Diabetes and Depression: The Diagnosis

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Diabetes and Depression: The Diagnosis

I am not a crier. I come from a long line of non-criers. I’ve never ever seen my mom cry, and the one time I saw my dad cry was when I was 10 years old and our cat Leo died. I remember being confused because I didn’t think my dad liked Leo that much. I learned much later that sometimes it’s easier for adults to cry over the death of a cat than a divorce or the loss of a job. When I was diagnosed with Type 1 diabetes at 14 years old and started to cry, my grandmother reminded me that there were children suffering from far worse diseases like cancer, and I dried my eyes. I toughened myself up. Crying wasn’t going to change anything. I was stuck with this disease.

For years my grandmother’s words echoed in my head, and I swallowed my tears through the highs and lows of my teens, twenties, thirties, and on into my forties. For years I held back the tears until one day I started crying and I couldn’t stop. At 44 years old, I found myself exhausted by life.

The day that I faced reality started with a run. I ran because running made me feel better. Living with Type 1 diabetes for 30 years has taught me that regular exercise is not a choice, but a necessity. I woke up at 5 AM so I could sneak out the door while it was still dark and run while the rest of the house was asleep. But I struggled to lace up my shoes. There was a heaviness in my chest and it was hard to breathe. You can do this! I told myself, thinking of how I always encouraged my boys with the same phrase, but halfway through the run I was choking back tears. As the sun began to light up the sky and cicadas buzzed around me, I had to stop and walk. I was grateful that I was alone on the path, but I was scared too. What if I couldn’t make it home? I started to cry for the third time that week and I realized that I couldn’t do this anymore.

I came home and Googled “women, diabetes, and depression,” and discovered that the way I was feeling was not uncommon. According to the Behavioral Diabetes Institute, “People with diabetes, both Type 1 and Type 2, are almost twice as likely to develop depression as those who do not have a chronic medical condition. On any given day, it is estimated that 15%–20% of people with diabetes are struggling with a moderate or severe form of depression.” I sat at my computer stunned. Depression? It didn’t sound like me. I was strong, I was tough, I was a working mom, and people depended on me. I’d been managing my diabetes for 30 years and knew there were people out there who had much bigger problems than me. But those words did nothing to lift the heaviness in my chest. All I wanted to do was crawl into bed and sleep.

The Behavioral Diabetes Institute says major depression is characterized by the presence of five or more of the following symptoms for at least two weeks. “They must cause serious distress and interfere with the person’s ability to perform the daily activities involved with self-care, work/school, or family and social life”:

• Sadness, irritability, or “empty” mood that lasts most of the day, nearly every day

• A loss of pleasure or interest in doing things you used to enjoy

• Feelings of hopelessness or pessimism

• Decreased energy, fatigue, and feeling “slowed down”

• Difficulty concentrating, remembering, and making decisions

• Feelings of worthlessness, inappropriate guilt, or helplessness

• Insomnia, early-morning awakening, or oversleeping

• Changes in appetite, eating either more or less than you used to (when not dieting), resulting in changes in weight

• Nervousness or restlessness

• Recurrent thoughts of death (not fear of dying) or suicidal thoughts

The BDI says: “Remember that depression can influence how you see the world. Because of depression, it may seem that anything you do or achieve is never good enough. Therefore, you may also feel like you are constantly failing with your diabetes. Even though it isn’t true, this can make it harder to stay motivated and to keep up your efforts to manage diabetes.”

Somehow I gathered enough energy that morning and got my kids off to school, said goodbye to my husband, and instead of driving to work, I went to the walk-in hours at a local women’s medical center. I was taken to a clinical exam room with bright lights and white walls and told to answer the questions on a computer screen. Do you suffer from feelings of worthlessness, helplessness, or pessimism for days at a time? Yes. Do you have trouble falling asleep at night or trouble staying asleep — waking up in the middle of the night or too early in the morning? Yes. Are you sleeping too much? Yes. Do you frequently feel tired or lack energy? Yes. I sat in the chair and again I started to cry. I didn’t think there were any tears left. How had this happened? Why couldn’t I just be happy? But I couldn’t. No matter how badly I wanted to pretend I was OK, I wasn’t. I was diagnosed with situational anxiety and depression, and prescribed medication that would take 4–6 weeks to kick in. Four to six weeks seemed like an eternity…

Editor’s note: Tune in next week as Amy discusses her road to recovery.

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