People who are diagnosed with a chronic physical health problem such as diabetes are 3 times more likely to be diagnosed with depression than people without it. Depression can have a serious impact on a person's well being and their ability and motivation to self-manage their condition. Depression is the most common psychiatric disorder witnessed in the diabetes community.

People with diabetes suffering from depression are at greater risk of suffering from an episode of diabetic burnout which collectively can have adverse effects on physical health and potentially instigate more long term complications both to do with diabetes and independent from the condition.

April 7 is being observed as the World Health Day. This year the theme was Depression: Let's talk. Depression is the leading cause of ill health and disability worldwide. More than 300 million people are now living with depression, an increase of more than 18% between 2005 and 2015. The World Health Organisation (WHO) is leading a global campaign on depression for World Health Day 2017, with the goal of enabling more people with mental disorders to live healthy, productive lives.

What is depression?

Depression is the term given when an individual experiences a number of symptoms including:

             Persistent sadness or anxiety, a feeling of hollowness

             An overriding feeling of hopelessness and negativity

             Feeling helpless and powerless to change your situation

             Loss of interest in activities or pleasures

             Lower energy and increased fatigue

             Insomnia, oversleeping, awakening early in the morning

             Concentration problems, memory problems and indecisiveness

             Dwelling on death or suicide

             Restlessness

             Weight change and decreased or increased appetite

A diagnosis of depression is made if many of these symptoms are present, continuously, for a minimum of two weeks.

For people with diabetes, dealing with a lifelong condition and managing the risk of complications can seem like an overwhelming task, particularly for newly diagnosed patients. Many diabetics struggle to cope with the requirements, feeling overwhelmed and unmotivated. If diabetes is not faced with an attitude of perseverance and defiance, often depression will prevail.

Depression is the perception of life situations as undesirable. Often, when individuals are faced with adverse events or conditions, they spend huge amounts of effort trying to escape or deny such circumstances. Avoiding unpleasantness and expending energy trying to minimise discomfort can cause symptoms of depression.

How can depression affect my diabetes?

Depression can affect a patient's capacity to deal with their diabetes, including managing blood glucose levels appropriately.

Research has found that people who suffer from both diabetes and depression have poorer metabolic and glycemic control which has, in turn, been found to intensify symptoms of depression.

Additionally, anti-depressants have been found to have hypoglycaemic effects causing serious problems for self-management.

It has previously been reported that depressed people with diabetes are less likely to adherence to medication and diet regimens and subsequently have a reduction in quality of life and increased health care expenditure.

Research has shown by addressing depression, glycaemic control is enhanced, mood and quality of life is significantly improved.

If you think you have depression, talk to someone you trust and seek professional help. There is obviously no shame in seeking help.

The writer is an Assistant Professor of Endocrinology Department at Bangabandhu Sheikh Mujib Medical University.

Email: selimshahjada@gmail.com