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Diabetes Positive Approach, Issue #1309-- Cope with Diabetes; Live Healthy
September 03, 2013
Now that our smile and praise club is working out, let us move it one step up. You must think me nuts and I don't blame you but I just can't stop. I want to move on and pay it forward in exchange for the good life I am enjoying. You know what it is? It is really simple. It is just doing something good for someone else especially now that our topic is on diabetes and depression.
I have done this a number of times: visiting a shut-in in the hospital, baby sitting for a mother who needs to go grocery shopping and playing scrabble with a 90-year old lady every Tuesday who said that my playing with her weekly is the best thing that ever happened to her. Can you imagine that? The feeling it evoked is priceless so let's do it together, shall we?
What is depression? It is a medical illness where one feels persistently sad and loses interest in everything. And the diabetics have a high risk to get depressed. It affects how one thinks and feels and makes one have problems doing the every day activities. It is not a weakness but one can't just drive away the blues and usually needs long term treatment. But most people feel better with counseling and medication and other treatment as well.
Some symptoms of depression are being unduly sad, restless, frustrated or irritable over small stuff, tired, indecisive, and having trouble concentrating, thinking and making decisions. They feel worthless and guilty and have thoughts of death and dying. They cry for no reason and either can't sleep or sleep all the time.
When feeling depressed, go and see a doctor because if left untreated it can lead to something worse. If you don't want to get treatment, at least call a friend, a priest, a loved one, a health care person or anyone you can trust and talk to them about what is troubling you.
If you are thinking of suicide, here are the steps to take:
1. Call a friend or a member of your family.
2. Get help from your doctor or other mental health professional.
3. Call your priest or minister or someone in the spiritual community.
4. There is a suicide toll-free 24-hour hot line number in the US at 800-273-8255.
Make sure we can all help someone who has suicidal thoughts and get emergency help. Let us call 911 if any of our loved ones is thinking of harming himself or we should take the person to the emergency room in a nearby hospital right away. There should also be someone to stay with that person all the time.
What causes depression? There are many factors involved like inherited traits, biological differences, changes in the body's hormonal balance, neurotransmitters, and life events like a death of a loved one. Even a traumatic event in childhood could trigger depression. And of course, the diabetics are vulnerable to develop depression.
The risk factors are many. Among them are having a serious disease like Alzheimer's and diabetes, having blood related relatives who are depressed, personality traits like being over critical of oneself, having few friends, traumatic events, abusing alcohol and taking medication for high blood pressure and sleeping pills. All these can make one at risk to become depressed.
The complications are many as well like substance and alcohol abuse, conflicts in family and in one's relationships, problems at school and work, social isolation, excessive feelings of anxiety, suicide, cutting oneself or mutilation and early death from other medical conditions.
How do you prepare for an appointment with a mental health provider? The time to see a doctor is short and a lot of ground has to be covered so it's a good idea to be prepared. Write down personal information and stress you are undergoing, your symptoms, a list of medications and supplements you are taking and the questions you want to ask the doctor. Also bring a friend along to help in remembering everything.
Some questions you may want to ask the doctor are the side effects of the medication, if there are alternative treatments instead of the medication or at least its generic equivalent and the restrictions you need to follow. Also you may want to ask the doctor if there is any reading material that can help you understand this condition better.
The doctor will ask you a lot of questions. It will help if you are ready to answer them so I am you giving a number of them: How long have you or a loved one felt depressed? When did you first feel the symptoms? Do your feel up and down sometimes? Do they affect your life? When you're down, do you think of suicide? Is there any in the family who suffers from depression and other mood disorders? Do you take illegal drugs or drink alcohol? How is your sleep? What makes your symptoms worse or better?
Before the final diagnosis, there will be tests. The doctor may ask you to fill out a questionnaire and then he will do medical and psychological tests and laboratory tests for a complete blood count and see if the thyroid is working well. Also he will talk to you about your thoughts. The doctor will make sure your symptoms are not caused by other conditions like adjustment disorder, seasonal affective disorder, bipolar disorder and others so you can get the proper treatment.
The most effective treatment is usually a combination of psychotherapy and medication. You may need to stay in the hospital or go on an outpatient treatment program. There are antidepressant medications to treat depression like serotonin and norepinephrine reuptake inhibitors, atypical antidepressants, norepinephrine and dopamine reuptake inhibitors, and tricyclic antidepressants.
Prescribed as a last resort when the other medications have not worked, is the monoamine oxidase inhibitors because of serious side effects. The doctor may also suggest other forms of treatment like anti-anxiety and mood-stabilizing medications and stimulants. To find the best treatment will be like trial and error for you and your doctor. Be careful when you take these medications; they now come with a black box warning from FDA.
