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(BPT) - Managing diabetes is as much a mental game as a physical one. In addition to taking medication or insulins, monitoring blood sugar, eating healthy, getting regular physical activity, and often experiencing physical symptoms of low and high blood glucose, people with diabetes also need to be vigilant for a serious potential complication that is often undiagnosed: depression.
Multiple studies show people with diabetes are at higher risk of depression. One study found 11 percent of people with diabetes experience major depression, and of those nearly a third are clinically depressed, according to research published in the Diabetes Atlas. Further, studies show about 45 percent of all diabetes patients have undiagnosed depression.
People coping with psychological issues and diabetes also don’t feel they’re getting the support they need; the DAWN2 study found that while 52 percent of health care professionals said they regularly asked patients with diabetes how their lives were affected, just 24 percent of people with diabetes reported they were being asked this by their health care providers.
“People with diabetes must manage their disease 24/7, 365 days a year, mostly on their own or with the help of a parent or caregiver. That constant need for attentiveness can lead to increased stress,” says Alicia McAuliffe-Fogarty, a clinical health psychologist and vice president of lifestyle management team at the American Diabetes Association (Association). “Medical providers are trained to help people manage the medical aspects of their disease, but they may not have as much knowledge about the impact psychosocial factors can have on the mental health of people living with diabetes.”
The Association recommends everyone living with diabetes have a mental health professional as part of their health care team. “Everyone is different, so it’s important people with diabetes get individualized, patient-focused care that includes a mental health component,” McAuliffe-Fogarty says.
In addition to care from a mental health provider, people with diabetes can take steps to manage their own mental health, including:
* Manage stress — Stress can affect your blood sugar. When you are upset or feeling stressed, your body makes stress hormones that can make your blood glucose go up and make diabetes harder to manage. Stress can also make it harder to think about taking care of yourself— you may eat too much or not enough, you might not exercise, or you may forget to take your medicines. Trying to figure out how to manage stress is important – from deep breathing, to listening to music, or enjoying a hobby. Figure out what works for you.
* Find a support network — Living well with diabetes requires support, so do your best to surround yourself with friends, family and trusted health providers. You can also find support through online or in-person support groups, where you will find others who understand the challenges and triumphs of daily diabetes management.
* Give yourself a break — Yes, managing your diabetes well can be the difference between life and death. But dwelling on that aspect of the disease, and putting undue stress on yourself every day, doesn’t do you any good. Instead, focus on the fact that diabetes management is just like anything else in life — there will be good days and bad days. Don’t add stress to your life by expecting perfection from yourself.
* Set reasonable goals — You need room to learn and grow in your diabetes management. Baby steps and small changes — such as adding physical activity and making healthier food choices — can set you on track for success, while not stressing you out with unrealistic expectations. McAuliffe-Fogarty advocates the S.M.A.R.T approach to goal-setting: Specific, Measurable, Achievable, Realistic and Time-bound.
* Have a stellar health care team — Diabetes management requires a team approach, and you should have health care professionals such as an endocrinologist, dietitian and primary care physician on your team. It’s important to also have a mental health professional on your team. He or she can provide initial and continuous mental health assessments, from diagnosis and throughout your diabetes journey.
To learn more about diabetes management, and the relation between diabetes and depression, visit diabetes.org.