Everyone gets sad sometimes. Sadness is normal after a loss. This may be a friend's death or learning you have diabetes.

But sometimes sadness means you have an illness called depression. In depression, feeling blue lasts a long time. It may make it hard to work or enjoy your life.

Depression can strike anyone. But people with diabetes are twice as likely as other people to become depressed.

You may be depressed if you have at least five of these symptoms for at least 2 weeks:

  • Long-lasting feeling of sadness or emptiness

  • Loss of interest and pleasure in sex or other fun activities

  • Sleeping too much or too little

  • Changes in weight or appetite

  • Tiredness or low energy

  • Feeling guilty, worthless, or helpless

  • Being restless or irritable

  • Problems making decisions, remembering, or paying attention

  • Thoughts of suicide or death

Depression varies from person to person. Some people have many severe symptoms. Others have fewer or milder symptoms.

Treatment helps most depressed people. But many people suffer needlessly because they do not seek help.

If you think you are depressed, talk to your doctor or nurse. Some illnesses cause symptoms similar to depression. Or a drug you take may be the cause. If you really are depressed, your primary care provider or diabetes specialist can treat your depression or refer you to a mental health professional.

Many kinds of professionals treat depression.

These include primary care providers, diabetes specialists, psychiatrists,psychologists, clinical social workers, mental health counselors, and nurse psychotherapists. Your provider or therapist should work closely with your diabetes team.

How can you find a therapist? Ask:

  • your health care team

  • your local Mental Health Association

  • your school counselor

  • your minister, rabbi, or imam

Review your health insurance before starting treatment. Some policies provide little or no coverage for mental illnesses. Some limit which therapists you can see. Some restrict how many visits you can have. But help is almost always available. If your insurance plan lacks mental health coverage, check whether your community provides mental health services.

Two common treatments are psychotherapy (talking therapy) and drugs.

There are many kinds of talking therapy. In one kind, you work to change harmful thinking patterns and actions. In another, you learn to interact better with other people and work to improve relationships.

In depression, brain chemicals get out of balance. Certain drugs help restore balance. Before starting a drug for depression, ask about its risks,side effects, and interactions with other drugs you take. Sticking with drug therapy is vital. Weeks may pass before you start to feel better. Your provider may need to try more than one drug to find the best choice for you.

Drug therapy and talking therapy together often work better than either alone.

Some people find it helpful to join a patient support group.

If you need help for depression right away, call the National Hopeline Network's 24-hour crisis center at 800-784-2433.

To find your local Mental Health Association, look in the Yellow Pages. Or call 800-969-NMHA or visit the website ww.nmha.org/affiliates/directory/index.cfm.

To find a support group, visit the website of the Depression and Bipolar Support Alliance: www.dbsalliance.org/info/findsupport.html.

For more information on depression, see the National Institute of Mental Health's website: www.nimh.nih.gov/healthinformation/depressionmenu.cfm.