A depression journal is a personal tool for treatment and recovery from this often-debilitating mental illness. Depression journals are trusted companions during your dark days, and they’re not mere passive sidekicks. They help you harness the healing power inside of you to gradually work your way through. People who use depression journals reap many benefits. Here, learn how you can benefit from journaling through depression plus tips on how to do it.

Depression Journals Can Relieve Depression

Numerous studies show that depression journaling is very helpful in many ways (Ackerman, 2019). One study by Katherine Krpan and colleagues (2013) asked people diagnosed with major depressive disorder to journal about their thoughts and feelings related to an emotional situation. They measured their symptoms before and after the experiment using the Beck Depression Inventory and the Patient Health Questionnaire-9 and discovered that their symptoms improved markedly (a control group who journaled about neutral daily events did not see a change in symptoms). Amazingly, it didn’t take long for people to find improvement; they journaled just 20 minutes per day for a total of three days.

Depression journaling is journaling with a purpose, and it is indeed a useful treatment tool. Not only can it reduce symptoms of depression, keeping a journal can help you improve the overall quality of your life. It does this by offering a wide variety of life-changing benefits.

The Many Benefits of Keeping a Depression Journal

Depression journals clear your mind of the clutter of negative thoughts and emotions. In so doing, they boost your mood, self-confidence, and motivation. As you write about various experiences with depression, you get things out of your head and out in front of you. This helps reduce the tendency to ruminate over negativity that is very typical in depression. The experience of clearing your head is stress-relieving, which in and of itself helps your mood and outlook.

As you clear your mind, you gain new perspectives and uncover helpful thought and behavior patterns. Depression journaling allows you to gain some distance between yourself and your negative thoughts and beliefs. As you put them to paper, you begin to see your depression as something apart from you, not who you are but something you’re experiencing. This, in turn, helps you identify specific negative thoughts and beliefs that are often hidden amongst the noise and clutter of all your depression symptoms. As you make these known, you can see and conceptualize problems as well as positives. You begin to know what to change and what to do more of to reduce the negative and enhance the positive.

As you write regularly in your journal, something almost magical begins to happen. You begin to find your voice. You learn what you want and what you don’t want, and expressing it in writing helps you know how to express it verbally. Including positive self-talk begins to replace the harsh, negative self-talk of depression. the act of journaling is also one of self-care. By doing it, you send a message to yourself that you are worth the time and the effort and the positive self-talk becomes self-confidence and self-efficacy (the belief in yourself and the knowledge that you can conquer depression).

Depression journals are valuable for your mental health and wellbeing, but when you are in the throes of depression, the idea of keeping one can seem daunting. How do you begin, and how do you continue? The following tips can help you.

How to Keep a Depression Journal

While there, of course, are no hard and fast rules, no right and wrong, (your journal is personal and you can create it and use it in any way that is meaningful to you), there are certain tips that can make the experience positive and undaunting. Try any or all of these:

• Write regularly (20 minutes daily is recommended but not necessary)
• Try different styles (free-writing, bullets, depression journal prompts, letters to yourself or others, etc.)
• Create a special space, free from distractions and pleasant to be in
• Give yourself time to quietly reflect after you write
• Keep it private so you’re not blocked by the idea of others reading what you write
• Let go of the need to make it perfect (let it be flawed, messy, and stress-free)
• Don’t dwell constantly on the negative (address the negative, but set a limit on how much time you’ll spend addressing what’s wrong and then switch to positives, gratitudes, goals, and plans)

Depression journals help you form a new, kinder relationship with yourself that empowers you to take back the control over your life that the illness stole from you. Natalie Goldberg, Zen practitioner, author, and painter captures the essence of depression journaling. “What’s important is that you’re having a relationship with your mind."

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A depression trigger is anything that contributes to the development or deepening of depression. Triggers are highly individualized and vary from person to person. Whatever your own unique triggers, you can create a toolbox to help deal with depression triggers.

Types of Depression Triggers

There are different types of depression triggers, and knowing what they are in general can help you identify which ones are bothersome for you to help you target them. Common types of depression triggers include:

• Situations external to you—relationships with others, loss, disappointments, and more
• Your own thoughts—depression’s automatic negative thought patterns cloud how you see yourself, others, and circumstances
• Your physical self—nutrition, level of exercise, inflammation in the body, and more affect the brain and its chemistry, functioning, and structures

Effectively dealing with depression triggers involves either changing the situation around you or changing the way you experience it. Lifestyle adjustments help beat depression, too.  

ACT to Deal with Depression Triggers

Acceptance and commitment therapy (ACT) is an approach to wellness that empowers people to make changes to improve their mental health and wellbeing. You can use the principles of ACT to deal with external circumstances as well as your own inner thoughts and experiences.

This brief rundown of the components of ACT can help you begin the process of dealing with what sets off depressive episodes.

• Accept what triggers depression to stop struggling against it, because when you fight it, that’s what you focus on. Different from giving into it, accepting its presence frees you to shift your attention and energy.
• Distance yourself from it by putting some space in your thoughts about it. For example, “I’ll never amount to anything,” becomes “My depression is telling me that I’ll never amount to anything, and depression isn’t trustworthy.”
• Practice mindfulness to pull yourself out of your thoughts about your trigger and into your present moment. Focus on your senses to ground yourself.
• Know yourself and your unique triggers. What bothers you, and what makes things better? The more aware you are, the better you can prevent becoming overwhelmed.
• Discover your values. Paying attention to what you want for yourself and your life is a way to take power away from what strengthens depression.
• Commit to pursuing your values. Triggers can’t keep you in depression when you are taking little steps every day to move away from them.

