According to most experts, depression and diabetes have been intricately connected in a vicious cycle. While the prolonged and sustaining nature of diabetes directly makes one vulnerable to the bouts of depression, doctors tend to locate traces of depression in the family history of an individual in order to diagnose the roots of diabetes. It won't be too far-fetched to state that both causes as well as affects the other.

If you have diabetes, either type 1 or type 2, you have an increased risk of developing depression. And if you're depressed, you may have a greater chance of developing type 2 diabetes. The good news is that diabetes and depression can be treated together. And effectively managing one can have a positive effect on the other.

How diabetes and depression correlated? 
There are myriad ways in which diabetes affects depression and vice versa. 

Firstly, tackling such a long drawn disease and its various pitfalls might cause a lot of anxiety to one and lead to depression. Whereas on the other hand, depression reduces the zeal to live and thus results in poor lifestyle choices which in turn causes weight gain, unhealthy food habits, physical inactivity. As we are well aware, all these have the potential to wreak havoc for any patient of diabetes. 

Similarly, diabetes ushers in various other health complications, adversely impacting one's productivity. This may cause depression in a lot of people. 

On the flipside, depression impedes one's ability and enthusiasm to work or communicate, this in turn intervenes with one's monitoring of diabetes. Since these two extremely malevolent diseases have such close connections, medical science recommends ways to grapple with both. The rigors of managing diabetes can be stressful and lead to symptoms of depression.

Diabetes can cause complications and health problems that may worsen symptoms of depression.

Depression affects your ability to perform tasks, communicate and think clearly. This can interfere with your ability to successfully manage diabetes.

Treatment

Depression is just like any other illness, it can be treated. Treatment can lift the depression and improve diabetes control.

Looking after your diabetes will help decrease the risk of getting depression. If you already have depression, good diabetes management will help lessen the negative impacts it can have. Depression is no different to any of the other complication of diabetes. It is a genuine illness for which you need to seek help and support from health professionals.

The treatment for depression and diabetes involves a coordinated approach that monitors both diabetes control and the symptoms of depression. It is about finding the treatment that works best for each person. For example, people with diabetes and mild depression may find that regular physical activity improves depressed moods and also helps control blood glucose levels.

Helping yourself.

If you suspect you might have depression, take control of your health by:

Going to a doctor or other health professional
Getting involved in social activities
Engaging in regular moderate physical activity
Learning about depression and diabetes
Very particular about medicines prescribed for diabetes
Eating healthily and including a wide variety of nutritious foods
Achieving and maintaining healthy weight
Limiting your alcohol intake
Getting help, support and encouragement from family and friends
Asking your doctor to check your blood pressure, cholesterol and blood glucose levels.

Diabetes and Depression

The risk of developing depression is found by the means of various researches to be two to three times higher in individuals suffering from a chronic disease than in normal individuals. Type 1 and type 2 Diabetes are chronic diseases that can prove to be very challenging to manage due to various setbacks and complications that can come in the way. Regular monitoring of the blood sugar levels is essential in managing the blood sugar. Navigation of the health care facilities, side effects caused by medications, and other related health conditions or even diabetic complications can cause an increased risk of developing depression. If left undiagnosed and untreated, depression can give way to a poor lifestyle choice that can further deteriorate the physical health of a person. 

Various risk factors that are associated with diabetes and depression are as follows- 

lack of physical activity
poor social environment
poverty
stress during pregnancy
Depression in diabetes can occur simultaneously due to a variety of factors. These include the psychological and psychosocial impact of the disease on an individual, a potential common genetic susceptibility and certain common pathophysiological abnormalities that involve neuro-immunological and neuro-endocrinal pathways, as well as microvascular brain lesions due to diabetes mellitus. However, issues concerning pathogenesis and causality of this high co-occurrence are not fully determined yet. Still, the presence of depression in patients with diabetes mellitus is of vast importance, as it is usually associated with poor disease control, adverse health outcomes and quality of life impairment.

When an individual is suffering from diabetes, the awareness of risks of developing depression is essential. It has been widely researched and found that these two conditions can occur simultaneously, where depression is usually undiagnosed. Diabetes, specifically type 2, and depression affect each other in a bi-directional manner, which means that each of the disease can prove as a risk factor for the other. In a state of depression, it is common for a person to consume high calorie foods and also to lead a sedentary lifestyle. This tendency can prove to be a risk factor for developing type 2 diabetes. 

