Treating Depression May Help Diabetes

Treating Depression May Help Diabetes

“It’s a two-way street. Research suggests that if you have diabetes, you’re more likely to suffer from depression. And if you are depressed, you’re more likely to develop diabetes. What does this mean to you? For one thing, being treated for depression may improve your diabetes symptoms. Read more important findings in this provocative article.”

More on depression and diabetes:

Diabetes and Depression Linked »

Diabetes and Depression-Which Comes First? »

Richard, the Canadian Diabetes Association shows in one of their brochures under " The serious complications " : …25 percent of people with diabetes suffer from depression . Indeed one would be self serving to manage this complication …if neglected , a big burden to one living with diabetes and those around you !

I certainly agree with you Nel. Thanks!

What to do is the problem. If I go to my doctor and say I am depressed he will quickly pull out his pad for a prescription of some horrid psycho chemical that mostly makes thing way worst.

As a possible step in the right direction ,connect ( In Canada ) with one’s Mental Health Association nearby and click on the link

The best treatment for Major Depression, Anthony is often a combination of meds and therapy to learn tools to manage both feelings and the thoughts that affect them. It often takes a little bit of trial and error to find the right dose of the right med for each person, and many people get frustrated if the first one doesn’t work, or has unwanted side effects. If someone is dealing with true clinical depression, it’s hard to get past without help of both sorts. You can no more wish it away than you can wish the D away. I recommend a Psychiatrist to prescribe meds as they are more knowledgeable than a regular primary care provider. And finding the right therapist for an individual is very important, based not so much on the number of certificates on their wall, but the way it feels to sit across from them.

Many people have become very cynical about the overuse of drugs to treat emotional and psychological problems. With good reason! They are not a solution and need to be combined with therapy and lifestyle changes. Kind of like diabetes! But don’t throw the baby out with the bath water. (weird saying!). I have seen many people come into my office wearing depression on their face and with every movement. In time, on the right combination of meds and therapy it is like a veil being lifted. I can’t tell you how many times I’ve heard someone say “I feel like myself again.” That is what meds should do, not dope you up or mask symptoms but be part of a larger treatment plan that gets you back to where you were before that veil fell down over your life.

That is a very good reply Zoe. Everyone who has experienced depression should read it. Thanks!

Thanks for posting this important topic, Richard! So many people with Depression feel they should be able to just “handle it” and then they suffer needlessly, sometimes for years.

Zoe, it is not much different with so many diabetes patients. They refuse to see their doctors after diagnosis and eventually begin developing serious complications. Some of them show up on the D forums and say they are out of control, but cannot motivate themselves to do the things they know they are supposed to do. They want us to inspire them to get started and practice good diabetes management. What can we say to them? They usually disappear from the forums, and do not return. It is easy to talk to the ones who are motivated, but not so when they are very depressed. Those are the ones who need the meds and therapy.

Can we convince them to get therapy? There is something very negative attached to having to see a psychiatrist or a psychologist. I have known people who kept it well hidden, and were ashamed. How can we convince people online to see someone like that. Some people even get mad if we dare suggest they need a psychiatrist. This is a difficult situation for me. I want to advise them, but I do not usually reply.

I think a lot of things contribute to people who don’t manage their diabetes, but I think you are absolutely right, Richard, that a lot of them may be clinically depressed. It’s kind of human nature to keep spinning our wheels with “I should do this, I know I should, I know I should” but not acknowledge that something may be in the way of “trying harder”. Lack of motivation and hopelessness about the future is one of the most common symptoms of Depression. If you don’t believe you are ever going to feel better, why spend time and energy that’s in short supply to fight the battle?

People on this board, though, often say exactly what you’d hear from a cognitive-behavioral therapist (the most common type of therapy for depression). “Try starting with one small manageable step”. It’s just that the therapist is there to keep supporting that process and like you said people on the forum often post once and then disappear from view.

I copied this from the Canadian Mental Health Association’s website …Bounce Back program available to people living in BC, Canada ,

" Depression and anxiety are the most common of all mental health problems. While everyone has bouts of low mood and excessive worrying, these are temporary for most of us. For others, however, the feelings don’t go away on their own and formal help is needed.

Many people are reluctant to take medications for their mental health problems, but family doctors may feel they have little else to offer their patients.

One very effective treatment, however, is cognitive-behavioural therapy (CBT). CBT has been shown to be as effective as medication in the treatment of anxiety and depression.1 Unfortunately, CBT is not readily available for doctors to access for their patients. There are long wait-lists for mental health services and a limited number of mental health clinicians who specialize in CBT.

More help for more people

In 2007, the Ministry of Health Services awarded a grant to the Canadian Mental Health Association BC Division (CMHA BC) to develop CBT services to support family doctors in providing mental health care. The goal of the grant was to increase the availability of CBT. Through this funding, the Bounce Back program was developed.

The provincial launch of Bounce Back took place in the Okanagan in June 2008. The program works with health authorities and other community partners to help primary health care providers respond to the very large number of patients in need of mental health assistance. It was initially designed to support individuals living with a chronic disease or chronic pain. However, Bounce Back is now available to all patients with mild to moderate depression and anxiety, whether or not they have a physical health condition.

The program is delivered through branch offices of the CMHA and is now offered in 17 locations around the province (see sidebar next page).

Bounce Back: what does it offer?

Bounce Back offers two forms of CBT help. Both are based on the work of Dr. Chris Williams at the University of Glasgow in Scotland.