The little steps that move you toward positive mental health are what goes into your trigger toolbox.

Create Your Trigger Toolbox to Decrease Depression

Think of filling a giant box or other organizational items with tons of protective factors that will buffer you against triggers. You might not be able to prevent some triggers from rearing their ugly heads, but you can equip yourself to stand up to them.

Everything on the list has been shown by researchers and mental health professionals to help keep depression from overtaking you. Gather what resonates with you and bypass others. Also, plan on choosing just one or two items to begin defending yourself against triggers. Doing too many things at once can be overwhelming and counterproductive, especially when you’re facing depression, a condition that zaps energy and motivation.

Here are some things to add to your toolbox:

• Create a vision board or journal to record a positive goal, and look at it often for motivation and planning.
• List distractions—quick activities you can do to deflect negative thoughts about the trigger.
• Unleash your creativity and reduce stress through coloring, drawing, painting, journaling, knitting, building, sculpting with clay, taking pictures, etc.
• Get physical, as movement and exercise positively impact the brain and body and improve mood.
• Relax purposefully with deep breathing, meditation, aromatherapy, yoga, and others.
• Build a support network, which can start with just one person. Talk with a friend, coworker, or family member. Let them share their experiences with you, too.
• Eat well. Avoid processed, refined, junk, and fast foods; sugary sodas, energy drinks, and alcohol, and add complex carbohydrates, fruits, vegetables, and other healthy foods and drinks to boost your brain and make it easier for you to deal with depression triggers.
• Deal with problems in the moment rather than letting them fester and grow. Temporary discomfort is preferable to long-term misery.
• Hone optimism by reframing negative thoughts and looking past triggers.
• Keep a gratitude journal to broaden your awareness beyond depression.
• Allow yourself to experience awe. Step outside at night and gaze at the stars, study a beautiful flower, admire beautiful art. This allows you to rise above depression and adopt the healthy, realistic perspective that a depression trigger isn’t the only thing in your life.

Depression triggers can overtake you, but you don’t have to stay down. Use ACT and your trigger toolbox to move past them and out of depression’s reach.

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Depression and loneliness are a miserable combination. Loneliness has less to do with how many people you are surrounded by and more to do with how isolated and alone you feel. Someone living with depression might be in the middle of a room full of friendly loved ones yet feel alone on a tiny island of misfit self. Feeling lonesome affects depression on both ends: loneliness can contribute to this crushing disorder, and it can be an unwanted effect of it, too. Studies have found that loneliness plays a bigger role in depression than shame and guilt, two other very powerful components of the illness. The good news is that even when depression and loneliness overtake you, you can do something to reduce their effects.

Loneliness and Depression Feed on Each Other

One reason why loneliness is so devastating is that it leaves an essential need unmet. In the middle of the last century, renowned psychologist Abraham Maslow developed what became known as Maslow’s hierarchy of needs, an explanation of the fundamental requirements for human growth, development, and flourishing (Broderick & Blewitt, 2006). Love and belonging are one of the basic human needs that, when unmet, contribute to mental health problems like depression.

While there are many individual differences in the type and amount of connections needed, in general, human beings require social connections, friendships, intimacy, acceptance, and belonging. Depression can develop when someone lacks love and belonging. On the other hand, when someone is depressed, it’s difficult to form and maintain meaningful connections. Depression and loneliness often perpetuate each other in a way that feels devastating.

Loneliness and depression feed off each other and lead to damaging beliefs like:

• No one understands me
• I can’t be myself around others
• I can’t find people I want to be around
• I’m not worthy of love or friendship

Feeling unworthy is a common experience with depression, and it contributes to deeper isolation and loneliness. It fuels self-hatred, a feeling that makes you feel separate not just from others but from your own self, too.

Depression, Loneliness, and Self-Loathing

A recent study conducted in the United Kingdom found that self-hatred and disgust is a connecting point of depression and loneliness (Ypsilanti et al., 2018). Someone with depression typically has a lot of negative thoughts, many of which are directed at themselves. Self-worth plummets, and people isolate. To make things worse, they blame themselves for being alone.

Changing your thoughts about yourself to make them more realistic is an important first step in overcoming the loneliness of depression. Some ways to create new, accurate self-beliefs include:

• Catch yourself ruminating over your shortcomings. When you notice negative thoughts, gently shift your attention to something in your here-and-now (this is known as mindfulness).
• Develop self-compassion by acknowledging your imperfections (everyone has them) but focusing more attention on your positive qualities (everyone has these, too—you included).
• Use affirmations. Write down short, positive statements about yourself and post them where you can see them. Repeat them often.
• Reframe your thoughts (“I don’t deserve friends because I’m never there for them,” might become “I’ve made mistakes, but that doesn’t mean I don’t deserve friends. Everyone makes mistakes.”

Loneliness and depression involve more than self-hatred, of course, and there are other things you can do to end their vicious cycle.

