Depression, Diabetes, and Heart Disease :: Diabetes Self-Management

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Mar 07, 2007

Depression, Diabetes, and Heart Disease

Joe Nelson

It seems that, with some medical conditions, there is a domino effect that is easy to recognize only when we are at the end of the process. For instance, we noticed that many people who develop heart disease have had diabetes for quite some time, so we finally began to do some prospective research that indicated that having diabetes was a risk factor for developing heart disease. It may seem kind of like an “Oh, duh” experience now, but there was a time when we only knew about the connection intuitively.

Some recent research that looked at the independent effects of anger, anxiety, and depression on the development of heart disease came to some interesting conclusions. Previous studies have found an association with anger/hostility and the subsequent development of heart disease. This new study didn't find this association with anger (or anxiety), but did find an association between the vegetative signs of depression and the development of signs of heart disease. (Vegetative signs include fatigue, lethargy, disinterest in doing things, lack of energy, and sleeping too much.)

Of course, many people who are depressed will have this set of symptoms, and it if this is the case, to recommend they "just start being active" is ridiculous. This study, however, provides important information when we remember that diabetes increases the risk of both depression and heart disease. In fact, this begins to look like a deadly triumvirate, because each of these conditions affects the others, potentially leading a person to get caught in a spiral of low energy, poor diabetes control, and the beginnings of the development of heart disease. This cycle suggests that there needs to be some type of intervention that can help shake things up enough that a person can begin to get a grip on at least one aspect of the situation.

I have some basic suggestions that may help people who are stuck in this cycle:

Seek support from family, friends, or health-care professionals. Find someone to talk with about this dilemma. I know it is probably the last thing you want to do and you may not think that they care, but doing this may help you start the process of getting the help you need.
Begin to develop a routine. Even if your energy is lousy, creating a daily plan and putting one foot in front of another will actually help. Don't decide each day if you are going to do something; simply do it each day without question.
Build in some movement. Even if it is a small amount, it will be useful to get your body moving.
Take your meds for diabetes and do some monitoring to check where your blood glucose is. Diabetes out of control shares some symptoms with depression, so doing something for one may help with the other.
Consider talking with your doctor about antidepressant drugs. In the study, people who took a class of antidepressant drugs called selective serotonin reuptake inhibitors (or SSRIs) had less buildup of plaque in their arteries. If you are OK with the idea of taking medicine for depression, the medicine can help with the "wet wool blanket" feeling that often comes with depression. The lifting of this sensation can also help you have more energy to follow some of these other recommendations.

Of course, I'd also recommend that you see a therapist, but often that doesn't happen until you have begun the process of getting better. If you have had issues with depression, diabetes, and heart disease, or have other ideas about how to get better, please share in the comments section.

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Anxiety and depression have debilitating effects that mimic some of the symptoms of diabetes, and others seem to be amplified. My recent diagnosis of type II diabetes came long after Post Traumatic Stress created a penchant for anxiety disorders in my world. I wonder if the stress of my executive jet lagged lifestyle compounded to bring on all the metabolism failures that increase feelings of anxiety or if it was the other way around.

Posted by: Mike Webber | Mar 07, 2007 02:47 PM

I'm not a "jet-setter" like Mike :-) but I fully believe that stress (I have depression and PTSD) contributed to the earlier development of my diabetes. I believe I was "bound" to get it eventually, but that stress (and the poor eating habits that go with depression) brought it to the fore earlier than it would have otherwise affected me.

I've come to understand how important activity is to battling depression, as well as diabetes. And activity WITH PEOPLE is even better. I wouldn't be as consistant if I were working out at home as I am in going to the gym (one with lots of friendly people!) partly because I know that if I don't show for a few days, I'm going to get a phone call! It has made a tremendous difference for me already.

And Joe - I've been fighting PTSD for almost 20 years alone. Only NOW am I starting to see a therapist to help me get through it. WHY did I wait so long? I wasn't ready to face it, I guess.

Posted by: Ephrenia | Mar 07, 2007 06:57 PM

I experienced about three days ago when I had an emotional upset due to the undoing of my daughter when my blood pressure shoot up and when I check with my strip test the reading was 232 while in the morning of the same day it was only 105. I therefore conclude that emotional situation should be avoided.

Posted by: edmundo ramos | Mar 09, 2007 12:50 AM

Mike, I suspect your jet-setting lifestyle would have gone without notice unless your body sent you a message about slowing down. Thanks to your body you are getting the message, so it might be good to listen.
Ephrenia, PTSD, by its very nature, prevents people from paying attention. It takes tremendous courage to face this disorder, and a lot of energy to stay in there and work on it. I am also wondering about how much PTSD may affect people who are diagnosed at early ages and must go through the process of finger pokes, lab tests, and shots without being able to scream or fight it off. The whole neurology of diabetes is a very curious thing, and PTSD is likely to have an interesting effect on your diabetes control. Hang in there and keep up the good work.

Posted by: joe nelson | Mar 14, 2007 01:01 PM

I'm sorry you're not still blogging. Maybe you can help with this: I haven't found anything written on the effects of bipolar disorder on glucose control. Depression seems to be addressed often, but I was just made aware recently that mania can raise blood glucose levels. The reason for this was not elaborated, and I haven't been able to find any data to support it--- do you know of any? Also, I've found what appears to be a contradiction between one of your recommendations above and a blog from 4/3/08 "What We're Reading: Antidepressants and Diabetes Risk" - you say that SSRIs may reduce the rate of plaque development that is a precursor to heart disease, right? This newest blog suggests that SSRIs in combination with a tricyclic may increase the risk of developing diabetes. I'm confused now! It's TRULY a case of depression, diabetes, and heart disease!

Posted by: Linda Mills Fouts | Apr 09, 2008 08:08 PM

Emotional Health

Taking Care of Me (11/18/08)
A Good Cry? (11/12/08)
Free Depression Screening, In Person and Online (10/10/08)

Heart Health

Drug Combo Linked to Increased Health Risks (08/15/08)
Tight Control and Cardiovascular Disease (Part 3): VADT (07/03/08)
The Ups and Downs of Meds and Diabetes (Part 3): Blood Lipids (06/30/08)

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