In May 2009 I fell into a depressive pit that lasted a good 10 months. During that time I spent whole days away from my computer - where, after all, I earn my living - sitting in front of the television and crocheting. Med changes would make a difference for a few weeks and then fail. My psychiatrist and I were so stumped and frustrated that he was recommending ECT.
I had been under stress - mostly bad, often terrible - since October 2005. I had had a blackly angry and depressed episode in the summer of 2008. The most recent stress had come from a happy event - moving into a wonderful new home - but it was still stress. I kept going until passing a final hurdle in early May of 2009 - and then my mood went to hell.
You can see that the timing and characteristics of the apparent 2009 depressive episode made sense. I'd had hardly a bit of a break from stress in more than 3 1/2 years. And I was spending my time with television and crocheting, just as I had during the 2008 dysphoric episode.
For the next ten months my doctor and I tried new meds, old meds, different dosages of meds - all to no avail. Meanwhile I lived on candy bars, Frappucino, coffee and milk - and stayed on the couch, depressed and with no energy, while my work piled up (I'd catch it up for deadlines or on good days).
Then in March of 2010 I had my annual physical and guess what? My blood sugar had gone into the diabetic range.
Most of that depression hadn't been from bipolar disorder - it had been from uncontrolled blood sugar. As soon as I went on medication for that, my mood improved radically - within a week!
I'd suffered through ten months of crippling depression that could have been treated by an inexpensive diabetes medication.
My doctors had failed me. My psychiatrist should have ordered blood tests - after all, I had been taking Seroquel for years and had gained a net 50 pounds since first going on psych meds in 1994 (I'd gained 80 and lost 30). And my primary care physician, who'd told me I was "pre-diabetic" in March of 2009 (just before the episode hit), should have done follow-up blood tests rather than just saying "You need to get on a better diet." I hadn't done that - in fact, sugar cravings had ruined my diet for all that time.
Sure, I still had - and have - short periods of greater depression, and longer periods of mild depression. For one thing, I had to deal with the repercussions of ten months of not living up to my responsibilities, paying bills late, etc., etc. I wasn't "well" - but I was better. It was now possible for my psychiatric meds to start working properly again - resulting in another period of trial and error now that the underlying physical condition was being treated.
Moral: If you have diabetes in your family; if you have gained a lot of weight from your meds or were already overweight; and/or if you have treatment-resistant depression, get your blood sugar checked via both blood glucose and A1C tests. And if the values are high but not dangerously so (according to your doctor), insist on follow-up tests. Discuss your psychiatric meds and any history of weight gain from them with your primary care doctor, and discuss your blood test results with your psychiatrist. If possible, get those two doctors talking to each other.
Uncontrolled blood sugar isn't the only condition that can mimic symptoms of bipolar disorder or depression. Thyroid disease, lupus and Lyme disease are some of the others that can cause similar symptoms. Take care of yourself and find out if you have any physical conditions that are affecting your moods.
More information and discussion:
From Merely Me: Diabetes and Depression: What's the Connection?
From John McManamy: Question of the Week: ECT
From John Folk-Williams: How Stress Causes Depression
Published On: May 31, 2011
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