Things You Can Do When Loneliness and Depression Overtake You

Try these strategies to stop feeling lonely with depression:

• Identify what is bothering you most, loneliness or another depression symptom. Start there. Working on one area helps the other.
• Consider this a dual process of decreasing the negative and growing into your vision for yourself and your life. Address both for the best results.
• Work on your whole self and all your needs: love and belonging, safety, self-esteem, appreciation of beauty, creativity, and cognitive needs like knowledge, understanding, and curiosity.
• Discover one interest and seek others that share it. Check into community centers or online sites like meet-up.
• Join support groups.
• Adopt a pet and find others who have the same love. Local pet stores and shelters often have bulletin boards with group information. Online searches for local pet groups can work, too.
• See a therapist to help you with negative thoughts, depression, self-esteem, and communication skills

Overcoming loneliness and depression isn’t a quick and easy task, but it is absolutely possible. The more you take action to work your way into a sense of belonging, the easier it becomes and the better it works. Create belonging and thrive.

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Knowing what to say to a depressed boyfriend, girlfriend or partner can be difficult. You want to show your support and let them know you're there, but you don't want to say the wrong thing and upset them. It's always better in this situation to say something rather than not acknowledge their illness, but what if you can never find the right words? Blaming and shaming can make someone you love with depression feel even worse about themselves, so tact is essential. Here's what to say to a depressed boyfriend or girlfriend, as well as what not to say.

What Not to Say to a Depressed Boyfriend or Girlfriend

There is often no “right” thing to say to a depressed boyfriend or girlfriend, and every person is different. However, there are plenty of wrong things to say.

1. Don’t say: “Why are you depressed?”
   
   According to the American Psychiatric Association, depression is a serious medical condition that's different from sadness or grief. It can affect anyone – even someone who appears to live in ideal circumstances. The many complex factors that play a role in depression include biochemistry, genetics, personality, and environment, so depression does not occur for any one specific reason. Asking someone why they are depressed can make them feel frustrated and misunderstood – especially if you tell them they have "nothing to be depressed about."
   
   Say instead: “Do you think something has triggered these symptoms?”
   
   During times when your partner's depression is particularly bad, you may notice patterns emerging – they may experience more depression symptoms at certain times of the month or year, or during a stressful period at work, for example. Your partner may also have become depressed partly as a result of a traumatic event or something that happened in their past. While you should never assume there is a reason for depression (just as there is often no reason for cancer or heart disease), you can gently question your partner to see if they want to talk about any contributing factors you could help them deal with.
    
2. Don’t say: “But you were so happy yesterday/last week!”
   
   Some people experience "episodes" of depression and feel "normal" for the rest of the time. If there's a bipolar disorder component to your partner's illness, they may even feel elevated during times they are not depressed. This can be confusing and difficult to keep up with, but you should know that no one struggles more with the inconsistency than your partner.
   
   Say instead: “I’m sorry you’re going through a bad patch. Can I help?”
   
   All cases of depression are different, and no two people will experience the same symptoms at the same level of severity. You should never compare your partner’s depression to anyone else’s – or compare their current state to how they were feeling on a different day.
    
3. Don’t say: “Is it me?”
   
   Depression is an illness, and although a traumatic life event or situation can act as a trigger, it isn't always "about" something.
   
   Say instead: "I know this is an illness, and it isn't about me, but If I ever do or say anything that makes you feel worse, then please tell me."
   
   Blaming yourself for your partner’s depression takes the spotlight off them and puts it on you, which is not helpful to either of you. You are not solely responsible for anyone’s mental illness, even if they tell you otherwise ("My Girlfriend, Boyfriend Has Depression: Is It Me or Their Problem?").
    
4. Don’t say: “But you’re taking medication!”
   
   In many cases, depression is a condition that's managed with medication rather than cured. Your boyfriend or girlfriend may be taking antidepressant medication, but that doesn't mean they're going to feel better straight away. Antidepressants can take up to six weeks to have any effect, and they sometimes make depression symptoms worse before they get better. Even people who have been taking medication for a long time may still experience symptoms of depression or have "relapses."
   
   Say instead: “How does the medication make you feel? Should we book a trip to see your doctor?”
   
   When someone has depression, you should always ask questions rather than confront them with facts. Rather than stating, "You're taking medication," which could make your partner feel bad that they're not responding as well as they'd hoped, asking how they feel about how well their treatment is working opens the conversation up and allows them to have their say. By saying "we" rather than "you," you also identify your partner's depression as a shared problem rather than something they have to deal with on their own.

When You Don’t Know What to Say to a Depressed Partner

There will be times when you don't know what to say to your depressed boyfriend or girlfriend. There will also be occasions when you don't have the answers, and that's okay. It is not your job to "fix" anyone's depression. Your only responsibility is to be kind, show compassion and provide support – both for your partner and for yourself.

See also:

• How Do You Make a Depressed Person Feel Better?

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Finding a depression therapist is something that takes careful consideration and research. Not everybody is a good therapist for depression. Therefore, it is important to take the time needed to ensure that the therapist you choose has the experience and education necessary to properly treat you. It’s also important that the depression therapist be a good fit for you. This is critical for your depression treatment and recovery.

Seeing a therapist for depression is a powerful first step toward feeling better and recovering from the condition. Let’s take a look at the qualifications to consider when selecting a good depression therapist; one that best fits your mental health and financial needs.

