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DEPRESSION CAUSED BY DIABETES?

Question

Diabetes and depression: What's the link?What's the connection between diabetes and depression? Can diabetes cause depression?

Answer

from Maria Collazo-Clavell, M.D.

If you have diabetes, you have an increased risk of developing depression. And if you have depression, you have a greater chance of developing type 2 diabetes. Though the relationship between diabetes and depression isn't fully understood:

■The rigors of managing diabetes can be stressful and lead to symptoms of depression.

■Diabetes can cause complications and health problems, such as diabetic neuropathy, that may worsen symptoms of depression.

■Depression can lead to poor lifestyle decisions, such as unhealthy eating, less exercise, smoking and weight gain — all of which are risk factors for diabetes.

■Depression affects your ability to perform tasks, communicate and think clearly. This can interfere with your ability to successfully manage diabetes.

The good news is that diabetes and depression can be treated together. Medications and lifestyle changes, including regular exercise, can improve both diabetes and depression.

If you have diabetes, watch for signs and symptoms of depression. These include:

■Loss of interest in normal daily activities

■Feeling sad, down or hopeless

■Problems sleeping

■Trouble focusing or concentrating

■Difficulty making decisions

■Unintentional weight gain or loss

■Feeling fatigued or weak

■Thoughts of suicide or suicidal behavior

■Unexplained physical problems, such as back pain or headaches

If you think you may be depressed, seek help right away. Your doctor or diabetes educator can refer you to a mental health professional.

 

BODY WEIGHT WORK OUT

One of the best way to get a great work out without using any equipment at all, is by using your own body weight. Check out the gang at the OUC in Washington DC as they go through a boot camp training session using just there body weight.






























Using one's own body weight for a challenging work out is not only effective, it is very convenient. A person won't have to manage carrying weights, mats, medicine balls or any other apparatus. It is a form of exercising thats fun and will keep you on your toes learning how to challenge yourself.

BOOST YOUR MOOD

EAT SMART

The foods you choose can also affect your mood. "Low levels or actual deficiency of such nutrients as omega-3 fatty acids, zinc, selenium, chromium, vitamin D, and the B vitamins folic acid and B12 are all associated with human depressive symptoms," says Alan C. Logan, naturopathic physician and author of The Brain Diet (Cumberland House, 2007). However, Ronald Pies, M.D., clinical professor of psychiatry at Tufts University School of Medicine and professor of psychiatry at SUNY Upstate Medical University, Syracuse, adds that there's no solid evidence to date that specific foods or nutrients can boost a person's mood under normal circumstances. The key, he notes, is moderation. "A nutritious, well-balanced diet is very important for maintaining a normal mood."

HAVE MORE FISH

Omega-3 fatty acids, found in fish, fish oils, and flaxseed, are being studied for their mood-boosting properties. Specifically, research suggests that eicosapentaenoic acid (EPA), an omega-3 found in oily fish, may be especially effective against depression. Though the jury is still out on all of the potential benefits of omega-3s, many experts say it's worth giving them a try. "Consider adding more omega-3 fatty acids to your diet, if not to boost mood, then to improve your overall cardiovascular fitness," says Ronald Pies, M.D., clinical professor of psychiatry at Tufts University School of Medicine and professor of psychiatry at SUNY Upstate Medical University, Syracuse. "This can be easily done by increasing your dietary consumption of certain fish, such as salmon or herring." You can also get fish oil in supplement form.

KICK DOWN YOUR HEELS

High heels may turn heads, but new research shows the long-term cost of wearing them is even steeper than the sky-high price tag of some coveted brands.

Along with aching feet and a variety of foot deformities, years of high-heel wearing can actually alter the anatomy of the calf muscles and tendons, according to a study by researchers in England, published online July 16 in the Journal of Experimental Biology.

The incline of high heels causes the calf muscles to contract. Over time, this causes the muscle fibers to shorten and the Achilles tendon to thicken, so much so that some women feel pain when they try to walk in flats or sneakers.

"You put on heels, you are going to deform your body. End of story," said New York City podiatrist Dr. Johanna Youner, a spokeswoman for the American Podiatric Medical Association who was not involved with the research. "High heels look beautiful, but the body isn't meant to wear them. There is no way around it."

For the study, Marco Narici of Manchester Metropolitan University and colleagues recruited 80 women aged 20 to 50 who had been wearing heels of at least 2 inches almost daily for two years or more. Of those, 11 said they experienced discomfort when walking in flatter shoes.

When compared with women who did not wear heels, ultrasounds revealed the women who wore heels had calf muscle fibers that were 13 percent shorter, while MRIs showed the Achilles tendon, which attaches the heel bone to the calf muscle, was stiffer and thicker.

"This is a great study that looks at the mechanism of how high heels may cause grief and aggravation to the woman wearing them," said Marian Hannan, a senior scientist at the Institute for Aging Research at Hebrew SeniorLife in Boston, who was not involved in the research. "This may have an impact on how future shoes are designed and help the industry understand how women can be slaves to fashion but not suffer so much physical discomfort."

It's not a big leap to know that shoes that hurt can't be good for you, Youner said. For example:

High heels put stress on the back and knees. Squeezing into high heels with narrow toe boxes can cause a condition called Morton's neuroma, a painful thickening of tissue between the third and fourth toes.

Haglund's deformity, sometimes called the "pump bump," occurs when back straps of heels dig into the tissue around the Achilles tendon. Too-tight shoes can bring on bunions, an enlargement of bone or tissue at the base of the big toe that pushes the big toe toward the second toe.

Pointy shoes can worsen hammertoe by forcing the toes to bend at the middle joints, eventually causing them to stay bent and rigid even when barefoot.

And then there are those uneven-sidewalk wipeouts that lead to ankle sprains and breaks.

The fix for many of these conditions, podiatrists said, may come as bad news for those emulating "Sex and the City" fashionista Carrie Bradshaw: Box up your stilettos, take over-the-counter anti-inflammatories if necessary, and wear more sensible footwear.

"I tell a lot of women to put on sneakers and take Aleve," Youner said. "A heel will make a woman's butt stick out and makes the body look taller, thinner. Society pushes us to look a certain way, and all women want to look attractive. In reality, it can be crippling, and it is literally changing the shape of the body."

And don't think those now ubiquitous flip-flops are your solution. Flip-flops offer no arch support or shock absorption, and the toes have to scrunch with every step to keep the foot from slipping, experts said.

"I have recently seen some lovely flip-flops injuries," Youner said. "Flip flops are meant for the beach, not for walking on cement or on vacation or at an amusement park. If you wear them, you are treating your feet poorly and you will eventually pay for it."

If you must wear heels, minimize the time you spend on your feet, wear wider heels that distribute the weight better and shop for shoes at the end of the day when your foot is larger, Hannan said.

More information from:

The American Podiatric Medical Association has more on choosing proper footwear.

GRIP IT, DON'T CHOKE IT

Today's Fitness Tip,

When lifting weights, don´t grip the weights any harder than you need to, unless you are training grip strength. Too hard of a grip can raise your blood pressure.

WALK AND TALK

Today's Fitness Tip

Invest in a good headset for your telephone. This leaves your hands free so that you can exercise while talking on the phone. For example, you can have a nice conversation with a friend while you lift weights. It will make the exercise time go faster plus you'll have some free time to spend on something else.