By Valerie Nosek
Several weeks ago, Ease@Work was asked to participate in a diabetes education program at one of our client organizations. At first, we thought it was because Ease could offer consultation with a certified diabetes educator through the nutritional coaching feature of our services. However, we were surprised to learn that we were being requested to focus on depression as associated with diabetes.
The group conducting this program had taken a survey of employees attending the sessions, asking pertinent questions about their actual diabetes care program, but also included in the survey were questions about depression, such as:
• How often do you feel blue or depressed?
• How long do these episodes of feeling down last?
• Does feeling down make you feel isolated or unable to enjoy things you used to enjoy? Etc.
Almost 50 percent of those who took the survey gave responses that indicated some level of depression.
Those in diabetes education are very familiar with the link between depression and diabetes. However, we found that link between mental health and diabetes is not as well-known in the general medical community or even by those who have lived with diabetes for years.
According to the American Diabetes Association (ADA):
• People with diabetes are at greater risk for depression
• Poor diabetes control can cause symptoms that look like depression
(high or low blood sugar during the day may make you feel tired or anxious; low blood sugar levels can lead to hunger and eating too much; low blood sugar at night can disturb your sleep; high blood sugar at night may make you get up often to urinate and in turn leave you feeling tired during the day)
The ADA goes on to say that there are no easy answers about why those with diabetes have a greater risk for depression, but they suspect a variety of reasons contribute to the likelihood, including:
• The stress of daily diabetes management
• The feeling of being set apart from family or friends due to the extra work of managing diet
• Other health complications from diabetes
• Feeling of losing control due to trouble or inability to keep blood sugar levels where you want them
• Tensions between family members, friends, doctors and other medical providers involved in diabetes care
• A vicious cycle of depression and low energy can lead to poor blood sugar testing/monitoring, which in turn exacerbates the situation; or anxiety may make it hard to maintain a good diet, or lead to skipping meals, which again, will cause blood sugar levels to get out of control.
As a comprehensive employee assistance program (EAP), we could offer assistance to a diabetic employee/or a family member in a collaborative manner on a number of levels:
• Consultation with a registered dietitian certified in diabetes education (CDE). A CDE could help the individual with menu planning, provide information on healthy food choices, discussion of any particular blood sugar control questions and more.
• Consultation with a counselorexperienced with depression as associated with medical conditions, such as diabetes. A clinician could help the individual/or family member address stressors, anxiety, feelings about not being in control, how to recognize/deal with depression, etc…
• Consultation with a fitness coach. Getting proper exercise is also a factor in managing diabetes effectively. Physical activity is also known to boost the “feel good” hormones produced by the body, which can alleviate some forms of depression.
On a personal note: A couple weeks after Ease’s participation in the diabetes education program, I happened to be talking with a longtime friend who is a diabetic. He was struggling emotionally and said he really didn’t feel like talking with me or anyone else…not to take it personally, but he just felt completely spent and down. I also knew he had been having trouble recently keeping his blood sugar levels in check.
When I asked him if he was aware of the connection between depression and diabetes, he was completely unaware…and this from a person who has been managing diabetes for over 25 years.
After talking with him a little longer, it was as if a light bulb went on for him – the connection between certain events and situations in his life seemed to make more sense when paired with the role depression may have played in them. I offered him some reading resources, and while I did not expect to remedy his situation, at least I know he has more awareness about the link between diabetes and depression, and that he is open to addressing the issue with a professional.
If you are diabetic, make an effort to monitor your mood as well as your blood sugar. If you find yourself struggling, call your EAP and speak to a counselor. If you know somebody who is diabetic, do not assume that they know of this connection. Chances are, they are not aware of it and they might be more likely to take action to get help if they understand the biological link to this common mental health issue.
