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Allan Schwartz, Ph.D.Allan Schwartz, Ph.D.
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Depression and Diabetes: A Deadly Combination

Allan N. Schwartz, LCSW, Ph.D. Updated: Jul 8th 2008

 Diabetes is a chronic and serious illness that, if left untreated, can lead to a slow and horrible death. Type 1 and Type 2 are the two varieties of this disease.

In Diabetes insulin, which is a hormone, is produced by the Pancreas. The importance of insulin is that it pushes glucose into the cells comprising our bodies. Without glucose, the cells would die and we would perish. Glucose comes from the food that we eat. Our digestive system breaks down sugars and starches into glucose. When the pancreas is not working correctly, the result is too much glucose in the blood stream. Too much glucose is dangerous because it can damage body organs such as the Nervous System, Kidneys, Eyes and other organs leading to hear disease, high blood pressure and death.

Type 1 Diabetes begins to occur during childhood and is characterized by the fact that the pancreas fails to produce enough insulin.

Type 2 Diabetes is the most common type and usually starts between the ages of 40 and 60. Obesity and lack of exercise appear to be the major causative factors in Type 2 Diabetes.

A Study recently completed at Johns Hopkins University has provided an answer to a nagging question about the relationship between Depression and Type 2 Diabetes. The question was the old one: "which came first question, the chicken or the egg?" In other words, does Type 2 Diabetes cause depression, or does depression cause Type 2 Diabetes? The results of the study show that the answer runs both : Depression causes Type 2 diabetes and Type 2 Diabetes can cause depression. The question is why?

Depression as a cause of Type 2 Diabetes:

The researchers at Johns Hopkins suggest that depressed people live the type of life style that leads to Type 2 Diabetes. This life style includes such things as: 1. Avoiding exercise, 2. Smoking, 3. Over eating, 4. Gaining a lot of excess weight.

During many years of private practice I have treated a number of people who suffered from Type 2 Diabetes. I also spent some time working on the medical side of the house in various hospitals rather than only the psychiatric side.

It soon became clear to me that Type 2 Diabetes involves serious emotional issues. Whether in private practice or in the hospital, those afflicted with this kind of diabetes were depressed people who also seemed to have some personality disorder types of problems.

For example, these were people who were obese and had been for many years prior to the onset of the illness. The patients were able to describe a life style devoid of exercise and comprised of over eating foods rich in sugars and starches. In all of the cases with which I was familiar, there were long standing and chronic family, economic and emotional problems going all the way back to childhood. It was not just that they were depressed now that they were ill but had suffered from depression for most of their lives. Consequently, they had always lived sedentary and passive lives except for their indulgence in the unhealthiest types of food.

Now that studies confirm the fact that Type 2 Diabetes and Depression both cause and reinforce one another it raises the question of what might happen if depression is treated early? In other words, could we prevent and therefore reduce the numbers of diabetics through an aggressive program of identifying and treating depression, even as early as childhood?

This is a complex issue because, in my opinion, it goes beyond depression into the personality disorders. What was striking to me about diabetic patients was their resistance to any type of help. Even those patients with poor blood circulation (a result of diabetes) and in danger of losing limbs through amputation, there was a stubborn refusal to alter diet and life style. I believe that part of this was due to denial but part of it was a life long and repetitive pattern of behaving in self destructive ways.

In my practice there was the example of a person, diagnosed with Type 2 Diabetes who refused to change eating habits, go on anti depressant medications or stay in psychotherapy for more than a couple of months. The last I heard was the diabetic disease was progressing with increasingly debilitating consequences.

Your comments are welcome and encouraged

 

Allan Schwartz, LCSW, Ph.D.

Readers who live in the Boulder, Colorado metro area, or in Southwest Florida may contact Dr. Schwartz for face-to-face consultation. He is also available for psychotherapy through Skype video for those who are not in Florida or Colorado. He can be reached via email at dransphd@aol.com for details.

    Reader Comments
    Discuss this issue below or in our forums.

    DIET, DIABETES, DEPRSSION - Anajinn - Oct 17th 2009

    I had an unhealthy childhood with emotional abuse and now I realize that, at least in some stages of their lives, my parents also suffered depression. As a result, I have been depressed most of my life but it got really bad in the pas thirteen years when I suffered trauma after trauma after trauma, including the deaths of my spouse and all of my family members, and four car accidents.

    I have not been able to work for seven years and, during the last four years, I suddenly ballooned up to at least double my weight. Now I have been diagnosed with type II diabetes, but I also have developed arthritis, although the tests for rheumatoid arthritis proved negative. So I don't know what kind of arthritis I have.

    I obviously have to lose weight. The only way I could keep my weight in check previously was on the Atkins diet. I was on it for many years. However, I suspect that, when I abandoned this diet, it caused a rapid and excessive weight gain, compared with the actual amount of food that I eat. I will admit that I have been eating starchy and fatty foods but not too many sugars.

    I am wondering if it would be my only solution to get back on the Atkins diet, as I must lose weight as quickly as possible, or if I will get any results just from cutting back on food intake and avoiding starches and fat.   

    I am wondering also if anti-depressant drugs are counter-productive as (a) I know they all cause weight gain and (b) given my inflammatory condition and the diabetes, can they have a negative impact on my chemistry?

     

     

     

    my best advice - Christopher - Feb 11th 2009

    My mother inlaw has diabetes and overincist cancer for many years and after my wife gave her vitamins to take and also encourage her mom to walk 30 min a day and about  8 months later her mom diabetes reversed. meaning that her mom diabetes has minimize as well as her cancer. When my wife's mom was diagnose with cancer she had 2 choices one is to do sugery and two is to see what god could do. If you have any quetions you could e-mail me at Topkhamphoumy@yahoo.com and I'll maybe my wife could give you some advice...

    Diabetes type II with depresiion - Marc Laurel - Jan 27th 2009
    My wife left me due to my Diabetes and depression ,Ive been sending 300.00 monthly for child support and it's getting to be hard on my expenses ..Have  been trying to apply for SSDA (disabilty)but can't get to it.My kidney disease is on stage III ,I have periphal neuropathy,Carpal tunnel on both my hands and the stress on my everyday life is fast cathching with and I'm seeing a family theraphist to talk with. Please advice me or what would be best to apply for SSDA.,My occupation requires 8 hours of driving and y eyes are getting affected big time.I'm insulin dependent too.

    have both diagnoses - MLD - Jul 9th 2008

    I have had depression since I was a child, have been in treatment since 1977, and was diagnosed with diabetes last year.  I am having a hard time regulating my glucose levels and also my blood pressure.  I am taking Januvia for diabetes, Zestoretic, Atenalol, and Norvasc for the blood pressure.  My cholestral is now under control by diet and Crestor.  I have eliminated all sugar from my diet, walk on a treadmill at least 30 minutes, 3 days a week, and do yoga 1 day a week (mostly stretches).  It is very hard to do much exercise because it aggravates the arthritis and fibromyalgia.  I'm 68 years old and I hate to think that I'll feel this bad for the rest of my life but what else can I do?

    I'd welcome any suggestions.                  Thanks

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