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Diabetes


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#1 Wonder

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Posted 07 October 2011 - 02:42 AM

Many people are now being diagnosed with Type 2 diabetes and slide into depression after being told. It is a difficult disease to manage; strict diet, measuring portions, testing, eating at regular intervals, injecting insulin etc.
For a person who suffers from a mental disability it is already a struggle to manage self-care.

I have been off work for 5 months and was admitted to Psych Ward in August to get my mood stabilized and my blood sugars under control. I was unable to take care of myself at home and now that I am back for the past month have not been keeping up with the program.
My days are turning into nights and my nights have turned into days. I don't leave my house or get off the couch. I just watch TV or get on my computer and dabble. I used to be able to read books upon books and now cannot pick one up and read more than 2 pages. I don't pick up the phone. I haven't been taking my meds, eating, or managing my diabetes and I feel guilty about it. I don't wan to let on to my doctors because they will be disappointed and might want me to go to hospital again. I keep telling myself tomorrow, tomorrow.
One thing good is that I am not thinking about suicide.

#2 LaurynJcat

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Posted 07 October 2011 - 03:42 AM

Hi Wonder.

I'm sorry to hear of your condition. It's difficult to manage type 2 diabetes at the best of times, let alone when you have depression. It's also common for people with depression to have trouble with keeping a regular schedule, self-care and housework. It sounds to me (from your inability to concentrate on books, irregular schedule etc) that you are quite severely depressed. I'm an avid reader too, and only during my most severe major depression did I lose the ability to concentrate on books. Are you on any anti-depressant medication?

Please be honest with your doctors so they can help you. If your depression makes you unable to regulate your diet, you may need to be in hospital. It's better than getting permanent physical damage from your type 2 diabetes. Your depression (and thus lack of motivation) is not your fault.

There is hope. I have a good friend who had both depression and type 2 diabetes, whose fasting blood sugar was 25 when she was first tested and now she's stable on meds for her depression, lost 50 pounds and doesn't need her diabetes medication any more (she still takes the anti-depressant). It took her about a year to get everything together.

Hugs and best wishes to you. Please take care of yourself, and if you can't, let your doctors know.
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Edited by LaurynJcat, 07 October 2011 - 03:43 AM.

"Be gentle with yourself. You are a child of the universe, no less than the trees and the stars; you have a right to be here."
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#3 rehill

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Posted 07 October 2011 - 04:56 PM

Hi Wonder--

I also have type 2 diabetes and am depressed. When I am really struggling I tend to take a "diabetes holiday" and stop my insulin, quit eating properly, don't check blood sugars, etc. The first few times I didn't tell my doctors either, and I am just very lucky I didn't get really sick.

You really need to let your doctor know what is going on. If you need to be in hospital, so be it. Better than the alternatives of uncontrolled diabetes. Trust me.....

The last time I took a diabetes holiday my doctor and I decided it was really a passive suicide attempt - I don't have to do anything, just let myself get really sick. And it took so long for me to get back on track, I don't want to have to do that again. And now my psychiatrist regularly asks how my sugars are, and if I can't tell him he knows I'm in trouble.

Please talk to your doctor. Let us know how it goes for you!

#4 Wonder

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Posted 08 October 2011 - 09:36 AM

@ laurynjcat and rehill

Hi,

Thanks for your replies.

I was in hospital in Aug 9 - Sept 9. They did get my moods stabilized for the most part and my blood sugars were too. Once I got home it didn't take long to slide on both counts. Rehill, you are probably right, it is passive suicide. It's been a life long battle. Cognitively I do realize my thoughts and inaction are destructive and irrational but it doesn't seem to matter. I rarely speak to anyone unless I have to and stay in home unless I have to go out for a doctors appointment or need groceries. I have lived alone for 12 years.

I see my psychiatrist one a week and my family doctor once per month. When I tell the truth about my lack of self-supervision, I get the reprimand from both. It's uncomfortable. And I know it is for my own good. I vow to do better after my appointments and totally intend
to yet I slide again within a couple of days.

I have issues about having ruined my life because of alcoholism (7 years sober now) and the risky behavior that goes with it. I have issues lingering from childhood abuse and domestic violence. It's all so overwhelming.

#5 litemorden

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Posted 04 November 2011 - 07:17 PM

Hi Wonder -

Just wanted to offer you my sympathy and support. My problem isn't exactly the same, as I'm a T1 diabetic since childhood (now in my late 20's), but the major symptoms of our diseases are the same, as are the complications caused by high blood sugars. Depression is definitely one of those complications, and it goes beyond the usual, "Oh, crap, I'm sick and this sucks." High blood sugars make the brain depressed, and depression makes blood sugars harder to control and good habits harder to maintain. Also, you mentioned difficulty concentrating - High blood sugar affects concentration, and so does depression. The two diseases together are a horrible combination. It feels like such a downward spiral! Also, I've struggled with addictions, emotional abuse, unemployment, social anxiety, poor body image. It all seems to pile on endlessly. It's easy to feel powerless in the face of that.