If an individual already has type 2 diabetes, the stress experienced during the management of disease can cause depression. Type 1 diabetes develops as result of the defect of pancreas in production of insulin. 

People with type 1 diabetes can also develop depressive symptoms due to difficulties in the management of the disease. If the symptoms of depression develop in the patient already suffering from diabetes, management of diabetes also becomes difficult. This can lead to cause various diabetes related complications and also decrease the life expectancy. 

Various signs that can be observed in a state of depression are as follows: 

Complete lack of interest in doing any activity
Irritation or mood swings
Depressed mood
Disturbed sleep pattern
Changes in the appetite
Constant feeling of despair
Guilt Fatigue, weakness
Difficulty in concentration, transient memory loss
Suicidal tendency
There is a certain risk observed between the consumption of antidepressant medicines and development of diabetes. It has been researched and concluded that consuming antidepressants should always be on physician recommendation, with a prior advice on the risks of developing diabetes. It has also been found that the people with type 2 diabetes, who are using insulin regularly, are at higher risk for developing depression as compared to the people on non-insulin medications or following only diet or lifestyle modification habits. An additional stress experienced in managing diabetes and accessing the health care services can cause such complication in insulin users. 

Common treatment protocol for depression includes psychotherapy or the cognitive behavioral therapy. It helps people to correct destructive thought patterns and behaviors that tend to increase the depressive symptoms. Other interventions like a structured problem solving approach, motivational interviewing, and interpersonal approach towards the patient is also effective in management. Certain medications can also help in mood-lifting and the management of symptoms of depression.

In diabetics, the treatment options that are available in addition to the standard medical healthcare provision includes self-management training sessions that help the people to increase healthy habits and improve control on their blood sugar levels. Diabetes as well as depression can improve with complete focus on lifestyle changes, like proper diet management and exercising regularly.

How Diabetes Can Lead To Depression?

Psychiatric disorders like bipolar disorder or schizophrenia do not appear all of a sudden. There are small changes that happen to an individual over a long period of time until the disease fully develops. These signs and symptoms might be too subtle in the early stage for other people to notice until they become obvious. But an early detection of any irregularity proves to be more beneficial for the patient in the long run.

It is important to know the telltale symptoms of mental disorder to distinguish between what is regular and what is not.

Withdrawal
Everyone needs some quiet time to cool off and relax but if a person continuously withdraws him/herself from social occasions and avoids meeting or speaking to friends, it could be a sign that something is wrong. Losing interest in life, work and people are symptoms of depression and psychotic disorder.

Thinking problems
Having trouble concentrating, remembering, understanding and explaining oneself in a coherent manner are some common signs of mental disorder.

Anxiety
Excessive stress and anxious behavior for a prolonged period are not normal. Frequent heart palpitations, headache, shortness of breath, racing mind and restlessness are cries of help that need to be heard.

Emotional outbursts
Sudden dramatic outbursts for no apparent reason, frequent mood swings and feeling distressed are potent signs of mental illnesses. These kinds of behavior are seen as part of a person's nature and so they are often unnoticed.

Changes in appetite and sleeping patterns
Oversleeping may be a sign of depression and insomnia could be a sign of anxiety. Changes in appetite and not caring about oneself or the world are indicators of a mental problem.

5 Silent Signs Of A Psychiatric Disorder


7 CHARACTERISTICS OF EMOTIONALLY STRONG PEOPLE

Emotionally strong people are better able to manage the stresses and distresses of daily life, and recover more quickly from challenges and crises when they arise. Is your emotional engine strong enough to take you through the ups and downs of life? Are you riding a bullock cart which can topple over anytime you pass through a broken road or are you driving a four wheel, all terrain vehicle, which will ensure you a safe trip through all the rocky terrains of your life?

A common cultural belief is that people who don’t cry and are unemotional, detached are the emotionally strong ones...and the ones who cry easily and exhibit emotional turmoil are the weaker ones. Well, this is just a myth and not an accurate indicator of one’s mental and emotional strength. A person’s internal coping mechanism will determine how strong he/she is emotionally and deal with challenges and bounce back from them. For eg. Two investors invest in a startup company and watch it fail after 5 years of hard work...one cries copious tears and falls apart, the other controls his emotions but feels defeated. Both were not emotionally strong as they couldn’t sustain the pressure and crumbled. It would have been fine if they felt sad and worried over the loss of time, resources and money and then bounced back with fresh ideas and renewed energy, which would have shown their capability to bounce back from difficult situations.