The first is a self-help DVD titled Living Life to the Full. It provides clear tips and strategies to manage your mood. The 45-minute DVD was originally filmed in Scotland and has been adapted for BC. It covers a number of the most useful CBT skills that people can learn to get more enjoyment out of life. The DVD is appropriate for those who aren’t ready for a more structured intervention like individual therapy.

The second is a telephone-delivered service. Bounce Back employs 20 community coaches who offer guided self-help over the phone to support people with mild to moderate depression and/or anxiety. The coaches support patients who are working through an effective, short-term mood improvement program. Their role is to teach new skills, help patients stay motivated, answer questions and monitor patients’ progress.

The program is based on the Overcoming Depression and Low Mood series2 of structured workbooks. The workbooks provide clear information and exercises to help people alter the way they think and act in order to bring about positive changes in how they feel.

Both forms of CBT help are available at no cost to patients. The DVD is available through your family doctor’s office. To access the telephone coaching program, a referral from your doctor is required.

Coaching typically involves three to five telephone sessions with a Bounce Back coach, which you can do in the comfort of your home.

Bounce Back coaches: what? who? how? when?
Research has demonstrated the benefits of guided self-help CBT interventions.3 The same research found that guided self-help programs don’t need to be delivered by a psychologist—they work just as well when provided by a paraprofessional. In cases of severe mood and anxiety conditions, however, specialist care is required.

Bounce Back coaches are not mental health specialists. Coaches come from a variety of backgrounds, such as nursing, medical office assistance and social work.

The coaches attend a mandatory three-day learning session on the CBT tools before they deliver services in their local community. Training is delivered by BC-based registered psychologists with CBT expertise. After formal training, coaches have weekly telephone consultation sessions with a psychologist. This provides the coaches with clinical support regarding cases and reinforces their CBT knowledge and skill development. In addition, coaches make audio recordings of telephone sessions with clients. These recordings can be reviewed by the psychologists to ensure program quality.

Bounce Back: results to date
Bounce Back has distributed over 18,000 self-help DVDs and nearly 2,000 referrals have been made to the program for telephone coaching. Program data from a provincial database shows that program participants generally experience improved mood, reduced anxiety and enhanced quality of life.

This is what would be expected through guided self-help CBT interventions. Early information from family doctors also shows that Bounce Back is considered a valuable community mental health resource.

The success of the Bounce Back program is being evaluated by independent consultants. An effectiveness study is also planned. Results will be available in 2010.Bounce Back provides a CBT intervention with the potential to reach a very large segment of the population troubled by depression and anxiety." …end of copied material .

Lots of reading, however I could not have explained the program and it’s usefulness any better . I attended the official launch of the program .

The only benefit I ever had from psycho chemicals is an unplugged nose from tricyclics. They are a potent decongestant for me. Nortryptiline is the most heart friendly one.

Here in Alberta talk therapy of some use but very expensive.

Since Nel was kind enough to talk about mental health services in Canada, I can provide some info about what’s available in the U.S. Here the largest number of therapists today would describe themselves as using an “eclectic” approach, meaning they take something from an array of different models. However, Cognitive Behavioral therapy is by far the most commonly used treatment modality for the simple reason that it produces results. While it is guided by a mental health professional, the goal is not to have someone dependent on that professional for untold years, but to learn tools they can use on their own to understand the “messages” they received as children which influence the way they view and function in the world as adults. These “messages” are ideas about themself, and themselves in relation to others that are no longer effective, and are, in fact, keeping them from living a satisfying life. We all interpret events through many “filters” based on past experience, and CBT believes that it is the way we interpret events that happen to us, more than the events themselves that cause us problems. If we can alter these perceptions we can alter how we feel and how we behave, based on how we think about things. The value of having a therapist guiding the process is that a person can “try out” their new approaches as “homework” in the real world and then bring that experience back to their weekly therapy to talk about.

There are many therapists in the U.S. trained in cognitive or cognitive-behavioral therapy, or those who integrate those ideas into their “eclectic” practice. The problem in the U.S. is paying for the service. Therapists charge high hourly fees and best practice is to see someone weekly, even if only for a limited course of treatment. Every year, insurance cuts back on the amount of mental health sessions they will allow, often limiting it to very short term “crisis intervention”. The Mental Health profession is fighting for “parity”, for equal coverage for mental health as physical health conditions. It’s an uphill battle. And of course, many people still don’t have insurance. I only know specifics about the state of California but here each County is required to provide free or low cost mental health services to those who can’t afford it. But the catch to that is that they are required to serve ALL Medi-Cal clients with a diagnosable mental health problem. In the poorer counties this means they don’t have enough funds to also serve people who do not have Medi-Cal, but can’t afford private pay therapy. I’m assuming other states have some version of this situation. So if someone has little income, and wants therapy, they should look for their County Mental Health (or “Behavioral Health”) office and see what services they offer and who qualifies. The services usually include an initial Assessment, then based on that Assessment they are offered group or individual therapy, and possibly also medication management by a Psychiatrist and Case Management. There is also a relatively recent wonderful movement called the Recovery Movement or Consumer Model that supports drop-in centers or “clubhouses” run largely by other people with mental illness, based on the idea that people do best if they are involved in their own treatment and supported by their peers as well as professionals. Sound familiar?

That is very valuable information Nel and Zoe. I hope it helps members who need it. Thanks!