Depression, Diabetes, and Heart Disease

By Joe Nelson | March 7, 2007 10:03 am

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:

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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Joe Nelson: oe is a psychotherapist in private practice in Minnesota, where he specializes in the psychology of chronic disease and sexual problems and works with couples, families, children, and teens. He has been a Licensed Psychologist since 1985 and has earned a master’s degree from St. Mary’s College Winona, a bachelor’s degree in social work from the University of Minnesota, and an associate’s degree in human services from the College of DuPage in Glen Ellyn, Illinois.

Joe has worked with troubled youth in Chicago and Minnesota and on a special project on Turtle Mountain Reservation in North Dakota. He was the first social worker hired by an affiliate of the American Diabetes Association. He worked at the International Diabetes Center for 20 years, directing psychological services there for 12 years. A Certified Sex Therapist, Joe co-developed the Sexual Health Center at Park Nicollet Clinic.

Having practiced meditation for over 30 years, Joe offers instruction in mindfulness-based meditation to patients in groups and as individuals. Joe is married, has a 23-year-old daughter, and enjoys scuba diving, motorcycling, golf, and being outdoors doing almost anything.

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