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Diabetes comes with a whole host of symptoms and complications that can affect everything from your heart to gut function. What is not very well known, however, is the connection between diabetes and mental-emotional conditions like depression. The Mayo Clinic and others firmly recognize that the two are linked, however. The good news is that when you change your lifestyle and eating habits, other conditions such as depression begin to improve as well.
Bidirectional Risk Factors
According to the Centers for Disease Control, if you have either Type 1 or Type 2 Diabetes, you have double the chances of developing depression. One 2016 study published in The Journal of Medicine and Life found that diabetes can triple your chances of being depressed.
Likewise, researchers acknowledge that if you have depression, there is a higher chance of Type 2 diabetes too. A 2011 study conducted at the Federal University of Rio de Janeiro in Brazil found that both those with Type 2 Diabetes and those with depression have higher blood sugar levels in general.
One of the largest studies to make a bidirectional connection between the two conditions was conducted by the Harvard School of Public Health in 2010. The study surveyed over 65,000 women aged 50 to 75 over ten years. It found that depression may actually have more of an influence on diabetes risk than previously thought.
So why would there be a link between such seemingly different conditions? According to the Mayo Clinic, the “rigors of managing diabetes” can put stress on an individual which may then lead to depression. If a person is already depressed, some of the complications that come with a diabetes diagnosis may make depressive symptoms worse. On the other hand, being in a state of depression can often lead to an unhealthy lifestyle in general since depressed individuals have difficulty thinking clearly or performing certain tasks.
Researchers have also discovered that the two share risk factors for other conditions. A study conducted at the NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development found that young people aged 5-13 who were depressed had insulin resistance at a higher level than non-depressive children. They also had a higher risk of obesity and diabetes later on in life. Other research notes that both those with diabetes and those with depression have a higher risk of heart attack than individuals who have neither of these conditions.
The Neurology of Diabetes and Depression
Experts agree that certain neurological environments can set the stage for both diabetes and depression. For example, neuropathy is a condition that affects the nervous system. Nerve communication plays a part in almost everything the body does, from heart rate to the senses. Peripheral neuropathy (that which affects the hands and feet) is quite common among those with diabetes, since high glucose levels can damage the small vessels that supply blood and oxygen to the nerves.
It was once speculated that peripheral neuropathy occurred as diabetes progressed. New research conducted at the University of Toronto, however, indicates that neuropathy is also common among those with prediabetes. In their report published in the journal of the American Diabetes Association, Diabetes Care, Dr. C. Christine Lee and her colleagues found that 50% of the prediabetic individuals they tested also had symptoms of neuropathy, compared to 29% in those with normal resting glycemic levels.
Individuals with neuropathy also have a higher rate of depression. Symptoms that come with neuropathy include changes in sleep, trouble concentrating, low energy, and pain. Up to 60% of those with chronic pain will develop either depression or anxiety, according to neuropathy expert Lt Col Eugene B Richardson, USA (Retired) BA, MDiv, EdM, MS, writing for the Neuropathy Journal.
Finally, a 2014 Finnish study found that the majority of individuals with neuropathic pain also had a life-long history of psychiatric disorders. They stated that “psychiatric morbidity was associated with increased pain intensity” in neuropathy patients. They also found that in those with anxiety disorders, the vast majority had the neurological impairments which had set up the condition long before neuropathy symptoms began to manifest.
Stress and Inflammation
Two other common factors that raise the risk of both depression and diabetes are stress and inflammation. Chronic stress, in particular, leads to higher levels of cortisol as well as reduced serotonin and dopamine, all of which have been linked to insomnia, appetite imbalance, inflammation, low immune system function, hormonal imbalance, and more.
A 2015 study on police officers found a high connection between job-related stress and MetS, or metabolic syndrome, a major precursor to Type 2 Diabetes. Recent research in the fields of neuroscience, neuroendocrinology, and biological psychiatry confirms the link between stress and depression as well. In fact, a major report put out by the peer-reviewed medical journal PLOS One tentatively described a potentially new condition entitled ‘‘stress-induced depression,’’ or STRID.
Of course, inflammation has also shown to play a part in both the development of depression and the development of diabetes. For both conditions, inflammation occurs for a variety of reasons. High cortisol levels, found in those with diabetes as well as those with depression, inherently causes a corresponding rise in inflammatory markers.
Oxidative stress (an imbalance of free radicals and antioxidants in the body) is another common factor that can lead to inflammation. A major 2018 study published in the journal Clinical Interventions in Aging found that many age-related diseases, including diabetes and neurodegeneration, are caused by oxidative stress and related reactive oxygen and nitrogen species (RONS) overgrowth.
What About Autoimmunity?
There is another possible common origin between the two, as well: autoimmunity. Diabetes Type 1 is categorized as an autoimmune disorder since insulin resistance in this condition is caused by immune system cells that are attacking the body’s own tissue. New research indicates that Type 2 diabetes could be autoimmune in nature as well.
