Depressão em pessoas diabéticas: desvelando o inimigo oculto

A depressao ocorre em portadores de DM, sendo frequentemente velada e confundida por profissionais de saude e pelos proprios pacientes com sensacoes de angustia, tristeza e melancolia. Estudos mostram que a depressao pode dificultar o enfrentamento da doenca. Este estudo teve como objetivo compreender como o portador de diabetes mellitus identifica e vivencia a depressao; descrever sinais e sintomas relacionando-a a vida cotidiana; e identificar os recursos de enfrentamento utilizados. Participaram diabeticos tipo 2 insulino-dependentes, acima de 50 anos acompanhados no programa do servico de Medicina preventiva da UNIMED GV (Cooperativa de Trabalho Medico de Governador Valadares). O referencial teorico metodologico utilizado foi a historia oral tematica proposta por Meihy. Dados provenientes de 13 entrevistas foram analisados, os conceitos que emergiram favoreceram a identificacao de tres temas centrais: condicoes de vida da pessoa diabetica influenciando na depressao, identificacao da depressao e o significado da depressao para o diabetico. Os sinais e sintomas de depressao indicados pelos diabeticos foram falta de apetite, medo das complicacoes e outras. Os colaboradores identificaram a depressao com mudancas percebidas no comportamento, melancolia, angustia, choro sem motivo aparente, perda de interesse, dificuldade de concentracao, insonia e pensamento de morte. A depressao descrita esteve relacionada a sentimentos de isolamento, problemas financeiros e conjugais. O enfermeiro precisa ser capacitado para perceber e intervir precocemente na depressao, elaborar plano de cuidados efetivos e adesao ao tratamento do diabetes e da depressao a partir de programas educativos e no emprego das mais variadas alternativas terapeuticas.(AU) Depression occurs in Diabetes Mellitus (DM) patients, being often cared for and mistaken by health workers and by patients themselves, as sensations of annoyance, sadness and melancholia. Studies show that depression can be a major difficulty in the coping process of the disease. The aims of this study were to understand how the DM-type 2 patient identifies and experiences depression, describing signs and symptoms present in their daily routine and identify the coping strategies used. The study sample was composed of diabetic type 2 insulin-dependent patients, over fifty years old that attended to the program Preventive Medicine Service – Unimed G.V. (Medical work Co-Operative of Governador Valadares). The methodological and theoretical reference used was the oral thematic history proposed by Meihy. Data from thirteen interviews were analized and the concepts emerged enabled the identification of three central themes: life conditions of a diabetic person that influence depression, identification of depression and the meaning of depression for a diabetic patient. Signals and symptoms of depression indicated by diabetics were: lack of appetite, irritability, fear of complications and others. The participants recognized depression through changes perceived in the behavior, melancholia, anxiety, crying for no apparent reason, loss of interest, difficulty to concentrate, insomnia and thoughts about death. Depression as described was related to feelings of loneliness, financial and marital problems. The nurse must be trained to perceive and interfere early in depression, develop an effective plan of care and of adherence to treatment, using educational programs and utilizing the various therapeutic alternatives.(AU)