Diapression, a combination of the words diabetes and depression highlights the complex interrelationship between these two conditions.
Separate from diabetes burnout, evidence from studies demonstrates a bidirectional link between diabetes and depression; diabetes seems to increase the risk of developing depression and depression adversely affects the control and outcomes of diabetes.[1]
The term was first used in research in 2011 by Dr Paul Ciechanowski.
It is well documented that some participants experience depression after diagnosis, although this varies from person to person.
Individuals with diapression often typically experience a feeling that goes beyond the physical symptoms of diabetes and the emotional symptoms of depression.
The combination of conditions can lead to decreased quality of life, increased functional impairment, and a heightened sense of despair or helplessness.[2]
The psychological distress from managing a chronic condition like diabetes, coupled with the debilitating effects of depression, creates a vicious cycle that can severely impact an individual’s mental and physical well-being.
How does diapression effect diabetes management?
Depression in people with diabetes (diapression) can prevent effective diabetes management.
Depression can remove the motivation to adhere to necessary diabetes self-care activities such as blood glucose monitoring, injecting insulin, adhering to a diet plan, engaging in physical activity, and taking other medications as prescribed.[3]
The physiological effects of depression include altered cortisol levels and inflammation which can worsen glycemic control making diabetes management more challenging.[4]
Treatment for diapression
Treating diapression requires a comprehensive and multidisciplinary approach.
Antidepressants and psychotherapy, particularly cognitive behavioural therapy (CBT), have been effective in treating depression in individuals with diabetes which can lead to improved mood and better diabetes management.[5]
Mindfulness has also been demonstrated to improve depression symptoms.[6]
Lifestyle interventions which combine diet and exercise can not only improve diabetes control but also have a positive impact on depressive symptoms.
Integrated care models that address both diabetes and depression simultaneously are recommended for managing diapression effectively.
Studies into digital apps have found improvements in depressive symptoms after 12-weeks use.
Challenges
The management of diapression is fraught with challenges.
Firstly, it is a new term that encompasses stigmas associated with mental health issues which may prevent individuals from seeking treatment for depression.
Secondly, healthcare systems often operate in silos with little collaboration between mental health services and diabetes management programmes, leading to suboptimal care for individuals with diapression.
Future research should focus on identifying biomarkers and psychosocial predictors for diapression to facilitate early detection and intervention, and to understand the mechanisms underlying the diabetes-depression link, which could lead to more effective treatments.
Studies exploring the efficacy of novel treatment modalities including digital health interventions and personalised medicine approaches are crucial.
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