If you are T1D, some studies have suggested that you are 4 times more likely to suffer from depression than a non diabetic.
This is because, Diabetes affects us by:
- Decreasing the size of our brainbox, and our mental capacity, and
- Increases the number of stressors we are required to carry in it.
It is no surprise that for many of us, the box becomes impossible to carry and depression occurs.
Mental Capacity Reduction.
Serotonin is the substance that is regarded to regulate brain chemistry and mood but is not only produced in the brain. It is also produced in the intestines and guess what system is responsible for its production? The very same system that is broken in us T1Ds: The endocrine system.
Furthermore, a recent article I read, discovered that serotonin is also, actually found in the beta cells of the pancreas of a non diabetic person and it has a link to insulin production. Another study suggests that serotonin is actually produced as part of the breaking down process of carbohydrates to glucose.
So, simply by being diabetic, we have greater potential to have less balanced brain chemistry, and therefore a lower capacity, a smaller box.
Increasing our Stressors
Stressors are the baggage we carry around.
Just as our non diabetic friends do, we carry around the stresses of everyday life:
- Work issues
- Relationship, marriages and divorces
- Financial obligations
- Moving house
- Families and children
- Your health and mortality
- Death of others and grief
- Mental Health disorders, anxieties, depression and self esteem
We also carry stressors specific diabetic stressors.
Psychologically, the stress of constantly monitoring your health, incessantly obsessing over food intake and levels is a large burden to carry. There has been a study released which estimated that a T1d makes an extra 320 decisions each day due to the condition.
There are also a number of additional stressors unique to us T1Ds.
- Diabetic Grief
- Diabetic Anxieties
- Diabetic Burnout
- Diabulimia
These will be discussed next in this series.
Diabetes and depression can actually be a vicious circle: Diabetes causes depression then depression affects diabetes and so on…. This was certainly true in my case.
Usual symptoms of depression include
- Low mood (to varying degrees of definition)
- Lethargy
- Failure to motivate yourself, even for things you enjoy
Depression in a T1D can also result in insulin manipulation in a number of ways:
Burnout
Depression can result in a lack of motivation for normal activities. Therefore, it is common for it to result in a lack of motivation for T1D care.
Lack of self care
In my case, my lack of self care and therefore diabetic care has heavily linked to my self esteem issues. In general, I just stopped caring about anything to do with myself.
Self harm
I did not discuss or talk of this at the time, but could my insulin omission during depression have been my way of self harming?
Not necessarily in my experience, but depressive insulin misuse could include:
- Denying insulin as a self punishment
- Overdosing insulin to instigate hypos
- As a cry for help?
- As an justification to satisfy a binge eating episode
Suicide
The saddest and most extreme example of depressive insulin misuse is when a T1D is suicidal and uses the insulin as the weapon. I do know of a few friends who did attempt to end their life by administering a huge dose.
Medical screening and personal evaluation of mental health is even more important to us T1ds for the added dangers above.
Use the knowledge here, to realise how depression can manifest itself. It is more vital for us to recognise it early before the viscous circle starts. It is not your fault, it is no reflection of you as a person, there is no shame.
It is not about “Get over it!” or “Pull yourself together!”. If you need help, you need to ask for it.
My mantra today is that is is not a weakness to succumb to mental health issues in diabetes, it is par for the course and normal, but conversely it is shows massive strength to refute them and that strength and weakness are not two sides of the same coin…..