Yet depression, while common in diabetes, is not normal, and there are things people can do to treat it. "We call it a biopsychosocial disease or condition, and usually treatment involves work in each of those areas," says Guzman.
It's easy to confuse physical symptoms of diabetes, such as lack of energy, with symptoms of depression, Guzman observes. But there many other symptoms that provide clues to a diagnosis of depression. These may include:
- Loss of pleasure in activities you used to enjoy
- Change in sleep patterns
- Waking up earlier than usual
- Change in appetite
- Trouble concentrating
- Feeling guilty that you never do anything right and worrying that you are a burden to others
- Morning sadness
- Suicidal thoughts
"Basically, if it's starting to affect their functioning," Guzman says, "it's time to get help." Yet a diagnosis of depression is missed 50% of the time in primary care settings, according to Mental Health America, the nation's leading nonprofit advocacy group for the mentally ill. And among people with diabetes, two out of every three depressed patients seen in the primary care setting receive no specific antidepressant treatment, one study finds.