It’s something of a triple threat: Not only have researchers found that there’s a very strong link between depression and diabetes, but having both can up your risk of dementia, according to a study from the Johns Hopkins Bloomberg School of Public Health.
When researchers evaluated people who developed diabetes in midlife, and then followed them for 20 years, the condition was associated with a 19 percent greater decline in cognitive function compared with individuals who didn’t have diabetes. “Some studies say that up to 60 percent of diabetics are likelier to suffer from depression,” says Kevin Goist, M.D., assistant professor of clinical medicine at Ohio State University in Columbus, Ohio.
The connection between diabetes and depression may be based on a number of factors. “Just like any other chronic medical condition, some of this has to do with the challenges faced with managing diabetes, having to change your lifestyle or not being able to enjoy certain foods you once ate,” says Dr. Goist.
But there may also be physiological changes taking place in a person with diabetes that can trigger depression. “We know that there are changes in brain hormones that can trigger depression, such as decreases in dopamine levels,” says Sheri Colberg, Ph.D., professor of exercise science at Old Dominion University in Norfolk, Virginia. “It appears that diabetes can also lead to lower levels of insulin in the brain, which may lead to a lesser blood flow there, and changes in brain hormones.”
While the 3Ds—diabetes, depression and dementia—might feel like a lot to take on, there is a silver lining: A lot of the same things that help people with diabetes control the disease, also do a pretty good job at bolstering brain health.
Here are 5 effective ways to manage the 3Ds, say experts:
You likely already know that keeping blood sugar regulated is the key to controlling diabetes. But did you know that better blood sugar control may also help you head off depression, as well as cognitive decline later in life? Chronic inflammation, which is linked to all three conditions, appears to cause neurodegenerative changes in the brain. A plant-rich diet —such as the Mediterranean diet—combined with regular exercise, are two of your best weapons in fending off chronic inflammation. When diet and exercise aren’t cutting it, taking medication to regulate blood sugar is critical. In addition to regulating blood sugar, the drug metformin may also lessen risk of dementia when used over time.
There’s ever-growing evidence about the strong connection between a healthy gut and a healthy brain. For example, anxiety and depression are thought to prompt such GI conditions as irritable bowel syndrome (IBS). In addition, experts are learning more every day about our second brain, the one that’s hidden in the walls of our digestive system. Researchers says that as we learn more about the ways in which the bacteria in our gut influence our brain health and can lead to depression, this will help us treat diabetes, too. You can improve your gut health by limiting fats, staying hydrated and eating more fiber-rich foods, Dr. Goist says. You can also talk to your doctor about starting a probiotic regimen. Early research shows probiotics can enhance gut flora, which in turn can help lessen the sad moods associated with depression.
The American Heart Association recommends at least 30 minutes of moderate-intensity aerobic activity at least five days per week for a total of 150 minutes or at least 25 minutes of vigorous aerobic activity at least three days per week for a total of 75 minutes or a combination of moderate- and vigorous-intensity aerobic activity.
“In general, any form of cardiovascular exercise that you can tolerate is best,” says Dr. Goist. “Just be sure to speak with your doctor about what exercises would be most helpful and safest for you. For people who struggle with joint pain or osteoarthritis, lower impact exercises such as water aerobics, swimming, bicycling or elliptical machines may be more helpful and cause less pain than walking, jogging, or using a treadmill.
Another motivator for exercising: Your brain releases ‘feel good’ hormones when you exercise, like dopamine, similar to the ones you get from eating sugar and refined carbs, explains Dr. Colberg. “When people are diagnosed with diabetes and cut out such foods, it can often lead to lower levels of dopamine in the brain and depression. Your best bet: Raise brain hormones with physical activity and meditation, not carbs and sugar.
Taking steps to reduce stress feels so good and it’s also really good for us. In fact, listening to classical music was shown to lower blood pressure and increase the feel-good hormone oxytocin, according to research conducted at the University of San Diego. “This has been studied before, including a 2012 study of African Americans with high blood pressure,” Dr. Goist says. “The researchers showed that those who practiced meditation were less likely to suffer heart attack or stroke.” And don’t forget to keep your brain ‘exercised’ too by doing crosswords, playing music and knitting.
While the evidence isn’t entirely straightforward, upping your intake of omega-3s, saturated fats found in fish (salmon, anchovies, tuna and sardines), spinach, walnuts and flaxseed oil, can’t hurt. “They have been shown to improve brain health and cognition,” says Colberg. “They’re also essential in the diet and good to eat more of for that reason alone.”