Qualifications of a Good Depression Therapist

Make sure you do your homework when searching for a therapist to help with your depression. Knowing the professional characteristics of a good depression therapist is vital in choosing the right therapist for you. You want to make sure that you choose a therapist that has a strong professional background in treating depression. There are several things to consider, like level of education, type of licensure, and years of experience.

Professional Background of a Depression Therapist

A therapist who is able to treat depression will have achieved a Master’s level degree or higher in counseling psychology, social work, mental health counseling, psychiatry or clinical psychology. He or she will also hold an active professional license (not a supervised license or a limited permit) to practice counseling.

Professional licenses that permit a therapist to treat depression include:

• Licensed mental health counselor
• Licensed professional counselor
• Licensed professional clinical counselor
• Licensed clinical social worker
• Licensed psychologist
• Licensed psychiatrist

Along with holding the degree and license to practice, you must also consider the professional experience of the depression therapist. Keep in mind that a license and degree proves that the therapist has completed the requirements to obtain the credentials. It does not account for the quality of the therapist.

When considering the quality of the depression therapist, think about how long it takes to be good at something. For a therapist, that means years of seeing patients. A good depression therapist will have at least 5 years of clinical experience with either a group practice or in private practice.

How to Find an Affordable Depression Therapist Near Me

There are plenty of resources to help you find a depression therapist near you. Some people choose to discuss a referral with their primary doctor, while others search for a depression therapist online. You can also call your local psychological and counseling associations for a referral. Each of these options is safe to use so long as you do the follow up research. This may include verifying their credentials and years of experience, along with an interview to determine if the therapist may be a good fit for you. Many therapists do not charge for the interview.

The cost of a chosen depression therapist is a consideration to take into account. To get the quality of counseling you expect and deserve is not something that is cheap or free, and it is critical to be aware of and avoid scams that promise things like free depression counseling. Good quality counseling for depression can run in the range of $75-250/hour depending on the depression therapist’s credentials and years of experience, but it is worth spending the extra money when working toward ensuring a healthy mind.

When considering prices for a therapist, compare the prices of therapists in your area. Be careful of therapists who set their prices too low because there is a reason why they are low. If you see a therapist is offering a rate that is considerably lower than others in their area, there may be an issue with the quality of care this person is able or willing to provide. Such situations can become unsafe, as you may be given poor therapeutic services.

If you are concerned with the expense that comes with seeing a therapist for depression, consider contacting your insurance company. As mental health awareness grows, so does coverage for mental health conditions like depression. Currently, most insurance companies are required to provide mental health coverage, so connect with your insurance company to find out what kind of financial coverage is available to you for getting the help you need to feel better.

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At first glance, one would think that weight gain in general is the biggest risk for metabolic syndrome in the psychiatric community and thus diabetes. But research shows that it's a specific type of weight gain that poses the most risk. For example, there are many psychiatric drugs such as the Tegretol and Depakote used for bipolar mania that can cause significant weight gain, and yet the risk for diabetes is the same as that of anyone overweight.

Dr. William Wilson, M.D. Professor of Psychiatry and Director, Inpatient Psychiatric Services Oregon Health and Science University, tells HealthyPlace.com that there has been no direct connection between psychiatric drugs and metabolic syndrome except for second-generation antipsychotics (atypical antipsychotics). Interestingly, atypical antipsychotic drugs with moderate weight gain, such as Risperdal, do not have a well-documented connection with metabolic syndrome. In other words, the drugs that raise glucose levels as well as cause weight gain seem to be the culprit.

It's All About Stomach Fat

"Increased abdominal fat is strongly associated with insulin resistance which can lead to impaired glucose regulation. Insulin sensitivity has been shown to decrease as the amount of belly fat increases."
- Dr. John Newcomer, Professor of Psychiatry, Washington University

A fat stomach from metabolic syndrome is different from other fat stomachs. It rolls, jiggles, comes on fast and is difficult to lose. It doesn't respond to sit-ups and often doesn't even respond to diet changes. It's easy to pick up the stomach and hold it in your hands. It's a loose spare tire that's uncomfortable and often shocking.

You may think, "Where did all of that fat come from and why isn't it more evenly distributed throughout my body?" The answer is that this particular type of belly fat is not typical fat. Dr. Andrew Ahmann, Director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University tells HealthyPlace.com, "This fat is metabolically active. When you gain weight fast from an antipsychotic, it goes into the central compartment. We are not sure why. The fat on women who have fat in hips and thighs may have a lower incidence of diabetes."

Weight gain problems with atypical antipsychotics still are not well understood. Ongoing studies that look into why drugs such as Zyprexa cause significant weight gain, while ones such as Abilify can actually help a person lose weight, will give more information on how patients can still take the high-risk drugs and hopefully mitigate the metabolic risk side-effects.

Considering that the atypical antipsychotic drugs are less than 20 years old, research is only beginning. It's not that the healthcare profession doesn't know about metabolic syndrome- they all do, as it's a part of a general medical education. The problem is that so few know the connection between the high-risk antipsychotics and metabolic syndrome. Instead of your doctor telling you about it, it may be that you're the one to first bring up the topic!

Learn how to prevent type 2 diabetes through weight loss, regular exercise, and lowering your intake of fat and calories.

