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?

We all have mood swings, but not all mood swings have the same intensity. People who have extreme mood swings ranging from depression to manic highs are said to be suffering from bipolar disorder. These extreme moods are known as episodes and usually last for a few days of even a few weeks at a time. A person suffering from bipolar disorder could have an episode several times a year. This is a very common psychological problem and can affect both children and adults. Though it cannot be cured, this disease can be managed with medication.

There are no known causes for bipolar disorder but genetics may play an important role in triggering this disorder. Hence, if a parent or sibling suffers from this condition, you have a risk of developing it as well. An imbalance in the neurotransmitters in the brain may also play a part in the development of this condition. Stress or traumatic events like the loss of a loved one can also increase your risk of suffering from this condition.
Given that mood swings affect almost each one of us, bipolar disorder can be difficult to diagnose. Some of the things to look out for are:

Change in self-esteem
Unusual talkativeness or quietness
Being increasingly prone to distractions
Decreased need for sleep
Agitation
Recklessness in terms of spending decisions, relationships etc
It must be kept in mind that a person must display at least 4 of the above symptoms simultaneously to be diagnosed as bipolar. Also, none of these symptoms should be a result or side effect of any kind of medication, drugs, alcohol or other intoxicants.

There are four main types of bipolar disorder.

Bipolar I: In such cases, the person has at least one episode of elevated moods and associated abnormal behaviour in his or her life. This may be preceded or followed by depressive episodes.
Bipolar II: In these cases, the person must have suffered from at least one depressive episode. It is very similar to bipolar I except that in bipolar II the highs never reach the manic stage.
Rapid Cycling: Some people can have 4 or more manic and depressive episodes a year. In such cases, they are said to be rapid cycling. This condition affects 10-20% of bipolar cases.
Mixed Bipolar: Usually, bipolar patients show mood swings that alternate between manic and depressive moods. However, sometimes a person may experience both elation and depression simultaneously or in rapid succession of each other. These cases are known as mixed bipolar.
Once diagnosed, bipolar disorder can be managed with a combination of medication and psychotherapy. In some cases, electroconvulsive therapy may also be needed. 

Bipolar Disorder - Things You Must Know!

Depression is a very common emotion you might have experienced at least once during your lifetime. Depression refers to a state of mind when you are feeling low due to persistent sadness and loss of interest. But if the depression is chronic and long lasting for you, then it indicates that you are suffering from clinical depression. Under clinical depression, it is preferable that you go through a proper treatment course by a certified therapist. The Most common types of depressions are:

-Major depression

Under this type of a depression you will be depressed for most days of the week and if this condition extends for a period greater than 2 weeks, then it is a case of major depression. The most common method to treat a major depression is to talk to a mental health specialist and take medications called antidepressants (only after a prescription by a certified doctor).

-Persistent depressive disorder

This is a more severe and long lasting type of depression which is identified if you are depressed over a period longer than 2 hours. The most common symptoms of this type of a disorder are - change in your appetite, too much or too little sleep, lack of energy or fatigue, low self-esteem, trouble concentrating or making decisions, feeling hopeless among others.

-Bipolar disorder

If you are experiencing extreme ups and downs of mood abruptly and without any apparent reason, then you might be suffering from this disorder. This disorder is commonly known as a maniac depression, because during an up phase you will be extremely happy, joyful outgoing and talkative but during the low phase you will be sad, tired and depressed.

-Seasonal affective disorder

This type of a depression might bother you only during the winter season. This happens whenever the days are shorter and your body is not able to get enough of sunlight. This mostly happens in the case of people who are very fond of sunlight, and they prefer the sunshine over dark periods of the night. This disorder is treated by SAD antidepressants and everyday light therapy of 15 to 20 minutes.

-Psychotic depression

Under this type of a depression, you will have a major depression along with some psychotic symptoms like - hallucinations, delusions, and paranoia. Hallucinations mean viewing things that are not there, in reality, delusions are false beliefs or misconceptions and paranoia is the constant fear that somebody is going to harm you.



5 Types of Common Depression

Smith and Mackie (2007) term self-esteem as a set of positive or negative opinions about oneself. Self-esteem is an important predictor of success in career, relationships, marriage and public life. People who are depressed have a very low self-esteem about themselves. They think of themselves as good for nothings and persons having a nil value. There are three states of self-esteem. They are;

Shattered: An example of a person having shattered self-esteem is when he says,  I am old and useless to do this kind of work . This person sees himself as an absolutely useless person.
Vulnerable: In this state, a slight embarrassment or defeat may expose the vulnerable side of the person. Otherwise, such persons have a positive frame of mind.
Strong: People in this state are very strong emotionally. Defeats, embarrassments etc. do not affect them. These people have a very high sense of self-esteem.
Psychologists, however, have prescribed several ways through which one can improve one s self-esteem.

