Shaina Farfel: Welcome to this edition of the Vanderbilt Health and Wellness wellcast. I'm Shaina Farfel with Occupational Health. Today, we are speaking with Dr. Chad Buck, Clinical Psychologist at Vanderbilt Work/Life Connections and Psychological Support Consultant for Health Plus. Hi, Dr. Buck. Thanks so much for being with us today.
Dr. Chad Buck: Thank you.
Shaina Farfel: So, November is National Diabetes Awareness Month. We hear a lot about prevention and management of diabetes, but one thing that often gets overlooked is how chronic diseases like diabetes may play a role in a person's mental health. Today, I want to specifically discuss the relationship between diabetes and depression. Is there any correlation between diabetes and depression? Like, is one condition a risk factor for the other?
Dr. Chad Buck: Well, if you have diabetes, either Type 1 or Type 2, you have an increased risk for developing depression, and if you are depressed, you may have a greater risk of developing Type 2 diabetes.
Shaina Farfel: What is unique or specific about diabetes that increases that risk?
Dr. Chad Buck: Well, the honest answer is it is sort of hard to know. There are several different types of studies that have been out that are trying to identify maybe the main aspects that could be contributing to that. One is when you are diagnosed with diabetes and you have to manage your blood sugar levels, you have to manage your carbohydrate intake and carbohydrates increase your serotonin levels. By restricting your carbs, your brain might not be able to manufacture enough serotonin and your mood might suffer. Carbs found in grains, fruits and vegetables, and dairy products are a key energy source for your brain and body, so you also might feel more fatigued or sluggish, and so, just having to change your food intake could actually alter some of the built-in "happy hormones," essentially, that we have in our brains.
Shaina Farfel: Very interesting.
Dr. Chad Buck: Neurotransmitters, I guess.
Shaina Farfel: Do signs and symptoms of depression present differently in folks with diabetes?
Dr. Chad Buck: The signs and symptoms are pretty much the same. There is loss of interest in normal activities, feeling sad or hopeless, unexplained physical problems like back pain or headaches, things aren't pleasurable, you might feel guilty or feel worthless or sad, and those are all things that are pretty global for depression. Now, with diabetes, they have something that is called "diabetes burnout." So, that's separate from depression. "Diabetes burnout" is everything that I just mentioned, but it is all focused on having diabetes, having to do frequent checks of your blood sugar, having to poke holes in your hands, having to take insulin, having to change medicines, doing everything right and it still doesn't work. All of that kind of stuff could be more related to the diabetes burnout.
Shaina Farfel: Are there specific things that we need to consider or be aware of when we are treating depression in someone with diabetes?
Dr. Chad Buck: I mean, it is not a given that someone will have both, but like I said, it is not that uncommon, and so, people do do well if they have usually a combination of medication and psychotherapy. Medications for both diabetes and depression and lifestyle changes and different types of therapies ... all of that comes together and it actually can help people to feel a lot better. Regular exercise is another aspect of things that could be helpful. When you are in therapy, particularly what is called "cognitive behavioral therapy" is most helpful where you challenge thoughts and feelings and kind of look at what core beliefs you might have. A lot of people with diabetes may feel like they are broken or that this is just my life and it's horrible and then you have to challenge some of those thoughts and look at the other things that are present in a person's life that can maybe fight off some of the negative thoughts that are affecting their mood.
Shaina Farfel: And just so people are aware of whether or not they have diabetes, if they are concerned they may be depressed, what is the first step? Where can they access help?
Dr. Chad Buck: Okay, in most people, I mean depression, even major depression, is treatable, so just trying to talk to someone will probably make a difference. If you have Type 1 or Type 2 diabetes and the symptoms go on for more than two weeks of depression, then probably talk about it with your healthcare provider, either your endocrinologist or your primary care provider. They may request a consult with a psychiatrist or recommend some brief counseling with someone. On our website, we have a self-assessment for depression that people can take. It's confidential. None of the data goes anywhere. It is just - do I have these symptoms? And then you can see if that may be relevant to you, and then if it is, you could call us at 615-936-1327 and one of our staff members can set you up with an appointment.
Shaina Farfel: Wonderful. Well, thank you so much for your time today. I think this information was really helpful and will be beneficial to all of our employees. Appreciate it.