Unfortunately, too many of us judge ourselves incorrectly in exactly such moments. If we react emotionally or tearfully to emotionally challenging situations we scold ourselves for being weak, even when we have every intention of persisting and moving forward and even when we believe we will eventually succeed. Tears are usually a sign of frustration and disappointment, not defeat. What you believe about your future chances of success and how discouraged you feel in the long term is far more important than how often you cry in response to stresses and bad news.

The following list will help you decide how emotionally strong you are and where you need to work on yourself:

1) Emotionally strong people are less discouraged by setbacks and disappointments: they see each failure as an opportunity to learn and improvise over the last one. They compare themselves with themselves and define their own measures for failure and success. You could do an analysis of your strengths, limitations, opportunities and impediments in order to get over difficult situations. Geet, a student who didn’t get into his desired subject of IT, sat through 5 years of Law and did some extra courses in corporate law and worked towards fulfilling his dream of working in the Corporate. He felt confident, happy and satisfied with his efforts.

2) Emotionally strong people are more adaptable to change: they welcome and embrace changes in themselves and their environment simply because it brings newer opportunities and learning which can catapult them on their way to success. New boss, different stage of life, children going away are changes that will surely happen. Preparing for them in advance, can help people cope better with changes. When Surabhi got married, she took marital counselling to prepare for the differences that will crop up due to changes in the environment, thinking and attitudes of her inlaws family. She is a happy and successful wife and mother today.

3) Emotionally strong people are able to recognize and express their needs: ability to acknowledge and express your needs is being genuine to yourself and an expression of self care. People who are self aware move faster on the ladder of success as they are devoted and passionate towards their goals and needs. Taking care of your health and exercising along with a professional career makes for an emotionally strong person. You can become aware of your needs and values in counselling and experience contentment and power as you take charge of your life.

4) Emotionally strong people focus on getting around a hurdle rather than on the hurdle itself: focussing on the hurdle can be very emotionally draining and demotivating. Emotionally strong people invest their energies in working through a problem and looking for viable solutions, which ensures their victory over stresses and strains. If you have lost money in business, then working on your sales and marketing skills could get you better gains rather than feeling defeated. Counselling can help you look at problems objectively and from different perspectives. Get in touch with your problem solving skills and feel motivated and accomplished again.

5) Emotionally strong people can learn from mistakes and criticism: who hasn’t been subjected to criticism or made some mistakes? It’s human to err. Working towards excellence rather than perfection and looking for the golden piece of advice in the strong criticism helps emotionally strong people win over situations and important relationships. Sarita, an intelligent and smart woman ignored the critical remarks of her mother in law because she knew that there is a lot to learn from her. She knew which battles to fight and which ones to let go of.

6) Emotionally strong people tend to see the larger perspective in a challenging situation: They don’t get weighed down by smaller defeats when they have the larger picture in mind. An emotionally strong employee, Martin, who experienced office politics, kept his cool and focussed on his work.

7) Emotionally strong people are able to recover more quickly from emotional wounds such as failure or rejection: nobody can reject you unless you give them the permission. Seeing each failure as an opportunity to grow and learn helps. Staying with what you can do differently next time and having fall back plans helps to reduce the impact of failure. Thomas Edison didn’t get deterred by the number of times he could make his bulb glow. He kept looking at different permutations and combinations and kept learning from each mistake. Finally, his bulb glowed and now we all can benefit from the fruits of his hard labour.

If you don’t find yourself scoring high on this list, then there is no need to worry because in personal counselling, you can build emotional strength and capacity to bounce back by working on your mindset and learning more adaptable responses to stresses of daily living.

7 characteristics of emotionally strong people

Role of relationship problems in depression and suicides - 
Almost everyday we read about people ending their lives by committing suicides from celebrities to common man to even children . Although this is not permitted in any religion and there is a legal debate on whether it should be legalized, the fact remains that people are driven towards this unfortunate step. Let's take a look at the common reasons for suicides to become so very common.

