It is estimated that 30 million people in the United States have diabetes and the numbers are growing. Diabetes is the 7th leading cause of death in the United States. In addition, diabetes is heavily associated with other diseases such as cardiovascular disease, heart attacks, stroke, blindness, kidney disease, and circulatory problems leading to amputations. As a result, diabetes doubles the risk of death of any cause compared to individuals of the same age without diabetes.
Depression affects people with diabetes more often than people without it — up to 15 percent compared with 6.7 percent in the general population. When depression occurs along with a chronic illness like diabetes, the symptoms tend to be more severe. Compounding the problem further, the symptoms can become worse as depression can lead to missing medication doses, overeating, or skipping exercise. This may mean poorer blood glucose control, which, in turn, means more long-term health complications.
So, in treating diabetes it is important to treat not only the physical problem but also the psychological problems such as depression. Mindfulness training, especially Mindfulness-Based Cognitive Therapy Mindfulness-Based Cognitive Therapy (MBCT) has been demonstrated to be effective in treating depression (see http://contemplative-studies.org/wp/index.php/2015/08/15/spiraling-up-with-mindfulness/ and http://contemplative-studies.org/wp/index.php/2015/07/17/dealing-with-major-depression-when-drugs-fail/).
In today’s Research News article “Individual Mindfulness-Based Cognitive Therapy for People with Diabetes: a Pilot Randomized Controlled Trial”
Schroevers and colleagues examined whether an individualized version of MBCT might be effective for depression in people with diabetes. In comparison to diabetic patients on a waiting list, MBCT resulted in clinically significant reductions in depressive symptoms and diabetes related psychological distress and increases in the levels of acting with awareness and attention regulation. These improvements were still present three months after completing the program.
These are impressive results and suggest that MBCT is an effective treatment for the psychological issues that frequently accompany diabetes. MBCT may be effective due to its emphasis on the present moment in mindfulness. Depression is often rooted in the past and the individual ruminates about the misery of the past. By shifting focus to the present moment, mindfulness can move the individual from being preoccupied with a troubling past to being focused on addressing the manageable problems in the present. Indeed, Schroevers and colleagues demonstrated that MBCT produces an increase in acting with awareness. The individual then is more aware of what they’re doing. For the depressed diabetic individual this can help in the recognition of how he/she is acting in response to the depression or the diabetes. This allows them to reprogram their responses to be more appropriate to the circumstances of the present rather than responding to the depression itself.
Mindfulness also stresses non-judgmental awareness of the present. There is a decreased tendency to be constantly judging what is happening and instead just accept it as what is. This reduces worrying. Indeed, mindfulness practice has been shown to reduce worry (see http://contemplative-studies.org/wp/index.php/2015/07/17/stop-worrying/). Since worry involves concerns about future occurrences to some extent based upon past experiences, the more one can focus on the present the less opportunity there is for worries to arise. Mindfulness training also trains the individual to accept the worry, experience it, and then move on. This reduces the impact of the worry and prevents the development of worrying about worrying.
Another possibility is mindfulness’ ability to increase emotion regulation. That is mindfulness assists the individual in recognizing emotions as they arise and not over respond to them. It doesn’t prevent emotions. It simply allows the individual to better deal with them when they do arise. So when depression occurs the individual can recognize it, accept it, and then let it go and not respond to it. This liberates the individual to find new ways of responding to the environment and other people.
So, be mindful and improve psychological well-being with diabetes.
“Life is not over because you have diabetes. Make the most of what you have, be grateful.” – Dale Evans
CMCS – Center for Mindfulness and Contemplative Studies