Diabetes Type 2

Depression, feeling down and mood swings

People with diabetes are approximately two to three times more likely to experience depression as others (National Institute for Clinical Excellence - NICE - Guidance CG91 2009). Yet there is little routine psychological support for people with diabetes.

Some people we talked to said they felt depressed when they were first diagnosed and could only see a bleak future ahead of them. However as they adapted to the changes to their lifestyle and started focusing on what they could do to improve their health, the feelings of depression passed. One woman with young children said, “Certainly depression lurks around, but having control over the disease, being able to control my diet, or to choose to go out and exercise is enormously important for getting over that kind of depression.”

Shahnaz felt very despondent during the first year she was diagnosed but with her family's...

Shahnaz felt very despondent during the first year she was diagnosed but with her family's...

Age at interview: 54
Sex: Female
Age at diagnosis: 31
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So have you ever felt you know, despondent, about things'?

Well, in the beginning, you know I told you, in the beginning, when it was my first year, then I had some. But by God's grace, my husband, my children, my daughter, gave me lots of comfort, gave me you know, they built up my courage and said 'this happens to lots of people, in the world, now don't do this''. I used to just sit and start crying, 'I can do nothing, I can do nothing!'. So my daughter did, you know she even used to bathe me, she used to do everything for me, but then slowly, slowly, slowly she's made me so capable, by god's greatness, that for the past five years I have been independent - I do the cooking, I go out with the kids to do shopping, I do everything, all the jobs in the house I do all that I can.

So it's Allah's mercy, I don't feel despondent or anything anymore. That's it, no more despondency.

Focusing on the positive things she could do helped Helen to feel less depressed.

Focusing on the positive things she could do helped Helen to feel less depressed.

Age at interview: 63
Sex: Female
Age at diagnosis: 60
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I learnt how to work my way round it. Not to say I didn't feel s-, slightly depressed. The more I read, the more depressed I found it being. And initially, and I've got a friend who's got diabetes as well and she feels exactly the same, they tell you all the bad news. You know, the doctor obviously feels obliged to tell you that, you know, you can have heart problems, you can have kidney problems, you can lose your sight, you can have trouble with your circulation, you can have... And, you know, by the time I came out the surgery I thought, I mean the, that was the worst part. I felt a little bit, because I thought you'd just be given, the ignorance, or tell me, 'Do this, do this, do this, do this, this.' Fine. But to tell me all the negative things. But I've now decided as long as I do what I'm told and I, and follow a regime and live as much as I can a healthy lifestyle. As the doctor said, 'I don't want you just to have ten good years. I want you to have twenty good years.' So I think, oh, that's just, so I don't get depressed about it any more. I get [more] depressed at night because I'm agitated when I go to my bed and I'm hot and bothered and I can't sleep. That bothers me more. But whether that's the diabetes or not, I don't know.

Because I really think I know the food I eat and I know what I can eat. And anybody that's got diabetes, the book, and I wish I could remember the name, the name of it, but I know it keeps talking about 'know your own mileage', know what your own body can do, know what you can eat, know what foods are good for you. And I find, I found once I, got rid of the obviously, the medical side of it, that I wanted to know, but 'I know about that. That's not the big issue. And if it is, I'll deal with it when, when the time comes' I was then able to dwell on all the positive things about it. Like having a good healthy lifestyle.

Although some people said they had not experienced feelings of depression and were naturally positive thinking people, other people actively had tried to be positive, as they coped with changes to their lifestyle. One man who was diagnosed with diabetes when he was 38 years old said, “I decided at the beginning that I was not going to let it control me. You've got to control it. You can't let it control you.” Another man said that he can understand how people might feel depressed at first, if they didn't realise that with the right support they could lead a normal life. 

Wasim believes attitude makes a big difference and he prefers to focus on staying positive.

Wasim believes attitude makes a big difference and he prefers to focus on staying positive.

Age at interview: 29
Sex: Male
Age at diagnosis: 28
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I've read about it [depression], but I think it's a bit too harsh for me to say, I don't know if it would be too harsh for me to say - you choose your attitude in life. You know, if you let things get to you then things will get to you - if you choose to look at more to the positive even if when there are negatives that are blatantly you know, taking you down, I think you have something like you say a goal to aim for, something more positive to look out for.

It can you know, if somebody, I can understand why somebody would think it's it was depressing, because if it is, if they're not managing it correctly, or they've not been given the support correctly, and that the support network's not in place and they're not aware of their options, they're not aware that you know they can still lead a normal life then I suppose, yeah, people could get depressed about it.

But it's again it's your own choice of how you feel, you know, you could choose to in the morning to get up and have a good day, you could choose to get up in the morning and have a miserable day. I think, well one thing I've been taught over the years as well, especially being from a sales background, is that you don't let those around you affect you, or if there is what you call a 'mood hoover', you know, somebody who sucks the mood out of the rest of the people. You try to change their attitude so that they become more positive. So it's the focus is just to just stay positive all the time.

Gareth does not worry about 'what if's' that may happen in the future but says he will deal with...

Gareth does not worry about 'what if's' that may happen in the future but says he will deal with...

Age at interview: 61
Sex: Male
Age at diagnosis: 50
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Well what about, some people might experience a bit of depression?

