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?

Smoking   Some Naked Facts!

Smoking kills > 420,000 people per year worldwide.
In India one million people die of smoking related diseases each year.
Tobacco use is the second leading cause of death world-over.
Smoking is more lethal than AIDS, Accidents, Homicides, Suicides, Fire, etc.
2700 substances have been identified in Cigarette smoke, most of them harmful including cyanide, benzene, formaldehyde, methanol, acetylene, ammonia, nitrogen oxide, carbon monoxide, etc.
Every cigarette takes 5.5 minutes of your life.
Smoking one packet a day for 10 years increases risk for Ischemic Heart Diseases by 300 % & risk for lung cancer by 500 %.
Passive smoking (breathing second hand smoke) is also harmful. Spending 2 hours in a smoky bar is equivalent to smoking 4 cigarettes. Living with a pack-a-day smoker is like smoking 3 cigarettes by yourself.

What are the Risks? 

Cancer: 85% of Lung Cancers and 28% of all cancer deaths are attributed to smoking. Smokers have higher rates of leukemia, kidney, stomach, bladder, and pancreas cancers. About 30% of cervical cancers have been attributed to both active and passive smoking.

Lungs: Smokers are generally at higher risk for nearly all major lung diseases like pneumonia, flu, COPD, bronchitis, emphysema, asthma, etc.

Brain: Smokers run almost two and a half times the risk of stroke as non-smokers and the risk for dementia is also higher in smokers.

Male Sexuality and Reproduction: Smoking decreases the amount of blood flowing into the penis, reduces sperm density, reduces sperm motility, and may lead to impotence & infertility

Female infertility, Pregnancy: Smoking increases the risk of female infertility, ectopic pregnancy, miscarriages, stillbirth, prematurity and low-birth weight, so also there is a risk of passing genetic mutations that increase cancer risks to unborn babies.

Children: Mothers exposed to smoke (active or passive) are more likely to have children with motor control problems, perception impairments, and attention disabilities. Exposure to smoke early on affect the lungs of infant as early as the first 2 to 10 weeks of life, it increases the risk for lower respiratory infections (asthma, bronchitis, and pneumonia) by 50% and worsens the condition of children who have existing asthma.
 
Spine & Bones: Smokers whose jobs involve lifting heavy objects are more likely to develop low back pain than non-smokers. They are at increased risk for developing osteoporosis and rheumatoid arthritis. Smokers are more prone to develop degenerative disorders and injuries in the spine, they have more trouble recovering from spinal surgery as smoking also impairs formation of new bone.

Why Quit?


Physical Benefits: They start as early as in few minutes.

Blood pressure and Pulse rate return to Normal in 20 minutes.
Levels of carbon monoxide and oxygen in the blood return to normal in 8 hours and chance of heart attack decreases in 24 hours.
Nerve endings start to regrow; ability to taste and smell increases within 48 hours.
Bronchial tubes relax; lung capacity increases by 72 hours.
In 2 to 12 weeks  time circulation improves and lung functions improve up to 30%.
In 1 to 9 months  time there is a decreased incidence of coughing, sinus infection, fatigue, and shortness of breath; cilia in lungs start re-growing, increasing the ability to handle mucus, clean the lungs, and reduce chance of infection.
Overall energy level increases.

Smoking - Facts, Risks & Why To Quit!

Schizophrenia is a severe, chronic mental disorder that affects an individual s ability to think and make decisions, as well as relationships and emotions. The illness is characterized by experiences or unrealistic thoughts, disorganized behaviour and speech, reduced participation in routine activities. A person diagnosed with schizophrenia also experiences difficulty concentrating and memorizing things.

Schizophrenia does not have a definite cure. However, psychological rehabilitation can help the patient manage the symptoms of the illness, and improve the quality of life. This is where psychosocial therapy steps in.

Rehabilitation Psychology for Schizophrenia

Rehabilitation Psychology is a speciality of Psychology that utilizes psychological skills, knowledge, and theories to evaluate and treat people diagnosed with disabilities and chronic health issues in order to maximize functional ability, independence, social participation, and overall health.

A rehabilitation psychologist individualizes services to address different patients with varying health conditions. In order to meet this goal, the discipline adopts a holistic approach and considers individuals within a broad social context.

Different Treatment Approaches

Rehabilitation psychology follows these techniques to address mental disorder like schizophrenia in people  

Individual Psychotherapy   a psychologist/therapist teaches the patient how to deal with their behaviours and thoughts. Patients learn more about the ailment and its effects   and how to distinguish between what is real and what is not. The therapy may also help them manage day-to-day life.

Cognitive Behaviour Therapy   CBT can help the patient change the way they think or behave. A psychologist can show them how to deal with hallucinations and voices. After a couple of CBT sessions, you may be able to identify what triggers psychotic episodes   delusions and hallucinations   and prevent or reduce them.

Cognitive Enhancement Therapy   CET teaches individual ways to recognize triggers, social cues better, and improve memory and attention, and the ability to organize thoughts. The therapy combines group sessions and computer-based brain training.

Social Skills Training aimed towards improving social interactions and communication
Rehabilitation procedures such as problem-solving support and job counselling

Even if the above techniques are able to improve the condition, a schizophrenic person will likely need to continue with special care and education on how to become part of the community. 




How Effective Is Rehabilitation Psychology In Managing Schizophrenia?