However, we also know that things will only get worse if we don't take care of ourselves properly. Lately I've been panicking about aging, and the complications that I will certainly face soon - the sickness, helplessness, surgeries, and expense of it all. I realize that things could get even worse than they are now, and they will rapidly deteriorate unless I get my crap together and work on being healthier. I'm using that fear as a motivator. We can make things better if we can somehow find the energy and impulse control to form better habits. That isn't to say that I'm doing great right now, but even just trying a little will lower your A1C a few points if at present you aren't trying at all.


Also, it can help immensely to have a team of people there to offer encouragement, such as doctors and perhaps diabetes educators, dieticians, and counselors. They aren't there to judge you, so try not to hide things or push them away if you've been in poor control. That's something I've had to learn, because of all the childhood memories I have of feeling like I was in trouble with the stern-faced adults whenever my blood sugars weren't good, or if I ate something I shouldn't have, or forgot to test my blood. For several years I went about things just "flying blind" with my diabetes control because I had such an aversion to paying attention to what was going on with my body, because I felt like I would be held accountable and shamed for every little mistake. Not so! As adults, we're accountable to ourselves for our own health. (Or, as I'm thinking right now, accountable to a potential future with a kidney dialysis machine as my companion sooner rather than later unless I take care of myself better.)

Good luck to you! If I can make improvements in my control (which I have done), anyone can.

#6 rehill

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Posted 04 November 2011 - 10:44 PM

Hi Wonder -

Just wanted to offer you my sympathy and support. My problem isn't exactly the same, as I'm a T1 diabetic since childhood (now in my late 20's), but the major symptoms of our diseases are the same, as are the complications caused by high blood sugars. Depression is definitely one of those complications, and it goes beyond the usual, "Oh, crap, I'm sick and this sucks." High blood sugars make the brain depressed, and depression makes blood sugars harder to control and good habits harder to maintain. Also, you mentioned difficulty concentrating - High blood sugar affects concentration, and so does depression. The two diseases together are a horrible combination. It feels like such a downward spiral! Also, I've struggled with addictions, emotional abuse, unemployment, social anxiety, poor body image. It all seems to pile on endlessly. It's easy to feel powerless in the face of that.

However, we also know that things will only get worse if we don't take care of ourselves properly. Lately I've been panicking about aging, and the complications that I will certainly face soon - the sickness, helplessness, surgeries, and expense of it all. I realize that things could get even worse than they are now, and they will rapidly deteriorate unless I get my crap together and work on being healthier. I'm using that fear as a motivator. We can make things better if we can somehow find the energy and impulse control to form better habits. That isn't to say that I'm doing great right now, but even just trying a little will lower your A1C a few points if at present you aren't trying at all.


Also, it can help immensely to have a team of people there to offer encouragement, such as doctors and perhaps diabetes educators, dieticians, and counselors. They aren't there to judge you, so try not to hide things or push them away if you've been in poor control. That's something I've had to learn, because of all the childhood memories I have of feeling like I was in trouble with the stern-faced adults whenever my blood sugars weren't good, or if I ate something I shouldn't have, or forgot to test my blood. For several years I went about things just "flying blind" with my diabetes control because I had such an aversion to paying attention to what was going on with my body, because I felt like I would be held accountable and shamed for every little mistake. Not so! As adults, we're accountable to ourselves for our own health. (Or, as I'm thinking right now, accountable to a potential future with a kidney dialysis machine as my companion sooner rather than later unless I take care of myself better.)

Good luck to you! If I can make improvements in my control (which I have done), anyone can.



You're right, depression makes diabetes harder to manage, diabetes makes depression harder to manage. It is a vicious circle. One thing that has sort of worked for me--when I take a diabetes holiday, I will try to set myself a really small goal like "Just for today I will check my sugar twice (or whatever)and take my insulin". I don't make any plans about I am going to do this right from now on, but just for today. And I tell a friend when I do that, and she will check with me in the evening to see how I did. No reprimand if I don't make it, and lots of encouragement if I do. And I have a great diabetes nurse who will just call me to check in, and ask if there is anything she can do to help.

Now, about that plan to have a dialysis machine as a companion.... Please don't go there. I am a renal nurse and have worked with dialysis and transplant patients for over 20 years. I currently work in the kidney transplant clinic. I look after people who have had kidney or kidney and pancreas transplants (for the type 1's). I know you know what to do.... When my doctor looked at me and said diabetes, I made a decision that day, over 15 years ago, that I was not going to become one of my own patients. And I when I am doing well I really stick to that goal. So that's how my doctors know when I am struggling - when I go on holiday - because they know my resolve never to have my colleagues looking after me. Anyhow, if you ever have questions about the renal stuff, feel free to pm me. I love my job and could talk about it for hours..... :)

Here's to all of us managing well - both with diabetes and depression!

