It's tough to be a teenager. The pressures of growing up and leaving behind the comforting routines of childhood tied to the unrelenting social pressures and unpredictable biological growth spurts can be hard to handle.
Adolescents with diabetes have an extra-added layer of worries that can make teenagerhood all the more daunting ... from coping with erratic blood glucose levels to managing the threats of going high or low to feelings of being different or isolated. It's a wonder that they don't occasionally feel down.
Unfortunately, teenagers with diabetes are more likely to suffer from depression that those that are not diabetic. No one knows why this is; it could be a number of factors including: the unrelenting need to manage the condition, or the perceived social stigma, or possibly even some biological trigger.
To exacerbate the matter, kids that are feeling sad or angry have a tougher time managing their blood glucose numbers, according to a study released earlier this year in the Annals of Behavioral Medicine. According to an article on dLife "when teens reported more positive feelings, such as happiness or excitement, they tended to have lower - nearer normal - blood glucose levels. In contrast, when teens reported negative feelings, daily diary entries revealed a tendency toward higher blood glucose levels."
Causes aside, the potential of someone with diabetes (no matter what age) suffering from depression is real. The incidence of depression amongst those with diabetes is 15% to 33% whereas the incidence is only 10% amongst those that do not have the condition.
What exactly is depression?
Many people who are depressed often don't realize that they are. Symptoms include "persistent sadness, lethargy, irritability, changes in appetite or sleep patterns, physical discomfort, difficulty concentrating, and/or thoughts of suicide or death."
After seeing her presentation at the Children With Diabetes conference this past July on Adolescent Tipping Points, I talked with Dr. Jill Weissberg-Benchell, a psychologist from Children's Memorial Hospital who specializes in treating the mental health needs of children with diabetes. According to Dr. Weissberg-Benchell, teens with depressed mood may talk about their blood sugar control or their daily diabetes care tasks by saying: "It doesn't matter ..." or "I really don't care ..."
Dr. Weissberg-Benchell went on to say that "Parents may note behaviors that indicate depressed mood like: their child spending less time with their peers, sleeping more (or even less), increased irritability, falling grades, tendency to spend more time alone and withdrawing from their social circles."
Working through the emotional issues of diabetes, regardless of how long a child has been diabetic, is just as important as the addressing the physical, albeit more immediate, needs of the disease. Since the physical aspects of diabetes are so uncompromisingly demanding, we tend to overlook the mental and emotional consequences of the condition and wait until another day when there's more time.
Dr. Weissberg-Benchell offered the following recommendations to parents who feel that their diabetic child may be battling depression:
• Seek help. If you feel your child would benefit from speaking to, or working with, a counselor, a place to start looking for referrals would be with your diabetes management team, specifically your endocrinologist or CDE (certified diabetes educator). Pediatricians also know which mental health practitioners in the community work well with children and teenagers. Your local ADA (American Diabetes Association) may also be able to help with referrals.
• Get your child out to exercise and socializing with friends. The more active someone is, the less likely they are to suffer from depression. "It is very important that you do not allow the child to withdraw," says Dr. Weissberg-Benchell.
What Works & Where To Find Help
"Cognitive behavioral therapy, at times in conjunction with medication," says Dr. Weissberg-Benchell, "are often successful in treating diabetic teens with depression."
A good place to start with finding a mental health therapist that specializes in diabetes and also adolescents, as was mentioned above, is to start with your diabetes management team.
Unfortunately, as with pediatric endocrinologists, there aren't enough mental health practitioners to serve needs of kids with diabetes. To further exacerbate the issue, many of those that do specialize in this area tend to be concentrated in specific geographic areas.
Published On: November 12, 2009