Depression, Diabetes, and Heart Disease

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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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