5 common problems with diabetes and depression

Mr. Li is a cheerful and warm-hearted person. He is often seen helping to maintain community security or clean public health. His hearty laughter often floats over the community. But since he contracted diabetes last year, Mr. Li's monthly medical expenses have cost him five to six hundred yuan, making his already poor family even worse.

It turned out that Mr. Li, who had a great voice and a warm heart, was gone. He was not interested in anything, and he sighed or frowned all day long. The family took him to see a doctor, and after the doctor conducted an examination and asked many questions, Mr. Li was diagnosed with depression.

Among many patients with diabetes, patients with severe mental disorders such as anxiety or depression or even schizophrenia are gradually increasing. However, because the clinical symptoms of such patients are hidden and complex, clinical attention is insufficient and they are easy to be misdiagnosed or missed, thus delaying treatment and affecting the patient's health. There are many adverse effects on mental mental and physical health.

What are the signs of diabetes combined with mental illness?

After being diagnosed with diabetes, patients have a lot to think about, including monitoring blood sugar levels, administering insulin, planning meals, and maintaining exercise status.

These can make patients feel physically and mentally exhausted and overwhelmed, which is called diabetes burnout. Clinically, the disease has an insidious onset, low recognition, and low clinical early diagnosis rate.

At present, it has been found that the common clinical manifestations of diabetes combined with mental illness include the following:

Neurasthenic syndrome, anxiety and depression, cognitive impairment, hallucinations and delusions, and disturbance of consciousness. Among them, anxiety and depression are the most common manifestations.

Diabetes and depression are more harmful to humans, and they often co-exist. The relationship between diabetes and depression is bidirectional. Diabetes can cause depression, and depression is also a risk factor for diabetes.

What are the symptoms of depression?

Depression, also known as depressive disorder, is characterized by significant and persistent low mood as the main clinical feature. Clinically, it can be seen that the depressed mood is not commensurate with the situation. The depression can range from depression to grief, low self-esteem and depression, and even pessimism and world-weariness. There may be suicide attempts or behaviors; even stupor; in severe cases, psychotic symptoms such as hallucinations or delusions may occur. .

The main manifestations of diabetes combined with depression are:

Depressed mood, loss of interest or happiness, with the characteristics of being heavy in the morning and light in the evening (sadness in the morning); slow thinking, poor concentration; lack of interest, preferring to be alone, withdrawing from friends and activities, decreased learning and work performance; sleep disorders , changes in sleeping patterns, with early waking as typical manifestations; suicidal thoughts; loss of sexual desire; feelings of guilt or worthlessness; accompanied by physical symptoms such as tension, anxiety, fatigue, palpitations, chest tightness, gastrointestinal discomfort, or constipation.

Why diabetics are prone to depression

Depression is the result of a combination of physical, psychological and social factors. The main causes of depression in diabetes include:

① Diabetes is a long-term chronic disease. There is currently no complete cure. Patients must always pay attention to dietary management, frequently monitor blood sugar, and take long-term medication. Some patients require long-term insulin injections, which greatly reduce the patient's quality of life. Some patients believe that the use of insulin indicates a serious condition, so they have greater psychological pressure and pessimism.

② If blood sugar is not well controlled, patients may develop complications within 5 to 10 years.

③Long-term treatment generates a large amount of medical expenses, brings heavy financial burden to patients and families, and increases psychological pressure dramatically.

④ Long-term hyperglycemia causes stress-like reactions in the body, increases plasma cortisol, glucagon, and growth hormone levels, and changes cortisol activity. These changes make patients prone to anxiety and depression.

⑤The psychological burden of diabetes can activate stress hormones, thereby worsening blood sugar control, increasing obesity, and causing inflammation, which may affect the central nervous system and may worsen mental health.

What are the dangers of diabetes combined with depression?

Diabetes combined with depression is very harmful, because depression and diabetes can interact and cause each other, forming a vicious cycle.

Diabetes can cause inconvenience in patients' lives and physical and mental pain. In addition, the final outcome of the development of diabetes may cause complications in important organs (such as eyes, kidneys, nerves, cardiovascular and cerebrovascular diseases, etc.), which makes many patients This resulted in heavy mental pressure. This negative emotion can not only affect the patient's compliance with treatment, but also cause neuroendocrine disorders.

In addition, patients with diabetes may also experience the following hazards when they are depressed:

① When patients are depressed, they are in a state of stress, and cortisol secretion increases, reducing glucose utilization, inhibiting insulin secretion, excitating sympathetic nerves, and increasing catecholamine secretion, leading to an increase in blood sugar and accelerating the occurrence of complications.

② Mood disorders themselves can directly cause immune dysfunction and increase the probability of developing diabetes.

③ Negative emotions cause patients to lack control over their diet, have poor compliance with hypoglycemic treatment, and have unsatisfactory blood sugar control. In turn, poor blood sugar control and worsening of the condition will make the patient more pessimistic and disappointed, aggravating the patient's depression. In addition to worsening diabetes, severe depression may even lead to serious consequences such as suicide.

How to Treat Diabetes and Depression

Elderly patients with diabetes or those with impaired consciousness have a higher mortality rate because their condition changes rapidly, their recovery is slower, and their mortality rate is higher.

For patients with diabetes and depression, it is necessary to formulate an individualized hypoglycemic plan, and try to choose drugs that are simple to take, convenient to operate and have a low risk of hypoglycemia. This can be followed by a range of psychiatric and psychotherapeutic treatments.

Through the implementation of diabetes education, patients' misunderstandings about diabetes are corrected, and patients are informed that diabetes is not an incurable disease, so as to relieve their pessimism and mental pressure, help patients build confidence in overcoming the disease, and encourage them to actively cooperate with treatment. When patients have negative emotions, they can take a variety of measures to stop them: take a breath; take a deep breath; drink water; sit down; lean back; shake your arms; try to silence yourself; take a walk. In addition, the whole society should actively lend a helping hand and offer love to alleviate their financial worries.

For patients with severe depression, antidepressant medication can be given under the guidance of a doctor.

In addition, exercise and cognitive behavioral therapy (CBT), either alone or in combination, can significantly alleviate depressive symptoms in patients with type 2 diabetes. Pioglitazone, alone or as an add-on to conventional treatment, can induce remission of depression. Drugs with PPAR-γ agonist properties may be clinically relevant antidepressants. In addition, metformin can also improve depressive symptoms and cognitive function in patients with type 2 diabetes and depression.