You may not feel like eating at all or struggle to keep up with a good eating plan. Of course, this will affect your blood glucose levels." Despite enormous advances in the past 20 years, eliminated? depression often goes undiagnosed and untreated. Individuals with depression often do not realize that they are depressed. People with diabetes, their families and The following are some general suggestions for dealing with stress and mild to moderate anxiety. • Examine your lifestyle for sources of stress.Are there stressors that can be Learn relaxation techniques.Yoga, meditation, prayer, and hypnosis may help. Make sure that you are getting enough sleep Exercise -The body's primitive stress response was designed to prepare the ,. , , .. . , . . , ,. .. . , ,, individual to fight or to run away. In our society, we do not usually respond to friends, and even their physicians may not distinguish the . , , . . . . _ . , . ' ,. , . . , ' ^ * stress with physical activity. Exercise helps our bodies deal with the physiological results of stress. • Make a list of the things that are worrying you. When you have a concrete list, the problems often look more manageable. symptoms of depression and it is easy to attribute the symptoms of depression to the diabetes. Yet people who suffer from both diabetes and depression tend to have higher health care costs in primary care. Depression is associated with elevated blood glucose levels, an increased risk for cardiovascular disease, poorer physical and mental functioning and complications caused by diabetes. The chances of becoming depressed increase as diabetes complications worsen. It is vital to treat depression as well as diabetes. According to Prof Lustman, professor of medical psychology in the department of psychiatry at Washington University School of Medicine, the combination of diabetes and depression can be deadly. "Because of physiologic and behavioural interactions between diabetes and depression, each becomes more difficult to control, increasing the risks of cardiovascular disease, diabetic retinopathy causing blindness, neuropathy and other complications." South African experts also mention obesity as a risk factor. "Depressed people often eat more and exercise less, which results in weight gain and sabotages efforts at controlling blood glucose levels", says Dr Korb. The following advice may be given to your patients with diabetes: If you are feeling down and are not sure if you are depressed, talk to your doctor. Diabetes that is poorly controlled can cause symptoms that look like depression. During the day, high or low blood glucose may make you feel tired or anxious. Low blood glucose levels can also lead to hunger and eating too much and at night, it could disturb your sleep. If you have high blood glucose at night, you may get up often to urinate and then feel tired during the day. There are many different treatments for depression, including anti-depressant medication, and psychotherapy. Doctors and psychiatrists show that psychotherapy and anti-depressant medications have positive effects on both mood and glycaemic control. Treatment for depression in the context of diabetes should be managed by a mental health professional, together with the doctor providing the diabetes care. This is especially important when anti-depressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. Part of the treatment plan should include education about depression. Often taking part in a self-help group is encouraged, where it is possible to talk to people who share the same types of problems. The South African Depression and Anxiety Group (SADAG) offer more information about depression, telephonic counselling by trained counsellors and referrals to appropriate mental health professionals and various support groups throughout South Africa. They can be contacted, 7 days a week, between 8 am and 8 pm, on (Oil) 262-6396 or 0800 70 80 90, or visit the website www.sadag.co.za. Many people do not like the idea that they may have a mental health disorder and find it easier to attribute everything to physical problems. However, good diabetes management is dependent on the development of self-knowledge. Many of the things that other people's bodies do automatically, people with diabetes must do consciously, like closely monitoring blood glucose and their emotional state. If you have diabetes, ask your doctor for a depression screening. Depression can make diabetes a lot worse, so it is essential that it is recognized and treated along with the diabetes. It could mean the difference between a return to full functioning and permanent disability. Treatment for depression can improve your well-being and ability to manage diabetes, thus improving the quality of your life. Depression is a treatable disorder. If you think you may be depressed or know someone who is, do not lose hope. Seek help for depression.
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SOUTH AFRICAN JOURNAL OF DIABETES
Dr Reddy's Help Line
0800 21 22 23
Pharmadynamics Police &Trauma Line
0800 20 50 26
Adcock Ingram Depression and Anxiety Helpline
0800 70 80 90
Destiny Helpline for Youth & Students
0800 41 42 43
0800 55 44 33
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0800 12 13 14
Suicide Crisis Line
0800 567 567
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011 234 4837
Akeso Psychiatric Response Unit 24 Hour
0861 435 787
CALENDAR OF EVENTS 2018
Teen Suicide Prevention Week
11 - 18 February
Bipolar Awareness Day
Substance Abuse Awareness Day
Mental Health Awareness Month
1 – 31 July
Panic Awareness Day
World Suicide Prevention Day
World Mental Health Day
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