I haven't, I personally haven't. That might well have, my wife might have thought I had been in depressions, but I haven't had anything on that lines at all. I am not really that type of person. I know depression can affect you at any time, but it hasn't with me. My outlook on life is fairly good. I'm not one of these people that say, 'What if?' I say, 'If it happens then I react to it. I don't want to react before it happens' sort of thing. So I've been fortunate in not being depressed. I've' No I've never been depressed. As I said earlier on if I have to take tablets which I have to, for the rest of my life, I'm quite prepared to do it. Some people think that is a chore, but it is not to me. It just giving me quality and I've never, not that I haven't got time to be depressed I suppose, but I should say I never am depressed. I might get a bit depressed if were was to lose at rugby but that is about it, that is my depression, but that is short-lived down anyway because it is only a game.

Some people said they felt low or 'down' rather than depressed on some days when their diabetes seemed to take the joy out of life. Sometimes needing to follow a diet, take drugs or injections every day or experiencing sexual problems made people feel fed up with their situation. 

Poor blood glucose control had also affected some people's moods. A few people talked about feeling tearful and irritable and then happy and laughing when their blood glucose levels went up and down. 

Darren gets down at always needing to follow a diet and take medication. He works hard at making...

Darren gets down at always needing to follow a diet and take medication. He works hard at making...

Age at interview: 34
Sex: Male
Age at diagnosis: 28
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And so I don't know, you get down days, don't you? And I definitely do, and I do feel like' You know, there is this whole big issue of permanently being ill which I can't escape from. I take my medication 3 times, 4 times a day. I inject twice a day, prick my finger numerous times a day, bleed for my disease. I' So, yeah, some days it's hard to deal with that. And I do feel like it's robbed me of a certain, a few joys, just a few things, you know, little simple things and now and again it crops its head up and just smacks you a bit really. You know, you talk about mortgages and then you realise, you know, how much insurance will be for a new mortgage because, because they're going to wop on me these extra bits of money because you're a diabetic. And you' 'Um' and 'ah' about going away on a trip and, then you think about the travel insurance and how much that's going to cost because you're a diabetic.

And' You go out and you're' You know, it's still stuff like at college, we all eat together on a Wednesday night and I get a special dessert come down for me of fruit - it's always fruit, they've got no imagination other than fruit - [laughs] so you know everybody asks for sort of either apple pie and custard and there's my fruit [laughs]. And so, it's just stuff like that, that when I think about it I get a bit annoyed about the whole thing and a bit cheesed-off with my genetics. And a bit cheesed off with of everything really.

And' But I suppose because I've been to that really bad place, I'm really' Very good at getting my act together when I get a bit down. I do work hard at making sure that I don't go there, and don't dwell in that place. I work very hard mentally and spiritually on bringing myself back out of that place as quickly as I possibly can. But I can imagine that for other people, dwelling in that place would be quite soul destroying. It just chips, it doesn't take the joy of life away, it just chips a little bit off the edge. And [laughs] now and again, it cheeses me off.

Sallie has experienced severe mood swings and is grateful that she has such a supportive husband.

Sallie has experienced severe mood swings and is grateful that she has such a supportive husband.

Age at interview: 50
Sex: Female
Age at diagnosis: 44
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We've been together, I was 15 and he was 17, so we have grown up together and we know each other, and we know where we are thinking. We don't even have to speak because we know what is going through each other's minds and thankfully, you know, like with diabetes you can have big, big mood swings. One minute I can be, you know, quite happy and laughing, the next minute 'boof', but you know, he just tolerates it all, you know, makes fun of it, gives me a cuddle and it's all forgotten. Yeah...

So why do you think it is that you have the mood swings? Is that still happening even though you are on metformin?

No. I've been better. I think the mood swings are because you feel so tired and helpless. You just can't do' Frustration, you can't do what you used to be able to do.

Some people experienced clinical depression which was hard to overcome. People who were clinically depressed said it felt like 'a black fog' or a 'blackness' came over them. Sometimes stress from work or family life tipped them over the edge, and people found it difficult to cope with diabetes. One man said that when he is not feeling depressed, he finds it much easier to eat healthily, but when he is depressed he comfort eats.

Antidepressants or talking therapies, such as cognitive behaviour therapy or counselling helped people cope with depression. Different people react differently to antidepressants, and sometimes it takes time to work out which drug works best. Several people we talked to were taking fluoxetine (Prozac) for depression and found that it worked quite well for them. One man who suffered from clinical depression before being diagnosed with diabetes, said,  “Medication seems to make it a lot easier than it was. It stops the tears but it doesn't stop the blackness.”

Depression caught Andy unawares but taking an antidepressant has helped.

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Depression caught Andy unawares but taking an antidepressant has helped.

Age at interview: 52
Sex: Male
Age at diagnosis: 52
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The one thing that he warned me about there are side effects with a number of the drugs, medicines sorry, that I'm taking, can cause depression. And I could see on occasions like this black fog coming down, and I knew it was depression, and I fought it and I fought it and I fought it and I wouldn't let it get to me. I had a bit of a bad time a work and next thing I know is [clicks fingers] I'm depressed. And I could recognise it but there was nothing I could do about it. I didn't want to do anything about it actually. I suddenly went from, I am going to fight this to, I've got it and I don't care. I didn't care. I didn't not care either. I didn't do anything'

Eventually I kind of, yeah alright, I'll go and see the GP. Made an appointment and he asked me all these questions. There was ten questions he asked me, to do with state of mind and what you're thinking and stuff and. 'Yep', he said, 'You're depressed' [laughs]' So he put me on Prozac. Again I reacted, quite upset tummy and stuff for the first few days I was taking that. And there's a bit of spark back to me now.



Many GP practices now have counselling services attached to them, and if not your GP may be able to refer you to a service. If you want to get in touch with a trained counsellor directly, you can call the Diabetes UK Careline. See more experiences of depression.
 

Last reviewed March 2016.
Last updated March 2016.

 

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