Depression Treatments

Treatment for depression ranges from psychotherapy to medications. Talk with your physician to find out what is best for you.

There is a wide range of treatments for depression from psychotherapy to medications. For individuals with diabetes, Self Management Education has therapeutic value, because better control reduces some symptoms of depression and builds self-esteem. 

Since, there are various reasons a person may be depressed, not all forms of treatment will resolve everyone's depression. Therefore, it's best if treatments get tailored to the individual. Just because someone you know, was put on Zoloft does not mean that it will work for you.

First step is to seek the help of a Mental Health Professional (MPH) for an initial assessment. Keep in mind that high or out of control blood sugars during your assessment or over the past two weeks may impact the diagnostic process.

Once the MPH understands the cause of your depression, treatment is then individualized. You will find more information on the various causes in the "Depression Etiology" section.

Treatment Types

Treatment is based on the initial assessment discussed in the "Depression Diagnosis With Diabetes" section. I would recommend meeting with a certified diabetes educator (CDE) while seeking emotion help from a psychotherapist. It is important to rule out the diabetes with the help of a CDE and your psychotherapist.

Certified Diabetes Education helps people get their diabetes management under better control through learning new methods of management, technology implementation and creating accountability, which may alleviate some symptoms of depression depending on the cause.1 Best when used in conjunction with Cognitive Behavioral Therapy or Psychodynamic Therapy.

Psychotherapy helps reduce various life stressors and symptoms of depression, while increasing self-esteem.  It helps people resolve personal issues and manage painful feelings like anger, sadness, hopelessness and frustration, to name just a few.2

  • Cognitive Behavioral Therapy is considered most effective, and research has shown good results in alleviating depression.
  • Psychodynamic Therapy focuses on the many aspects of an individual and tends to be more client/patient centered. 
  • Psychoanalytic techniques tends to not focus on direct behavioral change and more on resolving past issue that are still negatively impacting an individual in the here and now. Not recommend till you have mastered diabetes management.

Once your assessment is complete and extrinsic factors like your diabetes have been ruled out, your psychotherapist may refer you to a psychiatrist for further evaluation. For some people, medication will be needed to resolve some of the symptoms of depression that talk therapy won't resolve.

Medication Therapy helps reduce or resolve some of the symptoms of depression that may be interfering with your diabetes management. Some symptoms of depression make it difficult or even impossible to manage diabetes.1,3 For example poor concentration may cause problems remembering to test your blood sugars or give insulin before you eat.

  • Selective serotonin reuptake inhibitors (SSRIs) are used to reduce symptoms of moderate to severe depression and cause minimal side effects.4
  • Monoamine oxidase inhibitors (MAOIs) are also used to reduce symptoms are a second line of defense due to increased side effects and need for diet restrictions.  MAOIs can cause dangerously high blood pressure due to interactions with certain foods and medications. Not recommended for people living with diabetes, but in some cases when all else fails, they may be prescribed.5

Before starting any medication, over the counter medication, or herbal alternative to medication, please inform both your endocrinologist and psychiatrist of what you are taking. Some psychiatric medications may negatively impact both diabetes and non-diabetes medications, you already take and vice versa. For example, some psychiatric medication may lower or raise blood sugar levels.

Electroconvulsive Therapy (ECT) is the last resort, when all else fails. It is much safer than it used to be with minimal side effects. It is a process where electrical currents are used to induce a small Seizure.  It causes rapid changes in brain chemistry, reversing the symptoms of depression.6 This therapy requires hospitalization and is generally used for intractable depression.

Updated on: October 28, 2015
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