Mood disorders otherwise known as affective disorders are a large group of disorders that present with a change in mood and related disturbances. Among the different mood disorders, major depression is the most commonly seen. Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. This has a lifetime prevalence of about 15 percent. The risk for such a form depression is 10 to 25 percent for women and five to 12 percent for men.

Clues That You Have the Blues

Depression is much more severe than ordinary sadness. It usually lasts longer than two weeks at a time. One of the prevailing symptoms should be a depressed mood or. any loss of interest or pleasure. Other symptoms of depression can vary widely from person to person and can include:

• Significant weight loss or weight gain; or decrease in appetite
• Insomnia or hypersomnia -Restlessness or sluggishness
• Fatigue or loss of energy
• Feelings of worthlessness or excessive or inappropriate guilt
• Diminished ability to think or concentrate or indecisiveness

Depression results from abnormal functioning of the brain. The causes of depression are currently a matter of intense research. An interaction between genetic predisposition and life history appear to determine a person’s level of risk. Episodes of depression may then be triggered by stress, difficult life events, side effects of medications, or other environmental factors.

At any given time, most people with diabetes do not have depression. But studies show that people
with diabetes have a greater risk of depression than people without diabetes. About 25 to 33 percent of persons with diabetes suffer from depression. Causes underlying the association between depression and diabetes are unclear. Depression may develop because of stress but also may result from the metabolic effects of diabetes on the brain.

Facing diabetes complications like nerve damage, or having trouble keeping blood sugar levels can make one feel to be not in control. Even tension between the patient and his doctor or between patient and caregiver may make one feel -frustrated and sad. All these may contribute to poor diabetes selfcare. Studies suggest that people with diabetes who have a history of depression are more likely to develop diabetic complications than those without depression.

Depression and diabetes can go into a cycle. Depression can prevent one from good diabetes self-care. If one is depressed with no energy, chances are he will find such tasks as regular blood sugar testing too tedious. There may be times one may feel so anxious that he can’t think straight, making it hard to comply with a good diet. On the other hand, diabetes that is in poor control can cause symptoms that look like depression. During the day, high or low blood sugar may make one feel tired or anxious. Low blood sugar levels can also lead to hunger and eating too much. If one has low blood sugar at night, it could disturb regularity of sleep. If one has high blood sugar at night, he may get up often to urinate and then feel tired during the day.

Spotting depression is the first step. Getting help is the second. While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Prescription antidepressant medications are generally well-tolerated and safe for people with diabetes.

Specific types of psychotherapy, or “talk” therapy, also can relieve depression. However, recovery -from depression takes time. Antidepressant medications can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted.

In people who have diabetes and depression, scientists report that psychotherapy and antidepressant medications have positive effects on both mood and blood sugar control. Additional trials will help us better understand the links between depression and diabetes and the behavioral and physiologic mechanisms by which improvement in depression fosters better adherence to diabetes treatment and healthier lives.

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