#7 sober4life

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Posted 05 November 2011 - 09:27 AM

I used to not care much about my diabetes but I decided I didn't want to die from it. It's very serious and people should definately watch what they eat and take their pills or insulin. It basically destroys your body and kills you in a miserable way. So we have to eat stuff that usually doesn't taste very good. It could be worse.

#8 spenler

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Posted 16 November 2011 - 10:22 AM

Hi Wonder -

Just wanted to offer you my sympathy and support. My problem isn't exactly the same, as I'm a T1 diabetic since childhood (now in my late 20's), but the major symptoms of our diseases are the same, as are the complications caused by high blood sugars. Depression is definitely one of those complications, and it goes beyond the usual, "Oh, crap, I'm sick and this sucks." High blood sugars make the brain depressed, and depression makes blood sugars harder to control and good habits harder to maintain. Also, you mentioned difficulty concentrating - High blood sugar affects concentration, and so does depression. The two diseases together are a horrible combination. It feels like such a downward spiral! Also, I've struggled with addictions, emotional abuse, unemployment, social anxiety, poor body image. It all seems to pile on endlessly. It's easy to feel powerless in the face of that.

However, we also know that things will only get worse if we don't take care of ourselves properly. Lately I've been panicking about aging, and the complications that I will certainly face soon - the sickness, helplessness, surgeries, and expense of it all. I realize that things could get even worse than they are now, and they will rapidly deteriorate unless I get my crap together and work on being healthier. I'm using that fear as a motivator. We can make things better if we can somehow find the energy and impulse control to form better habits. That isn't to say that I'm doing great right now, but even just trying a little will lower your A1C a few points if at present you aren't trying at all.


Also, it can help immensely to have a team of people there to offer encouragement, such as doctors and perhaps diabetes educators, dieticians, and counselors. They aren't there to judge you, so try not to hide things or push them away if you've been in poor control. That's something I've had to learn, because of all the childhood memories I have of feeling like I was in trouble with the stern-faced adults whenever my blood sugars weren't good, or if I ate something I shouldn't have, or forgot to test my blood. For several years I went about things just "flying blind" with my diabetes control because I had such an aversion to paying attention to what was going on with my body, because I felt like I would be held accountable and shamed for every little mistake. Not so! As adults, we're accountable to ourselves for our own health. (Or, as I'm thinking right now, accountable to a potential future with a kidney dialysis machine as my companion sooner rather than later unless I take care of myself better.)

Good luck to you! If I can make improvements in my control (which I have done), anyone can.



My goodness, when I read your post, I felt like I wrote it myself! I have suffered from type 1 for 26 years now. Two years ago I was diagnosed with depression and a year ago with anxiety. I've tried all different kind of meds, which haven't worked. It is a daily struggle and a vicious circle dealing with all 3 illnesses. I'm so tired, physically, emotionally and spirtually from feeling like I'm going around in circles with no end in sight. I never do not take my insulin, but for someone who used to be very controlled, I'm certainly not that way anymore. I used to work with a diabetes team, however after missing 2 appointments (due to the depression) they decided to drop me as a patient. I had tried talking to my diabetes doctor about the depression and he wanted no part of it, told me that was an issue for my family doctor. My life has become so frustrating, there are more times now than ever that I feel like just giving up.
My greatest fear is kidney problems as well. I told my counselor that if it ever came down to having to go on dialysis, I couldn't do it.
I too need to get my crap together. But when the depression and anxiety are fighting against you, it is so very hard to do. I have never lacked motivation and energy like I do now. And it's so hard to talk to anyone about this, because they don't understand. My counselor isn't diabetic and neither is my doctor. So how can they possibly understand the constant battle that I face every day.
I hope that we can find some type of solution sooner than later. I am literally scared for my life.

Take care, Spenler

#9 litemorden

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Posted 22 November 2011 - 08:08 PM

My goodness, when I read your post, I felt like I wrote it myself! I have suffered from type 1 for 26 years now. Two years ago I was diagnosed with depression and a year ago with anxiety. I've tried all different kind of meds, which haven't worked. It is a daily struggle and a vicious circle dealing with all 3 illnesses. I'm so tired, physically, emotionally and spirtually from feeling like I'm going around in circles with no end in sight. I never do not take my insulin, but for someone who used to be very controlled, I'm certainly not that way anymore. I used to work with a diabetes team, however after missing 2 appointments (due to the depression) they decided to drop me as a patient. I had tried talking to my diabetes doctor about the depression and he wanted no part of it, told me that was an issue for my family doctor. My life has become so frustrating, there are more times now than ever that I feel like just giving up.
My greatest fear is kidney problems as well. I told my counselor that if it ever came down to having to go on dialysis, I couldn't do it.
I too need to get my crap together. But when the depression and anxiety are fighting against you, it is so very hard to do. I have never lacked motivation and energy like I do now. And it's so hard to talk to anyone about this, because they don't understand. My counselor isn't diabetic and neither is my doctor. So how can they possibly understand the constant battle that I face every day.
I hope that we can find some type of solution sooner than later. I am literally scared for my life.