Depression is one of the complex physical and psychological disorders. The disease is characterized by loss of pleasure or interest, sadness, feelings of guilt, low self worth, disturbed sleep and appetite, poor concentration and feelings of tiredness. The common effect of this condition is leads to the decreased activity level in some parts of the brain. The disease is a mild one that causes little annoyance in daily life. But the extreme stages may lead to severe effects where the affected person may fail to participate in their social life. In rare cases severity of suicide is even possible.

Depression is diagnosed by these symptoms:

    Lack of interest or joy in activities
    Sadness or low mood levels
    Feel of guilt without any reason
    Pessimism
    Inferiority thoughts
    Slow thought process
    Irritability
    Slow in interpreting sensorial stimuli
    Slow physical reactions
    Slow physical processes or digestion.

Types of depression
It can be either be a single disease or the effect of other diseases. It can also be due to two or more factors. Based on the cause the disease, it has been divided into six types, which are

    Reactive depression: Caused due to psychological struggle and stress.
    Endogenous depression: Caused due to strain or lack of rest.
    Depression by physical disease: This is caused due to any physical disease such as Parkinson s disease, stroke, hypertension, heart disease, cushing s syndrome, mononucleosis, hypothyroidism neurotransmitters in the brain etc.
    Depressive consequence of unsound lifestyle: This is caused due to less exercise, too much alcohol, coffee or tea consumption, least intake of necessary nutrients, too much sugar intake and fat.
    Postnatal depression: This happens mostly in women after pregnancy and child birth.
    Seasonal affective disorder: This happen due to cold and dark seasons of the year. The lack of light is the factor for causing depression as well. 

Treatment of depression
Best way to treat depression is through Psychotherapy, also anti - depression medicines are usually prescribed to treat the effects of depression. But the intake of these types of medicines result in nervous disorder. However, the best way to treat is through environmental changes and positive and happy surrounds to the affected person along with psychological counseling.

6 Types of Depression! + How it Affects Us?

Depression is spreading at a fast pace in modern India due to many reasons like poor diet, lifestyles, poor social support system and having too many unrealistic expectations from themselves and other people in their lives. It can affect the rich and the poor and any age group also. According to World Health Organisation, 1 in every 10 people suffer from depression. Due to the social stigma attached to it, most people remain undiagnosed and hence suffer from it silently. This is a huge waste of human potential and capability. Some common symptoms of Depression include:

Appetite loss or an increased hunger,
Insomnia or Oversleeping,
Pervading feelings of worthlessness, helplessness and hopelessness,
Anger and Irritability,
Intense physical, emotional and mental fatigue,
Self hatred for making mistakes and not coming up to the expectations of self or other people
Risky Behaviour like rash driving, addictions, dangerous sports,
Problems in Concentration, Memorising and Focussing
Unexplained aches and pains, stomach-aches, Back pain or Headaches
Sudden loss of Interest in Daily Activities, Hobbies. Work
Suicidal Thoughts or Attempts

Here are some basic tips to beat the blues.

Recognising and Conquering Self Criticising Inner Voice:
You would have heard this harsh voice which often reprimands you for making mistakes, or doing something silly or taking any risks. Often this voice would have said, "Its always your fault"," You are capable of nothing"," You are always making mistakes", "Only bad things have happened in my life", " My life is Over". These are called self destructive negative thoughts which can interfere and distract you from your daily activities and a general sense of confidence, power, wellbeing and balance. Depressed people often associate themselves with a negative image of self and of the world, which is very incapacitating and makes the person feel guilty, angry, worthless, hopeless and helpless. The trick is to combat this inner thinking process with evidence to disprove it and support the evidence with logical and rational reasoning and seeing the whole picture with its positives rather than focussing on the negative parts only. For eg.."Good things have also happened in my marriage"," I can learn from my mistakes and do things differently next time"," I have achieved many things in life so I am capable and intelligent"," Life is not over yet, there is hope because I am still alive". such statements are compassionate and help in restoring lost confidence, faith and hope which is vital to beat depression blues.

Be Active:
During depression, physical energy takes a beating as a person goes through an emotionally low phase. People who don't exercise regularly are more prone to depression as the body and mind lacks in blood circulation and "feel good" neuro chemicals called Endorphins. When you are feeling down in the dumps, exercising, yoga, gym, cycling, aerobics, dance can help in elevating the heart rate and thus increasing the blood circulation and elevating the moods. Cycling to work, using the stairs, walking just a little bit as a  daily small goal can be beneficial as energy levels can be very low in depression. Getting the sun on the back bone which carries many nerves is also important and helps in chemical synthesis in combating depression.

Be Social:
Man is a social animal by evolutionary process. We tend to feel better in harmonious social communities for our social and psychological wellbeing. Identify people who are well meaning and supportive of your condition. Don't withdraw from the society, thought hat may be the easiest and logical thing to do in depression. Meeting people with similar interests as yours, people who value you for who you are and some people who are funny and can make you laugh will be of immense importance for boosting your self esteem and self worth. See if some one can benefit from your care..caring for others is a huge booster of self worth and self esteem. Having a pet and caring for it can be another activity that you can look into. Watching comedy shows, movies, laughing at your own mistakes or other people mistakes can be a wonderful way to look at life more objectively. Don't take yourself and other people too seriously..everyone makes mistakes and nobody is perfect.


By no means is this list complete. Please look around and find more tips that can help in beating the blues. If Depression is caught in its early stages then its completely curable. Please don't self diagnose and take medications. Get it diagnosed with a psychiatrist or a psychologist. Cognitive Behaviour Therapy, Stress management, Marital Counselling, Meditations and relaxation techniques, Spirituality are very powerful in dealing with depression too.

3 ways to combat depression

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

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