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Depression and Anxiety

Teens with diabetes are at higher risk for depression than teens without diabetes. Depression and anxiety symptoms can make living with diabetes more challenging, and get in the way of daily management tasks, like blood glucose monitoring. Decreased blood glucose monitoring is associated with declines in glycemic control or A1c, and increased risk for hospitalization.

Signs of Anxiety

It is an understatement to say that living with diabetes can create lots of worry. This tension can be related directly to the diabetes (e.g., telling new friends; fear of hypoglycemia; going off to college; long term complications). Other things children and teens worry about may have to do with school exams or projects; talking in front of peers; relationships with boyfriends/girlfriends; getting into college, etc. Bodily symptoms of anxiety include:

  • Heart beats quickly
  • Restlessness
  • Butterflies in stomach or cramping
  • Sweating
  • Disorganized thoughts

Now sometimes, a little worry can be good motivation to prepare for that test, or make sure that job or college applications are done. However, a tendency to worry can cause someone to overreact to stress or avoid the situations that cause the upset in the first place. This much worry can be very unsettling, and can get in the way of your living your life, especially if the worry is diabetes-related and causes you to ignore certain diabetes-related tasks (e.g., checking blood sugar).

There are lots of ways to help yourself feel better; you have to build up your toolkit so you have different things to draw on when one doesn’t do the trick. Some suggestions include: reaching out to talk to someone who can help you feel less alone and more secure; taking several slow deep breaths and replace the negative thoughts with more positive thoughts that encourage you; listening to some music and/or taking a walk Staying fit and getting plenty of sleep can go a long way in helping you handle tension when it arises. Mindfulness is also another great tool that has been around for a very long time. It is the practice of trying to stay present in the here and now “on purpose” while letting other thoughts/preoccupations about the future/past just fade away, non-judgmentally. Mindfulness is also about intentionally focusing your attention on something so you feel you can have control over it, rather than it having control over you and how you react.

Anxiety often goes hand-in-hand with depression because sometimes it leads to our narrowing daily life experiences in an effort to deal with the tension, and avoid what it is that is getting us upset. In this situation, it might be important to seek out help from a professional.

Signs of Depression

Depression in children should not be assumed to be any less serious than it can be in adults. The symptoms might look a little different, but they should not be dismissed as mere signs of “laziness” or a transient bad mood; Feeling sad, disappointed or discouraged sometimes are natural human emotions all people experience on occasion when life gets them down or they have a personal crisis/major life change like a breakup; not getting into the college of choice, or significant family conflict. People who are not depressed though, usually feel better over time.

In contrast, someone who is depressed experiences feelings of sadness that persist, get worse over time and, ultimately drain them of the energy, concentration and motivation to perform every day activities. Sometimes, the signs of depression develop so gradually, that they go unnoticed for a while.

Depressed children and teens present with a number of the following symptoms that don’t go away for at least a 2-week period of time:

  • Depressed or sad mood
  • Difficulty sleeping or sleeping too much
  • Trouble staying focused or concentrating
  • Change in grades, getting into trouble at school, or refusing to go to school
  • Change in eating habits
  • Feeling angry or irritable
  • Mood swings
  • Feeling worthless or restless
  • Hopelessness Withdrawal from friends and fun activities
  • Loss of energy
  • Low self-esteem
  • Thoughts of death or suicide

The good news is that with appropriate attention and treatment, depression can get better. Try to talk to someone like your parent/guardian and/or school counselor about getting some help and relief.

Preparing for the Marathon: Building Resilience

Do you want to adapt quickly to stressful events and prevent them from getting you down? Think about the following tips that can help you see stress as a challenge or opportunity to grow rather than as something bad happening to you.

  • Try to see problems as temporary and solvable, not constant and impossible
  • Believe in your skills, and ability to master what comes your way
  • Build strong relationships with friends and family, so you feel part of something larger
  • Have a support system of people you can ask for help so you are not alone
  • Participate in activities that you enjoy and that bring you pleasure
  • Get enough sleep!

Many teens want to address problems that come up on their own. This is also the case with their diabetes; teens may lie about their blood sugars because they don’t want their parents to worry or are tired and burned out. Asking for help when you need it, either to problem solve with your parents, or ask them to share some of the responsibility for your diabetes, even as an older teen, can be a sign of courage and good judgment, not weakness. It reflects a mature understanding that support can help you build new skills that can move you that much closer to your ability to be fully independent and reach your personal goals.