A study out of Johns Hopkins in Baltimore has shown that depressed people have a stunning, 42- percent increased risk of developing diabetes when compared to people who aren't depressed. The study followed 5,201 people, aged 45 to 84, for three years. The subjects did not have diabetes at the outset of the study. Even when the researchers controlled for pre-existing factors such as obesity, inactivity, and smoking, they found that risk for diabetes was still 34 percent higher in patients with depression. They also found that the deeper the depression, the greater the likelihood that the subject would become diabetic.
The study also found an inverse relationship: diabetes can trigger depression. Patients who did not have depression at the outset stood a 52-percent greater chance of developing it after being diagnosed and treated for diabetes. Interestingly, those who developed diabetes but either didn't know it or weren't receiving treatment had no increased risk for depression at all. In fact, this group actually had a 25-percent decreased rate of depression when compared to subjects who did not develop diabetes -- a finding that has the researchers puzzled. Nevertheless, it certainly is an indicator that the connection, at least in this direction, may have a strong mental component.
Given the spiraling rates of both depression and diabetes, these findings have relevance for huge numbers of us. Rates of clinical depression have increased tenfold since 1945, with up to 20 percent of people in the US severely depressed at some point in their lives. Depression counts as the second most debilitating condition in the Western world already and, at the current rate of increase, will be the second major debilitating condition in the world by 2020, just behind heart disease. Meanwhile, diabetes rates escalate at a similarly alarming rate, with recent CDC studies showing a 15-percent rise in new US cases in the past two years alone -- bringing the number of Americans with type-2 diabetes to 24 million.
The press has called the results a chicken-and-egg scenario, since it appears that diabetes triggers depression and depression triggers diabetes, and it isn't clear where the trouble begins. What is clear is that both conditions simultaneously are escalating out-of-control in the general population. Theoretically, it should be easier to reverse depressive illness before diabetes sets in than to try and reverse diabetes once contracted. Depressive illness doesn't necessarily do direct physical damage to the body, but once a person progresses to full-blown diabetes, they've already damaged the pancreas, not to mention the other organs and systems which are compromised by high insulin and sugar levels in the blood. Then again, maybe there's a factor common to both diabetes and depression that might be playing a primary role in triggering both. And, as luck would have it...
Study director Sherita Hill Golden points out, "Those with depression are more likely to consume more calories, be less physically active and are more likely to smoke, so they just have poor overall health behaviors in general. That seems to be one component of treating depression that needs to be addressed."
Well, there it is -- that old diet and lifestyle thing. Its connection to diabetes is obvious, but many people are not aware of the role it plays in depression. Blood sugar swings, hormonal imbalances, nutritional deficiencies can all trigger depression. Unfortunately, the study apparently didn't track the eating habits or exercise routines of the subjects; nevertheless it's a good bet that the depressed folks in the study did indeed make lousy food choices and that they moped around instead of exercising. When depressed, most of us do tend to neglect our health routines. And gorging on comfort foods while lounging comfortably on the couch is a sure way to send the body to the diabetes clinic.
And other factors may also play a role. Dr. Hill notes that depression ups the level of stress hormones such as cortisol, which can lead to increased insulin resistance, a precursor to diabetes. That means that if you're depressed, it would be a smart move to get your depression under control before you eat and laze yourself into a diabetic stupor; and before your stress hormones shoot your insulin resistance to hell. Of course, depression paralyzes the will to act, so once depressed, you might not have much energy to do anything about it.
Oh ,one final note about why treated diabetics seem to get depressed while untreated diabetics appear comparatively carefree. It might be, as the researchers conjecture, because diabetics hate the health regimen their doctors put them on, with daily pin pricks, insulin shots, dietary constraints, and so on. It might also be that those who eschew treatment have a basically optimistic outlook anyway, believing they'll be fine if they do nothing. Or it might be because the drugs given to diabetics contribute to depression, though the medical establishment denies this possibility. Certainly the reverse is true: there's evidence that depression drugs up the risk of diabetes two to threefold, according to a 2006 NIH study. In any event, it's all good reason to maintain healthy routines and follow a Baseline of Health®type program for both your mind and your body.