If you want to lower your risk of getting type 2 diabetes, you'll have to make some changes. Making big changes in your life is hard, especially if you are faced with more than one change. You can make it easier by taking these steps:

• Take seriously a diagnosis of prediabetes. 
• Make a plan to change behavior.
• Decide exactly what you will do and when you will do it.
• Plan what you need to get ready.
• Think about what might prevent you from reaching your goals.
• Find family and friends who will support and encourage you.
• Decide how you will reward yourself when you do what you have planned.

Your doctor, a dietitian, or a counselor can help you make a plan. Consider making changes to lower your risk of diabetes.

Reach and Maintain a Reasonable Body Weight

Your weight affects your health in many ways. Being overweight can keep your body from making and using insulin properly. (Learn more about insulin and how it affects diabetes in "What is the Difference Between Type 1 and Type 2 Diabetes?")

Excess body weight can also cause high blood pressure.

Body mass index (BMI) is a measure of body weight relative to height. You can use BMI to see whether you are underweight, normal weight, overweight, or obese. Use the Body Mass Index Table (pdf)* to find your BMI.

• Find your height in the left-hand column.
• Move across in the same row to the number closest to your weight.
• The number at the top of that column is your BMI. Check the word above your BMI to see whether you are normal weight, overweight, or obese.

If you are overweight or obese, choose sensible ways to get in shape.

• Avoid crash diets. Instead, eat less of the foods you usually have. Limit the amount of fat you eat.
• Increase your physical activity. Aim for at least 30 minutes of exercise most days of the week.
• Set a reasonable weight-loss goal, such as losing 1 pound a week. Aim for a long-term goal of losing 5 to 7 percent of your total body weight.

Make Wise Food Choices Most of the Time

• What you eat has a big impact on your health. By making wise food choices, you can help control your body weight, blood pressure, and cholesterol.
• Take a look at the serving sizes of the foods you eat. Reduce serving sizes of main courses such as meat, desserts, and foods high in fat. Increase the amount of fruits and vegetables.
• Limit your fat intake to about 25 percent of your total calories. For example, if your food choices add up to about 2,000 calories a day, try to eat no more than 56 grams of fat. Your doctor or a dietitian can help you figure out how much fat to have. You can also check food labels for fat content.
• Limit your sodium intake to less than 2,300 mg—about 1 teaspoon of salt—each day.
• Talk with your doctor about whether you may drink alcoholic beverages. If you choose to drink alcoholic beverages, limit your intake to one drink—for women—or two drinks—for men—per day.
• You may also wish to reduce the number of calories you have each day. People in the DPP lifestyle change group lowered their daily calorie total by an average of about 450 calories. Your doctor or dietitian can help you with a meal plan that emphasizes weight loss.
• Keep a food and exercise log. Write down what you eat, how much you exercise—anything that helps keep you on track.
• When you meet your goal, reward yourself with a nonfood item or activity, like watching a movie.

Click here to see the Body Mass Index Table (pdf)*.

* pdf versions require the free Adobe® Acrobat Reader software for viewing.

Daily Physical Activity Can Reduce Risk of Type 2 Diabetes

Regular exercise tackles several diabetes risk factors at once. It helps you lose weight, keeps your cholesterol and blood pressure under control, and helps your body use insulin. People in the Diabetes Prevention Program (DPP), a large clinical trial, who were physically active for 30 minutes a day, 5 days a week, reduced their risk of type 2 diabetes. Many chose brisk walking for exercise.

If you are not very active, you should start slowly. Talk to your doctor first about what kinds of exercise would be safe for you. Make a plan to increase your activity level toward the goal of being active at least 30 minutes a day most days of the week.

Choose activities you enjoy. Some ways to work extra activity into your daily routine include the following:

• Take the stairs rather than an elevator or escalator.
• Park at the far end of the parking lot and walk.
• Get off the bus a few stops early and walk the rest of the way.
• Walk or bicycle whenever you can.

Take Cholesterol and Blood Pressure Medications to Prevent Type 2 Diabetes

Some people need medication to help control their blood pressure or cholesterol levels. If you do, take your medicines as directed. Ask your doctor about medicines to prevent type 2 diabetes.

Hope through Research

We now know that many people can prevent type 2 diabetes through weight loss, regular exercise, and lowering their intake of fat and calories. Researchers are intensively studying the genetic and environmental factors that underlie the susceptibility to obesity, prediabetes, and diabetes. As they learn more about the molecular events that lead to diabetes, they will develop ways to prevent and cure the different stages of this disease. DPP researchers continue to monitor DPP participants to learn more about the study's long-term effects through the Diabetes Prevention Program Outcomes Study.

People with diabetes and those at risk for it now have easier access to clinical trials that test promising new approaches to treatment and prevention. Participants in clinical trials can play a more active role in their own health care, gain access to new research treatments before they are widely available, and help others by contributing to medical research. For information about current studies, visit www.ClinicalTrials.gov.

Sources: National Diabetes Information Clearinghouse, NIH Publication No 09-4805, November 2008

For More Information

National Diabetes Education Program
Phone: 1-888-693-NDEP (6337)
Internet: www.ndep.nih.gov

American Diabetes Association
Phone: 1-800-DIABETES (342-2383)
Internet: www.diabetes.org

National Diabetes Information Clearinghouse
Phone: 1-800-860-8747
Internet: www.diabetes.niddk.nih.gov

Source: NDIC

Information on who is at risk of developing type 1 and type 2 diabetes. Risk factors that make certain populations susceptible to diabetes.

