I have been thinking about depression a lot lately. And not just because May is National Mental Health Awareness Month. When I wrote our post on Diabetes and Depression last year for our 411 series on diabetes complications, I had no idea that this particular complication was going to impact my life in such an unexpected way.
Earlier this spring, I found out that my friend, Caitlin McEnery, a type 1 PWD for 25 years and a passionate diabetes advocate, had passed away unexpectedly the day before her 27th birthday. She was found dead in her apartment after she failed to return her parent's phone calls. No one on her college campus, where she was getting her degree in nursing, had seen her either.
Caitlin and I have a few things in common that are fairly obvious — our age, chronic condition, and passion for helping those with diabetes — but we also have something in common that I have not discussed very much.
Depression and diabetes don't mix well together. In fact, one could say that depression is among the deadliest of diabetes complications because it's so insidious and so easily masked. While depression itself may not physically cause any damage, depression fosters anger, frustration and apathy. From there, depression can breed carelessness, recklessness and a fatalistic attitude toward health, relationships, and life.
All those things plus diabetes makes for a deadly combination.
After Caitlin passed away, after her death was announced and her obituary was published, many people asked me if she died from diabetes. I spoke with a mutual friend of ours to see if the family knew for sure whether this was the case. Nothing had been publicly released, but she replied, "Does it matter? Of course it was diabetes."
One way or another, it seems that it always comes back to diabetes.
A few months ago, I was diagnosed with depression. I started seeing both a therapist and a psychiatrist and started on an antidepressant. When I announced publicly that I had depression, a lot of people assumed it was the diabetes that caused it. To be honest, it wasn't. Not everything in life revolves around diabetes. But I will say that having depression made it very difficult to manage my diabetes. I didn't care to test my blood sugar as often as I should have, and I had no interest in examining my readings, despite knowing full well things weren't going so great. I comforted myself with poor eating habits. The depression caused lethargy which made it difficult to stay active. When all was said and done, my 30-day average on my glucose meter topped 250 mg/dl.
Living with diabetes and depression is like the chicken and the egg scenario. Either the diabetes causes depression, which can kill you, or the depression causes problems with your diabetes, which can kill you. Sometimes one comes after the other, but sometimes it almost feels like they're just happening at the same time. When you don't know what's causing the problem, it can be difficult to know how to get help.
And that's really the crux of this whole depression issue. The ability to speak up and tell someone how you're feeling. To be open and vulnerable and say, "There is something wrong and I need help," even when you have no idea what's really wrong and you have no idea what anyone could do to help you.
Depression convinces you that you are the only one going through what you're feeling. Depression convinces you that life isn't worth the work. Depression convinces you that no matter what you do, it will never be good enough and that the problems you face are insurmountable.
Basically, depression is a lying bitch. Considering diabetes is a relentless bitch, I can see why the two are often found in pairs.
In honor of National Mental Health Month, the Diabetes Advocates are working on a media campaign to help raise awareness of the correlation between diabetes and depression. Diabetes doubles the odds of depression, and approximately 30% of people with diabetes also have depression. Yet the media mainly focuses on heart disease, blindness and neuropathy as the complications of diabetes. But depression and diabetes is serious business. No matter what the cause, if you have both, you need to get help.
There are people who understand what you're going through, both people with diabetes, and trained therapists and psychiatrists who can teach you the coping tools — and if necessary, give you medication — that you need. Life really is worth the work. And that no matter the size of your problems, you can face them with the right support. It can be difficult to self-diagnose depression. I resisted seeking help for a long time. I didn't think I was "bad enough" and when I did have dark times, I assumed it would eventually "go away." Depression — real depression, not just feeling down in the dumps — does not just "go away."
Depression, as I learned, can be triggered by events in your life, not just because you have a chemical problem in your brain. For a long time, I thought life was just "getting to me" and that once life got better, I would get better. Depression can be caused by serious illness (obviously!), death or loss, conflict, genetics, and other personal problems. There is no single reason why people become depressed.
I'm so glad that I have a wonderful husband, family and friends, who were able to help me get on the road to treating my depression. I don't know how long it will take, but I know I'm finally on the right path. It was a scary first step, but I'm glad I took it.
I only wish I had my friend Caitlin to join me.