not

have the energy or motivation to maintain good diabetic management.

Depression is frequently associated with unhealthy appetite changes.

The suicidal diabetic adolescent has constant access to potentially

lethal doses of insulin. At this point in time, it is well accepted

that psychological factors and psychiatric conditions can affect the

course of medical illnesses. There is some suggestion that the stress

of depression itself may lead to hyperglycemia in diabetics. The

interaction between cardiovascular disorders (such as heart attack

and high blood pressure) and depression has been extensively studied.

Anxiety and depression can also affect other conditions including

irritable bowel syndrome, headache and skin diseases. Treatment of

anxiety and depression may lead to a better medical prognosis and

well as a better quality of life.

For over three hundred years, physicians have suspected an

interaction between the emotions and the course of diabetes mellitus.

Studies have examined whether stressful events or psychiatric illness

might precipitate either Type I (insulin-dependent) or Type II (Non-

insulin dependent) diabetes. So far, study results are not

conclusive. Now that we have more accurate methods of measuring

glucose control, it has become easier to measure both short-term and

long-term effects of emotional factors on blood glucose level. One

study found that children judged to have a " Type A " personality

structure had an increased blood sugar elevation in response to

stress. Children with a calmer disposition had a smaller glucose rise

when stressed. (Stabler et al. 1987) A 1997 study suggested that Type

I patients with a history of a psychiatric illness might be at

increased risk for developing diabetic retinopathy. Those patients

with a psychiatric history were found to have a higher average

glycosylated hemoglobin. (a measure of long term diabetic control)

(Cohen et al. 1997) Children whose relatives made more critical

comments had significantly poorer glucose control. Interestingly

enough, emotional overinvolvement between family members was not

correlated with poor diabetic control. (Koenigsberg et al. 1993)

Diabetic adolescents had a higher incidence of suicidal ideation than

expected. Those with suicidal ideation took poorer care of

themselves. Not living in a two-parent home was associated with

poorer long-term diabetes control. (Goldston, et al. 1997)

[Guest guest]

that was an interesting article. blue cross, my health insurance

co., started this free counseling program for people with diabetes,

all done by phone. had my introductory phone conference with one

nurse amy on monday and she started off with the subject of

depression. it was interesting because one doesn't have to have *an

issue* to be depressed.

anyways, i tend to think there is something to stress and the

endocrine system going haywire. personally, i'm totally type A. had

an incredibly high stress job and then i stopped work, and one month

later i became diabetic. i suspect living off of adrenalin and

cortisol for years and then a sudden total drop must have had a lot

to do with it all. the first time my endocrine system went haywire,

i was also being my complete high-strung self too...

rach

> GREETINGS --

> The following is the introductory portion of a piece from Northern

> County Psychiatric Associates that offers some good insights to

those

> diabetics affected by depression. The full document can be found

at

> www.ncpamd.com/dmdepression.htm

>

> wambo1941

>

> Diabetes, Depression and Stress

> Carol E. Watkins, MD

> Northern County Psychiatric Associates

[Guest guest]

In a message dated 6/23/2004 8:27:56 PM Pacific Standard Time,

rfong_tom3@... writes:

she started off with the subject of

depression. it was interesting because one doesn't have to have *an

issue* to be depressed.

Hi Rach, yes that was a great article, really made the wheels go around! I

think anyone who is diagnosed with a chronic thing like diabetes is going to

hit the depression button at least a little on occasions. I think that is why

groups like this are so important. A real purge place where others understand

why we feel the way we do.'My dh is a type A, I call hi Felix. Like the odd

couple guy. He was an engineer before the accident, they have a different mind

set than most I think and it almost killed him to have to retire. He loved

his job. Now he thinks this house should be run like a production floor! LOL

Too many kids and grndkids for that to happen! LOL Hugs, marilyn

[Guest guest]

In a message dated 6/23/2004 5:03:38 PM Pacific Standard Time,

wambo1941@... writes:

GREETINGS --

The following is the introductory portion of a piece from Northern

County Psychiatric Associates that offers some good insights to those

diabetics affected by depression. The full document can be found at

www.ncpamd.com/dmdepression.htm

I think there is a definite connection, at least in the early days when it

hits you like a ton of wet, moldy bricks! Thanks! Hugs, Marilyn