Can stress trigger the onset of type 2 diabetes in someone who is not obese? I have been active most of my life, but slowed down in my desk job over the past few years. I was diagnosed with type 2 in 2006, and the only link that seems plausible to me is that at that time I was suffering from deep depression, which was later diagnosed as post-traumatic stress disorder.
Mary de Groot, PhD, responds: Over the past 20 years, we have learned that people with diabetes are twice as likely to experience depression as people without diabetes. When people with diabetes have depression, it is more difficult to manage blood glucose and to stick to treatment plans like medication and regular exercise. Studies have shown depression to be associated with diabetes complications and even early death. Most recently, a series of studies in which individuals were followed over a period of 10 to 20 years found that people who have a history of major depression have an increased risk of developing type 2 diabetes later in life.
We do not yet know definitively how depression, stress, and diabetes are related. But here's the good news: Depression can be successfully treated in people with diabetes. There are a number of antidepressant medications that have been found to be effective. It is important to talk with your doctor about these medications and which one or ones may be the best for you. It is also important to keep in mind that antidepressant medications need time to take effect (typically two to six weeks), should be taken as prescribed (daily), and should be changed or stopped only on the advice of your health care provider. It is not uncommon for patients to be prescribed more than one medication before finding the right fit to treat their depression.
Another effective form of treatment for depression in people with type 2 diabetes is "talk therapy," or cognitive behavioral therapy. Studies have shown that people who meet with a therapist weekly for eight to 16 weeks learn to manage depressive symptoms more effectively by using tools that address common thoughts, feelings, and behaviors that come with depression. Exercise has also been found to be an effective treatment when combined with talk therapy.
It is important to tell your health care providers about changes in your mood so that you may talk together about the treatment options that are best suited for you. With help from your provider, it is possible to feel better with diabetes.