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It can be tricky for individuals with this condition to effectively tackle their diabetes. Here’s how healthcare executives can help.
Studies suggest that individuals with diabetes are twice as likely as non-diabetics to have depression.
Not only that, the chances of becoming depressed increase as diabetes complications worsen, according to Psych Central.
That’s seemingly made all the more troubling given a study published in Diabetes Journal, showing the risk of mortality among those with diabetes grew if they also had depression, anxiety, or both.
Major depressive disorder impacts 6.7% of U.S. adults at least 18 years of age and is more likely to be diagnosed in U.S. adults with diabetes, according to a study in the Journal of The American Medical Association.
The underlying issues behind the association of depression are unidentified, according to the study. It’s speculated that depression could be stress related or the culmination of the metabolic impact of diabetes on the brain. Studies suggest that people with diabetes-along with a history of depression-are more likely to develop diabetic complications than those who aren’t depressed.
It can be tricky
It can be trickier for individuals with depression to effectively tackle their diabetes, explains Sarah Markowitz, PhD, a psychologist in Ithaca, New York. Those with both conditions are much less likely to engage all the self-care required to help control diabetes, such as diet, testing blood sugar, and exercising, she says. “That’s hard for anyone, and if you’re also depressed, it’s really difficult. The two conditions interact and often compound each other, which creates a challenging cycle.”
Physicians can help by fostering an open line of communication with patients, says Dimitry Davydow, MD, a psychiatrist and medical director for Franciscan Behavioral Health at the University of Washington School of Medicine in Seattle. “If they’re having problems with diabetes and think they might be depressed, they should be encouraged to talk to their doctor,” Davydow says.
The discussion should include empowering patients to harness greater control over their own care, with physicians proffering support rather than exerting “the fear or shame approach,” Markowitz says. “A lot of people-especially if they’re depressed-already feel bad that they’re not doing a good job controlling their diabetes. If their providers use the approach ‘you should be doing better with this,’ it can exacerbate rather than improve matters,” she says.
“When people get down on themselves and discouraged, it’s hard for them to change and feel motivated toward doing well and being in control of diabetes, Markowitz sa.ys
Of course, it helps matters when patients assume more control of their health. Consequently, researchers and healthcare providers are designing decision aids, according to a February 28, 2017, article in The Wall Street Journal (WSJ). Providers can also walk patients through various options, helping to translate difficult to understand medical jargon and statistics.
Patients also are offered complete access to their medical records, while physicians are being trained to help guide them during the decision-making process, according to the WSJ article. Those participate in healthcare decisions with their physicians are less likely to regret the choices they make and more likely to stick to the treatment regimens they select.
There’s also a matter of everything patients probably have on their mind already, which physicians can help them deal with by working closely with other providers, such as a dietitian, diabetic educator, psychologist, and social worker, according to Markowitz. “Patients have to go from one practitioner to another on different days; that’s a burden, especially among those with fewer resources,” Markowitz says. “Things can fall through the cracks without that team-based approach.”
Another important consideration: having these two conditions together isn’t confined to adults. Studies show the prevalence of depressive disorders in the pediatric population suggest higher rates of depression, anxiety and distress among children and young adults with type 1 diabetes than the general population, according to a study in Diabetes Care. Similar depression rates have been demonstrated among adolescents with type 2 diabetes or in populations including both type 1 diabetes and type 2 diabetes.
No matter who’s impacted, the two diseases are extremely costly, with estimated direct and indirect costs of $245 billion and $210.5 billion, respectively, according to US Pharmacist.com.
Chuck Green has covered healthcare for more than 10 years.