Diabetes is not contagious. People cannot "catch" it from each other. However, certain factors can increase the risk of developing diabetes.

Type 1 diabetes occurs equally among males and females but is more common in whites than in nonwhites. Data from the World Health Organization's Multinational Project for Childhood Diabetes indicate that type 1 diabetes is rare in most African, American Indian, and Asian populations. However, some northern European countries, including Finland and Sweden, have high rates of type 1 diabetes. The reasons for these differences are unknown. Type 1 diabetes develops most often in children but can occur at any age.

Type 2 diabetes is more common in older people, especially in people who are overweight, and occurs more often in African Americans, American Indians, some Asian Americans, Native Hawaiians and other Pacific Islander Americans, and Hispanics/Latinos. National survey data in 2007 indicate a range in the prevalence of diagnosed and undiagnosed diabetes in various populations ages 20 years or older:

• Age 20 years or older: 23.5 million, or 10.7 percent, of all people in this age group have diabetes.
• Age 60 years or older: 12.2 million, or 23.1 percent, of all people in this age group have diabetes.
• Men: 12.0 million, or 11.2 percent, of all men ages 20 years or older have diabetes.
• Women: 11.5 million, or 10.2 percent, of all women ages 20 years or older have diabetes.
• Non-Hispanic whites: 14.9 million, or 9.8 percent, of all non-Hispanic whites ages 20 years or older have diabetes.
• Non-Hispanic blacks: 3.7 million, or 14.7 percent, of all non-Hispanic blacks ages 20 years or older have diabetes.

Diabetes prevalence in the United States is likely to increase for several reasons. First, a large segment of the population is aging. Also, Hispanics/Latinos and other minority groups at increased risk make up the fastest-growing segment of the U.S. population. Finally, Americans are increasingly overweight and sedentary. According to recent estimates from the CDC, diabetes will affect one in three people born in 2000 in the United States. The CDC also projects that the prevalence of diagnosed diabetes in the United States will increase 165 percent by 2050.

We know who gets diabetes, but we also know some diabetes causes and ways to prevent type 2 diabetes.

Source: NDIC

Trusted information on type 1 and type 2 diabetes. Diabetes symptoms, causes, treatments. Plus diabetes and depression and other mental health issues.

Contents in the Diabetes Community

Diabetes Information
Types of Diabetes
Diabetes Signs and Symptoms
Diabetes Causes
Diabetes Risk Factors and Prevention
Diabetes Treatment and Medication
Diabetes Complications
Diabetes and the Mental Health Connection
Antipsychotic Medication and Diabetes, Metabolic Syndrome
Diabetes Videos

Diabetes Information

• What is Diabetes?
• Some Sobering Facts about Diabetes
• How to Diagnose Diabetes: Criteria, Tests for Diabetes Diagnosis
• What is Uncontrolled Diabetes?

Types of Diabetes

• What are the Types of Diabetes?
• What is Prediabetes? Definition and Symptoms
• What is Type 1 Diabetes? Definition, Symptoms, Causes
• What is Type 2 Diabetes? Symptoms, Causes, Treatment
• What is the Difference Between Type 1 and Type 2 Diabetes?
• What is Gestational Diabetes? Symptoms, Causes, Treatment

Diabetes Signs and Symptoms

• Do I have Diabetes? Here’s How to Tell
• What are Type 1 Diabetes Symptoms and Signs?
• What are Type 2 Diabetes Symptoms?
• Diabetes Symptoms & Signs in Adults, Men, Women and Children
• What are the Symptoms of Diabetes in a Child?

Diabetes Causes

• What Causes Diabetes?
• Do Antipsychotic Medications Cause Diabetes?
• Do Antidepressants Cause Type 2 Diabetes?

Diabetes Risk Factors and Prevention

• What are the Diabetes Risk Factors?
• Who Gets Diabetes?
• Can You Prevent Diabetes and Metabolic Syndrome?
• How to Reduce Your Risk of Getting Diabetes
• Four Ways to Prevent Diabetes When You Live with a Mental Illness
• How to Delay or Avoid Developing Type 2 Diabetes

Diabetes Treatment and Medication

• What are Diabetes Treatment Guidelines?
• How Do You Treat Diabetes? Medications, Diet, Stem Cells
• Complete List of Diabetes Medications for Type 1 and Type 2
• Side-effects of Diabetes Medications
• Questions to Ask about Your Diabetes Medicines
• How to Control Your Diabetes
• Controlling Your Diabetes: Tips for Feeling Better and Staying Healthy (pdf)
• About Low Blood Glucose
• Eating and Diabetes: A Diet for Diabetes
• Diabetes and Exercise
• Financial Help for Diabetes Treatment
• Alternative Devices for Taking Insulin
• Prediabetes and Insulin Resistance
• What is a Diabetes Support Group? Where Can I Find One?

