Depression Relationship to Medical Illness - Coursework Example

 Depression Relationship to Medical Illness Depression associated with a medical disease can manifest in various forms depending on its severity and relation to the signs and medications of the disease. Depression can be manifested in the patient completely devoid of any relation with the medical illness. It can be associated with the stress that is caused by the condition of the patient .Secondary depression is another presentation which follows the medical disease and is thought to be caused by the condition itself. Depression can also be caused by the medications taken for the therapy of the medical condition and the symptoms can also occur as a response to the condition of the disease and the patient’s current situation. A strong association has been recognized between diabetes and depression by recent researches and studies. The co-morbidity of depression and diabetes has established through prevalence rates ranging from 8.5% to 27.3% (Perry 2005). Diabetes has been labeled as a growing epidemic by the WHO and estimates of 300 million cases in the coming year of 2025 have been calculated. Apart from physical affects, diabetes also has disabling effects on the social and emotional aspects of the individual. The kind of relationship depression and diabetes have is still not clear yet. Two important questions arise in association to their link that whether depression leads to the occurrence of diabetes or diabetes is a high risk factor for depression (Yavari & Mashinchi 2010). This association establishes its significance through the high prevalence of both the conditions. In US 6.5% of the adult individuals suffer from diabetes and 16% of the adult population develop depressive symptoms in their life span. Hence if they are linked, this calls for a significant attention into the issue (Mezuk et al 2008). In a research carried out by Engum et al in 2001, a strong co-morbidity relationship was established between depression and diabetes and several factors affecting this link were highlighted. Depression prevalence rates were found to be increased in the population suffering from diabetes as compared to the non-diabetic population. Some factors which were related to type 2 Diabetes and depression occurrence included education, physical conditions and individual complaints. Diabetic population who had presented with a lack of education or had poor education and reduced physical activity or disability showed increased rates of depression. Another important conclusion was the existence of co-morbid chronic diseases with diabetes and its effect on the depressive symptoms. People who were suffering from chronic illnesses along with diabetes like cardiovascular diseases, hypertension showed increased rates of depression as well (Engum et al 2001). The study of Mezuk et al in 2010 highlighted the bi-directional nature of the link between the two conditions. Diabetes is a metabolic disorder and the incidence that it is a risk factor for directly causing depression is quite low. It can cause depression because of the threat and warnings this illness carries and the serious lifestyle changes an individual has to make in order to avoid the complications of Diabetes. Depression on the other hand exhibits an increased incidence of causing diabetes. It is caused by behavioral changes and lack of healthy habits like increased food intake, alcoholism or smoking. It can lead to abnormal activation of the hypothalamic-pituitary and adrenal gland system along with excessive cytokine production which can cause insulin resistance, an important pathological change occurring in diabetes type 2. The association of depression with obesity also indicates the link with diabetes. Central obesity is a potential cause of glucose intolerance in the diabetic patients. The results of the study showed that the relative risk for depression linked with diabetes was 1.15. On the other hand, the relative risk for diabetes caused by depression was 1.60. Hence, depression builds a stronger link as a risk factor for diabetes (Mezuk et al 2010). In another research, the relation between depression and complications of diabetes type 1 and type 2 has been established by de Groot et al 2001. According to the hypothesis, chronic hyperglycemia is the leading factor for the diabetic complications and depression on the other hand is associated with hyperglycemia. Hence, depression also makes its link with the complications of diabetes occurring in the long run. Complications like neuropathy and cardiovascular diseases caused by chronic hyperglycemia are also strongly associated with depressive symptoms in diabetic patients. The analysis showed that the increase in severity of depression also lead to an increase in the complications. These complications included retinopathy, neuropathy, and sexual dysfunction and macrovascular diseases. Out of the twenty-seven research reports included in the meta-analysis a positive result of 89% was obtained (de Groot et al 2001). Foot ulcers, a complication of diabetes, are also linked strongly with depression. Depression itself can lead to the occurrence of foot ulcers because of reduced activity and poor management for diabetic control. The foot ulcers itself can lead to depressive symptoms because of the physical disability and the increased rate of mortality related to it (Yavari & Mashinchi 2010). Diabetics suffering from depressive symptoms have showed an increased mortality rate as compared to patients who were not a victim of depression. Studies showed that in diabetic-depressive patients, macrovascular and micro-vascular occlusions resulting in organ failures account for increased mortality rates. The increased incidence of stoke, cardiovascular incidents and end-stage kidneys caused by chronic diabetic conditions in patients suffering from depression as compared to the non-depressive diabetic population explains the synergistic role of the two conditions. Another important problem is the achievement of therapeutic goals. With the co-morbidity of depression and diabetes a poor performance in this area has been showed. Such patients have a difficulty in controlling their cholesterol levels, glucose levels, blood pressures and maintain a healthy and active lifestyle. If only treated with diabetic medications, they show no or poor results. However, when treated with anti-depressants along with diabetic therapies, they show improvements in their conditions. Psychotherapy and anti-depressant drugs are recommended for individuals with this co-morbid condition. Cognitive Behavior Therapy is used for treating the depressive symptoms in the diabetic patients and is highly recommended because of its effectual outcomes. Selective serotonin re-uptake inhibitors (SSRIs) and Tricyclic Anti-depressants (TCAs) are two widely indicated drugs for treating depression in diabetic people. SSRIs are preferred over TCAs because of lesser adverse effects like sedative action and weight gain problems (Yavari & Mashinchi 2010). Depression is associated with the medical condition of diabetes. Research has put forward the fact that diabetes and depression are interrelated. Patients who suffer from both diabetes and depression show reduced health improvements if both the conditions are not accessed and treated. Thus, it is important that this link is understood by the health practitioners. References de, Groot. M., Anderson, R., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (January 01, 2001). Association of depression and diabetes complications: a meta-analysis.Psychosomatic Medicine, 63, 4.) Engum, A., Mykletun, A., Midthjell, K., Holen, A., & Dahl, A. A. (January 01, 2005). Depression and diabetes: a large population-based study of sociodemographic, lifestyle, and clinical factors associated with depression in type 1 and type 2 diabetes. Diabetes Care, 28, 8, 1904-9. Mezuk, B., Albrecht, S., Eaton, W. W., & Golden, S. H. (December 01, 2008). Depression and type 2 diabetes over the lifespan: A meta-analysis. Diabetes Care, 31, 12, 2383-2390. Perry. (2005). “The Interaction of Major Depression and Medical Illness”. Medscape Education. Yavari, A. & Mashinchi, N. (2010). “Diabetes and Depression”. Journal of Stress Physiology & Biochemistry. Read More