Diabetes and Depression

with Dieter Schmidt, M.S., Certified Diabetes Educator, Columbia St. Mary’s

Posted: Nov. 1, 2004

For those people recently diagnosed with diabetes, it’s common to go through a grieving process that may include feelings of depression. After all, living with diabetes may mean significant lifestyle changes such as monitoring your blood sugar level, taking medication and altering your diet to help control the disease.

But if you’ve been feeling symptoms of depression for more than two weeks, it’s wise to seek treatment, said Dieter Schmidt, M.S., CDE, who is a health behaviorist and Certified Diabetes Educator with the Diabetes Treatment Center at Columbia St. Mary’s. He identified some common signs of depression as feelings of worthlessness or guilt, a loss of interest in everyday activities, a loss or gain in appetite and lack of energy.

“If it’s more than a fleeting feeling, talking to a counselor may be worthwhile,” said Schmidt.

Dieter Schmidt, M.S., Certified Diabetes Educator, Columbia St. Mary’s "The approach I use provides self-encouragement. People need to put themselves in charge so they can gain control of the disease."

The correlation between diabetes and depression has gained attention during the past several years. Recent studies have shown that people with diabetes are two to three times more likely to suffer from depression as those without the disease.

Schmidt said people with uncontrolled diabetes also seem to be at a greater risk for depression, although it’s not clear if the disease itself is a contributing factor.

“What happens is the risk of depression goes up in those with uncontrolled diabetes, but the depression also contributes to people’s inability to control the disease,” explained Schmidt. “It becomes a revolving door.”

Counseling methods
When treating people with diabetes for depression, Schmidt uses a short-term method that typically involves 12 to 20 sessions. He subscribes to a cognitive-behavioral approach based on the idea that how a person thinks influences the way they behave.

“I look at what could be negative thinking and try to improve the patient’s approach to diabetes and how they feel about the disease,” he said.

According to Schmidt, diabetes is one of the most stressful diseases there is. A labor-intensive condition, diabetes is life-altering. Not only are people with diabetes required to take medication and test their blood sugar levels daily, they need to learn to count carbohydrates and adopt a regular exercise program.

“It’s potentially stressful unless you put it into perspective,” he said.

By changing their view of diabetes, Schmidt helps his patients overcome their feelings that it is a hopeless condition so they can function with the disease.

He added that it is important for people with diabetes and their health care providers to perceive change as a process and not an event. “Change doesn’t happen right away,” he said.

That’s especially true for those people in denial about the disease, which is why Schmidt warns health care providers against using scare tactics to evoke change in their patients.

“Diabetes is a serious condition that does need immediate attention, but telling people they’re going to go blind or go into kidney failure if they don’t change their habits is a very risky approach,” Schmidt said. “It can send people deeper into denial.”

Positive approach
People diagnosed with type 2 diabetes are particularly susceptible to feelings of guilt due to the fact that their sedentary lifestyle and associated weight gain may have contributed to the disease.

“They often beat themselves up emotionally,” said Schmidt. But even though inactive, overweight adults are at greater risk to develop type 2 diabetes, Schmidt points out to his patients that there is also a genetic component to the disease.

He also encourages his patients not to refer to themselves as diabetics but as people with diabetes. “It makes a difference for a lot of people,” he explained. “Any time you view yourself as a label, you risk losing your sense of self.”

While a diabetes diagnosis is a life-changing event, it’s not life-ending. With the aid of therapy, and in some cases medication, the staff at Columbia St. Mary’s Diabetes Treatment Center is prepared to help people with diabetes cope with depression and exchange potentially harmful habits for healthy behavior.

In addition to individual and family counseling, the Center offers cognitive-behavioral-based group programs that assist people in actively managing their diabetes in order to lose weight and regulate blood sugars.

For more information, call 414-961-4641.

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