Diabetes and Depression - Valerie Lambert, LCSW

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Utah Diabetes Telehealth Program --

Wednesday, August 19, 2009
12:00 p.m. - 1:00 p.m. (MDT)

To participate visit http://health.utah.gov/diabetes/telehealth/telehealth.html

Approximately 20% of the U.S. population and 40% of individuals with diabetes are affected by depression. Not only can depression lead to poor health outcomes, but it can also impact productivity and general quality of life.

To explore the issues surrounding depression and diabetes, Valerie Lambert, LCSW will focus on how to recognize the signs and risk factors which may indicate depression and anxiety in patients with diabetes; how to apply strategies to help someone with diabetes manage or decrease depression/anxiety and increase coping skills; and how to recognize when referral for treatment of depression/anxiety would be appropriate.

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Diabetes and Depression - Valerie Lambert, LCSW

  1. 1. An Evil Duo!
  2. 2. What Is Diabetes? (Naïve View) <ul><li>Dietary changes </li></ul><ul><li>Insulin shots ( cure?) </li></ul><ul><li>Can’t eat sweets </li></ul><ul><li>A big bother </li></ul>
  3. 3. What Is Diabetes? (Naïve, Newly Diagnosed View) <ul><li>May initially minimize effects </li></ul><ul><li>Gradually begin to grasp implications </li></ul>
  4. 4. What Is Diabetes? ( Experienced View) <ul><li>Patient With Family History or Other </li></ul><ul><li>Second - Hand Experience </li></ul><ul><li>Patient who has been diabetic for some time </li></ul>
  5. 5. Why Worry About Depression in Diabetics? Research findings: Diabetes Depression Depression Diabetes
  6. 6. Why Worry? <ul><li>Comorbid diagnoses = greater impact of both diseases </li></ul><ul><li>Depressed diabetics have earlier, more severe prevalence of physical problems </li></ul>
  7. 7. Why Worry? <ul><li>Diabetics report earlier onset than general population </li></ul><ul><li>Definite link, bidirectional influence </li></ul><ul><li>No causation found </li></ul>
  8. 8. Depression Populations
  9. 9. What Is Depression, Anyway? <ul><li>Depression is : </li></ul><ul><li>A physical & emotional illness </li></ul><ul><li>Very treatable </li></ul><ul><li>Very common </li></ul><ul><li>Often missed if other illness is present </li></ul><ul><li>Depression is not : </li></ul><ul><li>Feeling sad or discouraged </li></ul><ul><li>A character defect or weakness </li></ul><ul><li>Curable through willpower or denial </li></ul>
  10. 10. What Is Depression, Anyway? <ul><li>DSM-IV criteria </li></ul><ul><li>Depressed Mood: Sad, anxious or irritable feelings, flat affect </li></ul><ul><li>Anhedonia: loss of pleasure in most activities </li></ul><ul><li>Weight/appetite changes : Decreased weight without dieting, increased weight </li></ul><ul><li>Sleep Disturbance: Insomnia or hypersomnia </li></ul>
  11. 11. <ul><li>DSM Criteria, continued </li></ul><ul><li>Fatigue or lack of energy </li></ul><ul><li>Psychomotor Changes: Agitated or slower than usual </li></ul><ul><li>Feelings of Worthlessness or Guilt </li></ul><ul><li>Impaired Concentration : difficulty making decisions… </li></ul><ul><li>Thoughts of death /suicide </li></ul>
  12. 12. Causes of Depression <ul><li>Genetic </li></ul><ul><ul><ul><ul><li>Biological </li></ul></ul></ul></ul><ul><li>Environmental </li></ul>
  13. 13. Contributing Factors <ul><li>Personality Traits </li></ul><ul><li>Childhood Trauma </li></ul><ul><li>Some Illnesses </li></ul><ul><li>Some Medications </li></ul>
  14. 14. Effects of Depression <ul><li>Decreased Self-Esteem </li></ul><ul><li>Unmotivated </li></ul><ul><li>Appearance </li></ul><ul><li>Poor Hygiene </li></ul><ul><li>Loss of Strategies </li></ul>
  15. 15. How Can We Help? <ul><li>Brief Self-assessment Inventories </li></ul><ul><li>Beck Depression Inventory </li></ul><ul><li>Mayo Clinic Self Assessment </li></ul><ul><li>PHQ screener* </li></ul><ul><li>Brief PHQ screener* </li></ul><ul><li>*also screens for anxiety </li></ul>
  16. 16. How Can We Help ? <ul><li>Assessment </li></ul><ul><li>Talk with Patient – MOST IMPORTANT </li></ul>
  17. 17. Treatment <ul><ul><li>Medication </li></ul></ul><ul><ul><li>Stress Management </li></ul></ul><ul><ul><li>Problem Solving </li></ul></ul><ul><ul><li>Refer for Counseling </li></ul></ul><ul><ul><li>Support Group </li></ul></ul>
  18. 18. References and Citations <ul><li>For information on references and citations please contact: </li></ul><ul><li>Valerie Lambert, L.C.S.W. </li></ul><ul><li>(801) 533-5632 </li></ul><ul><li>[email_address] </li></ul>

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