Checking Blood Glucose Levels

• Continuous Glucose Monitoring
• Check Your Hemoglobin A1C: Know Your Blood Sugar Numbers (pdf)

Diabetes Complications

• Diabetes Complications
• Diabetes and Heart Disease, Stroke
• Diabetic Neuropathies: The Nerve Damage of Diabetes
• What Is Diabetic Nerve Pain? – Symptoms, Causes, Treatments
• What Treatment for Diabetic Nerve Pain Is Available?
• Anxiety and Diabetic Neuropathy: What Helps?
• Diabetic Nerve Pain and Depression
• Diabetes and Eye Problems
• Vision Loss from Diabetes and Dealing with Related Anxiety
• Diabetes Erectile Dysfunction in Men with Diabetes
• Is It Erectile Dysfunction from Diabetes or Performance Anxiety?
• How to Reverse Erectile Dysfunction from Diabetes
• What is Diabetes Hypoglycemia (Low Blood Glucose?
• Diabetes and Kidney Disease
• Diabetes Sex and Urological Problems
• Diabetes and Gastroparesis
• Diabetic Necrosis: Definition, Symptoms, and Anxiety It Causes
• Feet Can Last a Lifetime kit (pdf, 387 KB)
• Diabetes and Dementia: Can Diabetes Lead to Alzheimer’s Disease?

Referrals to Diabetes Health Professionals

• American Diabetes Association
• American Dietetic Association
• National Library of Medicine

Diabetes and the Mental Health Connection

• Diabetes and Mental Health: How One Affects the Other
• Relationship Between Diabetes and Mental Health
• Diabetes and the Mental Health Connection
• What’s the Link Between Diabetes and Mental Illness?
• Uncontrolled Diabetes and Mental Health Complications
• Diabetes of the Brain: How Diabetes Affects the Brain
• How Diabetes Causes Brain Fog and Memory Loss: Can Anything Help?
• Diabetes and Psychosis: Can Diabetes Cause Psychosis?
• The Strong Link Between Schizophrenia and Diabetes
• Schizophrenia Makes Diabetes Management Challenging
• How Does Diabetes Affect Bipolar Disorder?
• Diabetes and Depression: The Chicken and the Egg
• Diabetes and Depression: Two Difficult Conditions to Manage
• What are the Effects of Diabetes on Mood Disorders?
• Diabetes and Anxiety: There’s Plenty to Be Anxious About
• Are There Connections Between Eating Disorders and Diabetes?
• Alcoholism and Type 2 Diabetes: Does Alcoholism Cause Diabetes?
• Diabetes and ADHD: The Correlation is High
• Challenges of Treating Diabetes When You Have ADHD
• ADHD and Diabetes Can Look Similar
• Challenges in Managing Diabetes When Living with OCD
• Diabetes and OCD: Obsessing Over Your Blood Sugar Levels
• Does Diabetes Cause Mood Swings?
• Diabetes and Irrational Behavior, Mental Confusion
• Diabetic Rage: Can Diabetes Cause Aggressive Behavior?
• Is There a Diabetic Personality Disorder?

Antipsychotic Medication and Diabetes, Metabolic Syndrome

• Metabolic Syndrome: Those with Schizophrenia and Bipolar Disorder at Highest Risk
• Antipsychotic Drugs, Metabolic Syndrome and Diabetes
• Atypical Antipsychotics, Stomach Fat and Metabolic Syndrome
• Solutions to Resolve Antipsychotics Leading to Diabetes
• Which Atypical Antipsychotics Carry the Highest Risk for Diabetes?
• Are There Any Safe Antipsychotics in Diabetes Treatment?

Videos on Diabetes

• Videos on Diabetes

Learn four ways a person with a psychiatric disorder can make small changes that can help prevent diabetes.

They say "prevention is the best cure." With that in mind, here are some ways to prevent diabetes.

1. Get Tested for Metabolic Syndrome

There is a standard set of tests healthcare professionals use to measure a person's risk of metabolic syndrome. They include:

• baseline weight
• body mass index rating
• stomach measurement
• glucose test
• blood pressure test

The glucose level test is, of course, the most important test for diabetes. Most who have insurance and are able to get a yearly physical have easy access to these tests. They are not overly expensive and only require a one-time doctor visit for the measurements and a blood draw. In a perfect world, all people with a diagnosed disorder and especially those on the high-risk antipsychotics are tested upon diagnosis and are monitored every six months for changes.

Of course, we are not in a perfect world. The reality is that there are many people without access to adequate mental health care which translates to a lack of physical health care as well. Dr. William Wilson, M.D., Professor of Psychiatry and Director, Inpatient Psychiatric Services Oregon Health and Science University, puts it this way, "The main problem with our system is that there is a lack of care all around when it comes to mental illness. People often need help regarding the labs for metabolic syndrome, but it's hard when they have to see a psychiatrist and a GP to get the care they need. Patients in the hospital get all of the panels from blood tests to weight and cholesterol levels. The problem is when they get out of the hospital. Monitoring is hard, especially if there is no insurance."

So what is the solution? It all comes down to finding someone with the time and for some, finding someone they can actually afford. Dr. Wilson answers, "I believe that this is actually a political question. It's not that health care professionals don't have information about metabolic syndrome and the risk of diabetes. They know what tests are needed and how often people need to be monitored. The delivery system is the problem. People simply don't have access to care."

If you, or the person you care about, don't have easy access to the diabetes tests, are there free clinics in your town that offer metabolic panels? Can you find a pharmacy that offers a one-time blood sugar test? Can you pay out of pocket for these tests? If you only can pay for one test, it's a good idea to try the A1C. It measures your glucose level over a period of two to three months. You may have to get creative, but the tests are essential to your health.

