“Depression makes everything more difficult,” says Scott Strange, 49, of Kansas City, who was diagnosed with type 1 diabetes in 1970 and has struggled with depression since childhood. “I ignored my diabetes for four decades.” Though he took insulin, he avoided carb counting, blood glucose measurements, and all the other daily practices that help keep people with type 1 healthy.
No one says living with diabetes is easy, but adding depression to the mix can turn taking care of yourself into an overwhelming burden. Depression is common, too, affecting 1 in 6 Americans, and some studies suggest the rates are higher in people with diabetes. There is a silver lining, though. New approaches that treat diabetes and depression give hope that these dual burdens can be lifted.
Not Happy Together
People with type 2 diabetes are at a 54 percent greater risk of developing depression than those without type 2, according to a 2008 study in the Journal of the American Medical Association. The study also found a modest association between depressive symptoms and the development of type 2. “It’s clear that depression is a risk factor for diabetes, and there is evidence that it goes in both directions,” says Jeffrey Gonzalez, PhD, assistant professor in the Diabetes Research Center at the Albert Einstein College of Medicine. “It’s difficult to say which comes first. It’s a ‘chicken or egg’ problem.” The link between type 1 diabetes and depression is even less clear, as few studies have focused on this question.
Researchers are exploring both biological and behavioral underpinnings to explain the relationship between diabetes and depression. On the biological side, depression is linked with changes in hormone levels, the nervous system, and the brain that may increase blood glucose levels. These biological changes could potentially trigger diabetes or worsen blood glucose control in those with the condition.