How to improve one s self-esteem

Control your thoughts- Watch out what your inner critic is saying to you. Every time you hear its voice, ask yourself- would this be the way your best friend would speak to you? If your inner critic is being merciless on you all the time, you need to silence it.
Focus on the good things that happen to you- Everyday, write at least 3 good things that happened to you. Avoid the obstructive or harmful things that came your way. Focus on the happier side of the day. Do not dwell upon the negatives.
No need to be perfect- In the quest to be perfect, many people lose control of themselves. It probably must do with the pressures of modern life where achievement is the be all and end all. But, not everyone can be perfect. Rather, focus on the effort or process. This way, you will be better able to appreciate yourself as a person.
Accept mistakes- Often we fail to realise that mistakes come to us masked as opportunities. But, we are too fixated by the mistakes we commit. We are obsessed with the thought,  Why did I commit this mistake?  rather than,  How to avoid this particular mistake? . If we learn how to avoid committing mistakes, we will tremendously improve our self-esteem.
Experiment with new skills- Try out new skills and then improve upon them. For example, you may pick up music and track your achievement levels. If you continually improve yourself in this new skill, you will obviously set new benchmarks. Give credit to yourself after achievement of every new milestone.
Accept your limits- You are no superman. You have your own limits. Once you accept your limitations, you will stop blaming yourself for all the wrongs that are happening to you. 

Self Esteem - How Can You Improve It?

What is avoidant personality disorder?

Feelings of inadequacy for long durations and being extremely sensitive to what others think of you is a disorder called avoidant personality disorder symptom. Such feelings of inadequacy in turn push the person to become isolated from the society and the person avoids people, work, and other activities. Social and occupational functioning is affected as the person is extremely sensitive and has very low self-esteem. Symptoms of avoidant personality disorder are:

1. Avoiding social interactions: people suffering from this disorder avoid almost all sorts of interpersonal contact since they lie with the fear of rejection, disapproval and criticism.

2. Avoiding risks: they avoid taking personal risks or being involved in activities which seem new, because they fear that they will embarrass themselves.

3. Socially unplugged: they are not willing to get involved with individuals unless they are absolutely certain of being liked by the person.

4. Preoccupied with negative perception: the idea of being criticized or rejected in social functions is so deep within their psyche that they are often preoccupied with only this thought in their minds.

5. Inferiority complex: people suffering from avoidant personality disorder consider themselves as good for nothing, unappealing, and inferior to everyone else.

6. Avoid intimacy: they are always reluctant to get into intimate relationships because they feel that they will be shamed and ridiculed. Because of such fears, they let go of relationships where they would have been genuinely cherished too.

The only treatment possible for this disorder is psychotherapy. While some people opt for long term therapy, most people usually visit a psychotherapist only when they feel overwhelmed with their fear and emotions.

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6 Signs of Avoidant Personality Disorder, 2nd Most Common Psychiatric Disorder

While we all know substance abuse is a social issue and learning that a loved one is affected by the problem can be nearly heart-breaking. It is definitely not something that can be easily accepted. At the same time, the affected individual needs all your love and attention and more importantly support to get through the situation. It is important to not show anger or frustration at the person but to empathize and help them get out of the situation. 

Read on to know some of the ways in which you can play an active role in supporting your loved one under such circumstances. This involves both of you coping with the situation at hand, as well as helping the person come out of the abuse. 

Educate yourself: When you are trying to help a person, you should know in detail about the substance that was being used and its ill effects. This gives you greater credibility, unlike the person who got carried with the happy feeling it gave and got into abuse. 
Ensure safety: This is both for the affected individual and yourself. With the required substance not being available, the person could look at harming either self or others, especially ones who are trying to get them out of the abuse. Though the intent is to help, they are looked at as people who are depriving the feel-good feeling produced by the substance, which is no longer easily available. Therefore, ensure safety. 
Talk openly: In the beginning, be a good listener. Once you get their confidence, make them understand that the entire situation is making you upset and perhaps angry or frustrated too. Get them to focus on your proposal of getting out of the habit together. If they are willing then this can ensure greater success in quitting the habit. Get to understand how exactly the habit developed including the people responsible for it, the circumstances leading to it, and the various chemicals that were used. The duration and frequency are also important. Tell them it is okay and that you will both get out of it with each other s support. 
Participate in therapy sessions: Individual counseling will work effectively for the primary client, but it is also important for family members to get involved. The counselor also would need support beyond the few counseling hours for completely getting rid of an individual s habit. Therapy can help you learn how to manage the issues back at home. 
Find your  me-time : With all that is going on, you will need some time for yourself to just be. Eat well, stick to your workouts, sleep well, keep your friends, and make time for your hobbies. These will ensure you are in good shape to support the affected individual. It is not possible for you to help another person when you are not in great shape yourself.

Substance Abuse - How Should You Cope With Someone Going Through It?

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