2. Change Your Diet 10%

It's well documented that any amount of weight loss is a positive. In fact, just losing 10% of your body weight can make a big difference in your diabetes risk, especially if you can lose weight around the stomach. Dr. Andrew Ahmann, Director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University, notes, "There is such an emphasis on weight loss for cosmetic reasons. So people have these unreachable goals that they think have to happen in order for them to get healthier. But reducing weight by even 5% can make a significant difference in diabetes risk."

Trying to completely change your diet to prevent diabetes is overwhelming, but just changing 10% of your diet can help you lose a small amount of weight that can make a big difference. Then you can lose more from there.

The biggest goal is to lose fat around the stomach. This can be difficult if the weight gain is due to an antipsychotic, but it never hurts to do all you can until you can find a medication with less weight gain. Here are some small but powerful changes you can make immediately:

• Gradually change from soda pop and juice to soda water. Pop is a true empty calorie product. All pop causes weight gain simply because the body doesn't know what to do with the empty calorie except slap it onto the body as fat. Juice has more nutrition but is often very high calorie for just a small amount. Soda water may not be as appealing at first, but you can get used to it.

• Eat one low-fat meal a day. A low-fat diet is one of the best ways to manage and prevent diabetes. Just make one change a day. A salad at the restaurant with a low-fat dressing. No cheese on the hamburger. Half the fat ice cream. Milk instead of cream. It's a start.

• Eat half of whatever you're having. If it means sharing meals when you eat out, asking for small portions in restaurants or cooking a lot less at home, do what you can. There is no need to 'cook for the week' if this causes you to eat a lot more.

• Have zero junk food in the house. Zero! Unless you're willing to get in your car at 2 AM for a cookie run, having zero junk food in the house is an excellent way to end night binging. You may eat a bag of carrots instead, but that is better than a bag of cookies.

• Read the book Eat This Not That to learn how to count calories in commonly eaten foods. When you find out the calorie count of a scone for example, (500-700 calories) you will never look at food the same.

• Look at labels and avoid all products made with high fructose corn syrup. The less sugar you eat the better- which makes sense if you're trying to manage or prevent diabetes, but if you find this difficult, at least eat natural sugar.

These are a few basic suggestions that can help you eat a healthier diet. (Of course, if you have diabetes, you already have your dietary guidelines.) There is no question that diets, such as those recommended by the American Diabetes Association are the best choice, but if you're having psychiatric symptoms, you do what you can. Cleaning vegetables, chopping them, cooking them, eating and then cleaning up can be extraordinarily difficult when you're not doing well, but moving towards this is always a good goal.

Dr. Ahmann tells HealthyPlace.com, "There is no time in a typical medical visit to make significant or productive dietary and exercise plans. You can go rah-rah and try to go over the issues. So while we tell patients they have to have a healthy diet, you have to keep it limited and set targets and goals for each visit. For a lot of people, it may be just one goal- park your car at one end of every parking lot, try to make a note on the fridge that says eat this many vegetables a day. I try to find other types of support for my patients who do have time to deal with their diet, but it can be hard."

No matter what situation you're in, if you keep one goal in mind- to reduce belly fat- you have a good chance of reducing your risk of diabetes significantly. And all research shows that lowering your weight is the #1 way to manage your health. So keep trying and do all you can and remember, just a 10% change can make all of the difference and believe it or not, can reduce your risk of diabetes by as much as 60%!

3. Exercise More that You're Exercising Now

Joe, the man who spoke of depression and type 1 diabetes tried to find the right exercise for many years. Here is how he describes his quest:

"I eat right and do all that I should to manage diabetes. I exercise as much as I can. I play tennis and do other sports, but I've found that weight training 45 minutes a day is the only exercise that really helps. It has to be weight training and it has to be that amount of time. It's always a challenge to find the time- but it's the only way I've found to keep my blood sugar balanced."

The type and impact of exercise is an individual matter and what works for one person certainly may not work for another. What exercise do you like to do? Have you thought of belly dancing, flag Frisbee, or simply walking with a friend in a beautiful location? Are you a group person or a solitary exerciser? If you have a lot of depression, what do you need to do in order to exercise more than you do now? If you care about someone with schizophrenia who never exercises, is there something you can do together that doesn't seem like exercise? Remember, any amount of exercise helps.

4. Work with a Healthcare Professional to Find the Right Medications with the Lowest Diabetes Risk

This is the most important step if you have gained weight due to a high-risk antipsychotic. Of course, this has to be done with a licensed doctor, preferably a psychiatrist (a specialist in psychiatric medications), and it will take time to find the best medication. It all depends on the level of your symptoms and of course, your access to healthcare. Metformin, the most popular anti-diabetic drug (for type 2 diabetes) in the United States, may be a great help as well. The antipsychotic dilemma is obviously the biggest detriment to healthy insulin production. If you are able to tolerate Abilify or Geodon, it's worth discussing a change with your healthcare professional.

Of the four above, what can you do first? You can just choose one and see great improvement.

The Diabetes Prevention Program (a multicenter clinical study that included the National Institute of Diabetes and Digestive and Kidney Diseases) concluded that people can reduce their risk of diabetes by over 50% with very simple diet and exercise changes. These changes can also normalize blood sugar and lower other health risks associated with metabolic syndrome. The study also showed that Metformin reduced the risk of diabetes by over 25%. This is good news for anyone with a psychiatric disorder.