Psychotherapy is a way of treating depression by talking about the condition with a health care professional. Electroconvulsive therapy (ECT) is a form of treatment where electric currents are passed through the brain. This is used for the severely depressed who are at high risk to commit suicide and can't get better with medications.
There are other treatments for depression. The transcranial magnetic stimulation uses magnetic fields to change the brain activity while the vagus nerve stimulation uses electrical impulses to affect the mood centres of the brain. This may be used when the depression is chronic and resistant to other forms of treatment. All the above treatments are to be prescribed only by the physician who has examined and diagnosed you.
"The happiest of people don't necessarily have the best of everything;
They just make the best of everything they have." - Unknown
6. Some Humour - Let's laugh together at this joke even if it's not funny. William Fry, M.D. is a humor guru from Stanford University. He said that creativity and humor work similarly. Why did he say that? It is because both humor and creativity create relationships between two items that are not connected and they engage the whole brain. I am running out of time and space so next month I will show you an example on this.
A little old man shuffled slowly into an ice cream parlor and pulled himself slowly and painfully on a chair.
Old Man: May I have a banana split please?
Old Man: Make it fast. I am thirsty and hungry.
Waitress: Crushed nuts?
Old Man: No.
Waitress: What then?
Old Man: Arthritis.
7. Do you have a question or comment for the team?
Drop us a line at our contact form and write your questions or comment there.
7. Q&A: Are There Home Remedies for Depression?
Moving the body is not only good for the physical health but also for mental health It is like an antidepressant medication because it increases the chemicals in the brain and encourages the release in the brain of a hormone that aids in reversing the toxic effects of depression.
Sleeping well is an essential part of healthy living. After just a few nights of restless sleep or inadequate sleep will lead to some adverse effects like becoming irritable, lowering of concentration, memory as well as coordination. And the immune function declines too. It’s no wonder that depression and poor sleep go together.
There are alternative medicine therapies to relieve the symptoms that include herbal remedies and supplements like St. John's wort, omega-3 fatty acids, SAMe, and folate but remember these are not substitute for the prescribed treatment plan and tell the doctor before taking any as they may obstruct the professional treatment you may be currently on.
Inadequate omega-3 fatty acids in the brain cells will not be able to make them understand the message from the serotonin that helps turn off the brain’s stress response. Similarly, lack of omega-3 mixes up the messages of dopamine which is the transmitter that turns on the part of the brain that keeps us in good mood. Not enough omega-3 promotes inflammation in the body that reduces tryptophan, the building block of serotonin. It also harms the part that triggers the stress hormone which has depressive effects on the brain.
Go out in the sun and get enough sunlight because this stimulates the production of serotonin in the brain. This increases the feelings of well-being. Research has shown that after an hour or two of exposure that bright light people feel better and are less liable to fight and argue with others.
Mind-body connections use mind-body techniques to relieve the symptoms like yoga, meditation, acupuncture, massage therapy and guided imagery. This will keep the mind and body in harmony which will help one stay healthy, but be careful using this as the sole treatment plan as good as they are, they are not enough to treat depression.
How does one cope when suffering from depression? Read books and websites on how to cope and write your thoughts in your diary where you can freely talk about your pain and fear. Make your life simple by cutting out the non-essentials. Eat healthy meals, exercise and get a good night sleep. Know how to relax and manage stress with yoga, tai chi and meditation. Plan your day and activities, without making big decisions when you're depressed. Participate in social activities and join support groups.
Be social and get connected. The most valuable way to treat depression is to spend time with family and friends, just walking or playing games or going to shows. These activities will help fight thoughts and reflections which could lead to depressive thinking. Having a schedule of activities with friends and families will increase the activity in the brain that has an antidepressant outcome. .
Can depression be prevented? No one has found a way to prevent depression but we can take steps to make us less vulnerable by managing stress caused by the life storms effectively, eating healthy, exercising, sleeping well, keeping up with friends and watching for the early signs so it can be treated and stopped on its tracks instead of getting worse.
Before changing your treatment plan, talk with your doctor especially if you are being treated for depression. These lifestyle changes though may help with your current treatment plan. There is no harm in trying these lifestyle changes if your doctor agrees as he knows your health situation for then you can overcome depression.
8. Got something to say? Please write down your questions and comments in the contact form in our website.
Do a good turn daily with no thoughts of getting paid is what we are going to do from now on. We will keep doing this to people who have nothing to give us back in return. Do you know that if we do this, we will receive more than we can possibly give?
I guarantee you, the feelings you will get from doing good to people who cannot return the favor is beyond description. We know because it happened to us. We will realize how fortunate we are to be able to do something nice to others. To lighten their load is what we want to do.
Roger and Evelyn Guzman
Did you like this newsletter? If so, please recommend it to your friends. If you have any questions or tips, please leave a comment at our contact form and write your questions or comment there. This newsletter is copyright 2013 Roger Guzman, M.D.
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