1) Lack of intimacy- We see that although we are surrounded by people most of people are having friends only on Facebook. Even among the people we interact everyday nobody wants to open up with anyone or allow you to open up with them.The fact that you are surrounded by people who don't share themselves with you intimately starts pulling your mind downwards. Work colleagues are bothered only about work, family is only bothered about the income you are generating, partners are obsessed with how much you can spend on them, friends are occupied with what benefits you can share with them. Therefore all in all, despite having all relationships, people feel left out and alone like as if their inner self has been left unwanted and uncared of. The monotony of mechanical life hastens the culmination of this abuse into drastic steps like suicide.

2) High demands- People are often left to fend with high demands from them from their social circle. Many people cannot attempt this and some who attempt are not able to make it. This leaves them with a feeling of failure which is often frowned and looked down upon whether it is a student or a professional. It is no surprise that today even below 10 years olds are successfully attempting suicides.

3) Inappropriate planning- Planning is a key necessity for successful results whether it is financial or relationships. but unfortunately many people are unable to obtain the correct know how which will enable to implement their plans successfully.

4) Inability to cope- Many people plan to do things but are unable to cope with the harsh realities that come with the plans. To some it may be unseen to some unbearable. So although they set out on doing something the journey is not what they had expected.

5) Lack of results- Sometimes although everything is planned well, executed well and completed well it does not fetch us the rewards that may seem appropriate to the level of efforts. This is something that is very difficult to deal for most people and is a result of many unfortunate casualties.

6) Lack of desire-It is very important to have something to look forward to in life. But unfortunately in an age where drinking water and using the toilet cost s money many people cannot think of having something to look forward to and hence this unfortunate step.

Therefore, you have to be very prudent in what we are doing today because we can never predict which way our lives may go and even importantly which way you may yourself go based purely on circumstances beyond our control dependent on the choices we make today or others make for us. Although suicide is not a sensible solution to any problem it does remain a common reality. If you are feeling suicidal please remember to seek help.

Please feel free to consult me privately for further assistance.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Health Tip - Role of Relationship Problems in Depression and Suicides

Are you a 'What-If' person? Kill anxiety in 4 easy ways

Thinking about dangers and risks is a normal phenomenon, it helps us to stay alert and to become a good problem solver. It’s only when worrying gets out of a person’s control, it turns into a problem. If a person is constantly preoccupied with “what-if " and keeps imagining worst-case scenarios, worry actually turns into the cause for high pulse rate, insomnia, poor mental and physical health. 

Here are 4 simple steps to cope with anxiety and worry.

1. Breathing technique: The first thing to do when you get anxious is to take deep breath. Deep breathing is a powerful anxiety-reducing technique because it activates the body’s relaxation response. Try slowly inhaling to a count of 5, filling your belly first and then your chest, gently holding your breath to a count of 5, and slowly exhaling to a count of 5 and repeat several times.

2. Accept that you’re anxious: Remember anxiety is just a feeling, like any other feeling, by reminding yourself that anxiety is simply an emotional reaction, you can start to accept it. Acceptance is critical because trying to eliminate anxiety often worsens it. But accepting your anxiety doesn’t mean liking it or resigning yourself to a miserable existence. It just means you would benefit by accepting reality as it is – and in that moment, reality means 'anxiety' you are feeling.

3. Question your worries. When people are anxious, most of the time their brains start coming up with all sorts of unrealistic ideas, which most likely will never occur. To avoid unnecessary worry, one should ask himself / herself a few questions like:
- Is there a reason to believe something is wrong?
- What evidence is there that something is wrong?
- If the worst possible outcome happens, what would be so bad about that?
- What are the options I can use to handle the situation at hand?


4. Focus on right now: When people are anxious, they are usually obsessing about something that might occur in the future. It is important that when a person becomes anxious, he/she takes a deep breath and pay attention to what’s happening right now, around them. Even if something serious is happening, focusing on the present moment will improve your ability to manage the situation.

If you would like to consult with me privately, please click on 'Consult'.

From Lybrate: If you found this tip useful, please thank the doctor by clicking on the heart icon below. Also, spread good health by sharing this tip with your loved ones over WhatsApp, Facebook and other media.

Are you a 'What-If' person? Kill anxiety in 4 easy ways

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