Take care, Spenler


Whatever you do, don't give up! Find someone who will work with your depression.

Re dialysis - My uncle, who was diabetic, died at 40 because he refused dialysis. I would take dialysis over death! His sister, my aunt, who is also T1 from her childhood, often in poor control during her 20s and 30s, alcoholic for a time, and a chain smoker until her 40s, is still alive and nearly 70 years old. She has had many surgeries, including two heart bypasses and a pancreas transplant in the last 10-15 years (so, technically, she isn't diabetic any more). I'm not sure at what point she started dialysis, but she was probably in her 40s or 50s. Point being, we can survive a long time with medical interventions and the will to live. I'm scared to die, so I would rather live, but the quality of my life, being depressed and lonely from social anxiety, is so low that it's hard to take the steps needed to stay in good control. You're right - it is so very scary and discouraging. Still, being imperfect and yo-yoing in our motivation doesn't mean we have to give up. :)

That's also completely whack that your diabetes doctor wouldn't deal with your depression issues. I'd switch doctors! I've found that endos can be that way, very impatient and unwilling to consider the whole patient. I've been seeing internists now for a while because I think they tend to have more specialized knowledge than family doctors, but are more holistic in their approach than endocrine specialists. (You'd think endocrinology would be innately holistic, since hormones control everything!) On the website for my nearby hospital, it allowed me to search for internal medicine doctors who have stated a specialty in diabetes. There are also ways to search for therapists/counselors who specialize in patients with chronic illnesses. Psychologytoday.com has a therapist finder that lists therapists' credentials and areas of expertise. I'm using that to find a new therapist, but have been procrastinating making the call. :(

It would be nice to find a therapist who has experienced what I have first hand. However, just because someone is also diabetic doesn't mean s/he will necessarily understand you better. I had a diabetic friend who I recently had a friend-breakup with b/c she was a completely destructive, self-centered b-word. It's more important that the person you're talking to is an insightful listener who's willing and able to consider you as an individual.

Best of luck - Especially if you've been in good control before, you're likely to achieve that state again. I've been told that it's normal throughout our lives to go through periods of better or worse control. It's just a hard thing to maintain throughout a whole lifetime. It takes its toll. But a person is so much more than a disease.





#10 AquaViolet

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Posted 27 November 2011 - 10:46 AM

Many people are now being diagnosed with Type 2 diabetes and slide into depression after being told. It is a difficult disease to manage; strict diet, measuring portions, testing, eating at regular intervals, injecting insulin etc.
For a person who suffers from a mental disability it is already a struggle to manage self-care.


I can relate. I have Type 2 Diabetes, and I find it very difficult to get myself to eat right, check my blood sugar, etc. Heck - I find it difficult to want to take care of myself at all. It is probably because of my depression. I'm on meds that help, but I still feel somewhat depressed.

Edited by AquaViolet, 27 November 2011 - 10:47 AM.

~~AquaViolet~~
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My Diagnoses: Severe OCD, panic disorder, depression
My Current meds: Geodon, Cymbalta, Klonopin, Lyrica 

My Previous meds:
Prozac, Paxil, Celexa,
Lexapro, Luvox, Zoloft, Clomipramine (a horrible med for me),
Xanax, Seroquel, Zyprexa, Risperdal,
Gabapentin (this med did nothing), Buspar (also did nothing)

#11 rehill

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Posted 27 November 2011 - 09:29 PM

Actually, I don't think it is inappropriate at all for your diabetes doctor to suggest you speak to your family doctor. Many specialists do not feel competent to deal with mental health issues. I know the doctors I work with, while they acknowledge that depression can have hugely negative impact on patients, do not feel they are equipped to handle mental health concerns. And they believe they will do more harm by "faking it" than by suggesting a patient speak to someone else with more expertise. We refer patients back to their family doctor if they have one, if they don't, our doctors will initiate a referral to psychiatry and have our social worker initiate some form of support in the meantime. We certainly do not leave them hanging, but a family doctor is a more appropriate place for most people to start. At least in our patient population, a family doctor probably sees them more than the once or twice a year that we see them.

And personally, I would not want my diabetes doctor dealing with my depression any more than I want my psychiatrist dealing with my diabetes. Of course, that could just be me....




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