Interestingly, recent investigations also suggest that depression may have an autoimmunity component too. Spurred on by inflammation, immune system cells called cytokines can spike during depressive episodes in a way that is similar to an allergic reaction.
”Cytokines have received increasing attention as potential mediators of the interaction with the immune system, neuroendocrine system, and specific pathways involved in mood, energy, and activity control,” said a 2009 report by Brazilian researchers.
5 Actions You Can Start Doing TODAY to Heal Both Diabetes and Depression
The links between depression and diabetes should be pretty clear by now. But what can you do about it? The good news is that both conditions can be significantly improved by lifestyle changes, healthy eating habits, and making key natural substances a part of your daily routine. Here are a few specifics:
1 | Change Your Diet
The key to healthy eating for both diabetes and depression is to stay away from highly inflammatory foods as well as foods that could imbalance hormones, including insulin and cortisol. Stay away from processed foods, especially processed meats, as well as trans fats.
Going “low sugar” and getting in lots of green vegetables and low-glycemic fruits like berries and green apples is ideal. Finally, stay away from too much caffeine and alcohol, which tends to tax the liver, spike up cortisol, and throw off hormones. Eating an anti-inflammatory diet is great for diabetics since it will keep your insulin levels balanced naturally.
2 | Lower Stress
As we shared above, there is a direct correlation between chronic stress and both diabetes and depression. The absolute best way to lower stress responses is to learn stress management tools and practice them every day. One of the easiest tools to learn is meditation. The best thing about meditation is that there is no “right” way to do it. You can meditate for five minutes or for an hour. You can combine meditation with prayer or breathing techniques, or you can meditate as you walk. You can even meditate in the bathtub!
Here is what the experts at the Mayo Clinic suggest:
“Experiment, and you’ll likely find out what types of meditation work best for you and what you enjoy doing. Adapt meditation to your needs at the moment. Remember, there’s no right way or wrong way to meditate. What matters is that meditation helps you reduce your stress and feel better overall.”
3 | Exercise
Just like meditation and prayer, even a few minutes of brisk walking a day can boost your health overall. The key, again, is consistency. According to the American Diabetes Association, “Exercise improves blood glucose control in type 2 diabetes, reduces cardiovascular risk factors, contributes to weight loss, and improves well-being.” An ADA position paper published in November 2016 also stated that regular exercise can be of great benefit for individuals with Type 1 diabetes. They recommend getting a minimum of 150 minutes of physical activity per week. This translates to about 30 minutes of brisk walking, five days a week.
Likewise, regular exercise can also help to calm symptoms of major depression, and it can lift the spirits in general when you are just feeling “down.” Getting your heart rate up produces endorphins and other healing chemicals in the body. It can reduce inflammation and pain, can boost the immune system and metabolism, and can help to release growth factors which assist nerve cells in the brain to make new connections.
“In people who are depressed, neuroscientists have noticed that the hippocampus in the brain—the region that helps regulate mood—is smaller. Exercise supports nerve cell growth in the hippocampus, improving nerve cell connections, which helps relieve depression,” says Dr. Michael Craig Miller of Harvard Medical School. Dr. Miller says that exercise can be as powerful as drugs for elevating depression in some people.
4 | Get Plenty of Vitamin C
Inflammation is a causal factor for both diabetes and depression, and vitamin C can lower inflammation, among other things. Vitamin C is a powerful antioxidant that has been shown to reduce free radicals in the body as well as lower C-Reactive Protein (CRP) levels. CRP is a marker for systemic inflammation. C can be found in most vegetables and fruits, especially citrus.
Vitamin C may also be diabetes-preventative as well. A study sponsored in part by the National Institutes of Health (NIH) gathered data on over 232,000 participants who used C supplementation for seven weeks. The investigators of the study hypothesized that supplementation corresponded to an almost 10% reduction in diabetes risk compared to not supplementing.
Other vitamins can fight inflammation too. Some include B vitamins, found in fresh, organic meats, seeds, nuts and eggs, vitamin D from the sun, and vitamins A and K, which are prevalent in many kinds of rich-colored vegetables such as kale and carrots.
5 | Consider Other Natural Healing Substances
Besides vitamin C, there are quite a few other natural substances that have been shown to be beneficial for both metabolism and brain health. Some of these include omega 3 fatty acids, CBD oil, ginkgo biloba, curcumin (found in turmeric), holy basil, ashwagandha, matcha green tea, and many varieties of medicinal mushrooms.
You Can Turn Things Around!
Right now, over 10% of all adults in the United States have diabetes. In those who are over 60, the number jumps to 23%. Close to 15 million Americans suffer from a major depressive disorder, and millions more go undiagnosed with minor forms of the disease.
While these statistics may seem dire, the very good news is that there are things you can do to turn both conditions around. Our advice is to start simple and with the basics – whole foods, plenty of exercise, lowering stress – and then add in other things as you go along. More than likely, you will feel a thousand times better in both body and in mind before long.
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