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If you have diabetes or know someone who manages the condition, you will understand the mental and emotional challenges often associated with striving to live well with diabetes.
From the initial diagnosis, through adopting a management strategy, and adjusting to life with diabetes, it’s important to look after all aspects of your wellbeing.
Diabetes is one of the fastest growing chronic conditions in Australia, affecting more than 1.7 million Australians. Depression and anxiety disorders are common in people with diabetes but also affect family and friends who care for them.
While one-in-five Australians is affected by mental health problems at some time in their life, people with diabetes can be especially vulnerable to mental health conditions such as depression or anxiety.
Research suggests that diabetes doubles the risk of depression compared to those without diabetes. The chance of developing depression also increases if diabetes complications worsen.
National Diabetes Week is marked from July 12 to July 18 this year and aims to highlight and educate about the mental and emotional impacts of living with diabetes.
Mental and Emotional Challenges of Living with Diabetes
According to Sane Australia research, people living with diabetes often describe feeling frustrated and overwhelmed or have intense feelings of anger, fear and guilt.
Managing the condition, such as being careful with foods, checking blood glucose levels and taking insulin, can be difficult to get right and staying motivated to effectively manage changes can be emotionally demanding.
As such, the constant worry and pressure of living with diabetes can lead to mental health problems such as diabetes distress, depression, anxiety and eating disorders.
However, support and treatments that involve a coordinated approach in dealing with both the mental health and diabetes concerns are available and can help you become and stay well despite the challenges.
Types of Diabetes
There are four main types of diabetes.
Type 1 diabetes is an autoimmune disease which destroys the insulin producing cells in the pancreas leading to a build-up of glucose in the blood stream. It cannot be prevented or managed by lifestyle factors and regular insulin injections are required to keep blood glucose at normal levels.
Type 2 diabetes is a metabolic disorder relating to how food is taken and stored in the body. Blood glucose levels are higher than normal, and the body doesn’t produce enough insulin or can’t use the insulin it does produce effectively. Type 2 diabetes can be managed with regular exercise, healthy eating and weight loss. Tablets or insulin injections may also be required.
Gestational diabetes is a temporary insulin resistance and intolerance to carbohydrates, which usually returns to normal after birth. However, some women with gestational diabetes will develop type 2 diabetes after giving birth.
Pre-diabetes is when blood glucose levels are higher than normal, but not high enough to be diagnosed as diabetes. Pre-diabetes can be managed through making healthy lifestyle changes to reduce the risk of developing type 2 diabetes and heart disease.
Diabetes and Mental Health Challenges
Living with diabetes can sometimes give rise to mental health challenges such as diabetes distress, anxiety, depression or eating disorders.
Diabetes Distress
Diabetes distress describes the emotional toll of living with and managing diabetes. People may feel overwhelmed and concerned they are failing with managing their condition. They may be worried about long term complications or frustrated that they don’t have any control.
Diabetes distress becomes a problem when those emotions affect daily life, impacting work, school, relationships and ongoing diabetes management.
Diabetes and Anxiety
Anxiety is one of the most common mental health issues which may affect Australians. Among those with diabetes, some have anxiety before a diagnosis, while for others, specific fears associated with managing diabetes may trigger anxiety.
Anxiety becomes a problem, or mental health concern, when these feelings last for more than two weeks and negatively affect daily life. Symptoms of anxiety may include feeling nervous, unable to stop worrying, having trouble relaxing and becoming easily annoyed or irritable.
Serious anxiety can also result in physical conditions such as a tightness in the chest, headaches, increased heartbeat and an upset stomach.
Diabetes and Depression
Depression is common among people with diabetes. Depression is a medical condition in which people experience a significantly low mood for a long time. While everyone feels down from time to time, people with depression experience a persistent feeling of sadness, without reason, that cannot be shaken and that affects their capacity to get on with their daily lives.
Some people with diabetes have depression before a diagnosis of diabetes, while for others, depression is diagnosed later. Depression can also increase the likelihood of developing diabetes complications through struggling with tasks such as regular blood glucose testing, taking medication, following a healthy eating plan and regular physical activity.
Diabetes and Eating Disorders
As part of living with diabetes there is often an increased focus on food intake, weight and body image. This can sometimes lead to behaviours such as severely restricting food intake, binge eating and vomiting or other unhealthy weight loss tactics.
Research has shown that some people with diabetes struggle with maintaining healthy eating, develop fixations about food and misuse insulin for weight management.
Negative emotions such as feeling unhappy with your body and ashamed or guilty around food can also contribute to poor habits such as skipping meals or mismanaging insulin to lose wight.
Eating disorders are a serious medical and mental health issue for everyone but are especially dangerous for those living with diabetes.
Know When to Get Help
It is important to look after both your physical and mental health. However, sometimes with diabetes it can be difficult to know whether it is a physical or mental issue affecting your wellbeing.
Some of the physical symptoms of depression and anxiety – such as feeling tired or having poor sleep – may be similar to those caused by diabetes. High blood sugars may also produce some symptoms of depression, including fatigue and changes in sleep, weight and appetite.
People with depression or anxiety may not realise that how they feel could be caused by a physical condition such as diabetes. On the other hand, people with diabetes may not realise that how they feel could be caused by a mental health problem.
If you’re worried, feeling unwell or concerned about changes in your mental or physical wellbeing, talk to your GP. Once diagnosed, there are a range of support and treatment options available.
Treatments for diabetes and mental health related issues will usually involve a coordinated approach involving some or all of the following:
- GP
- endocrinologist
- diabetes educator
- nurse practitioner
- dietitian
- counsellor or psychologist
In general, the most effective treatments will combine medical and psychological care, depending on your situation.
What You Can Do to Manage Wellbeing with Diabetes
The first step in taking control and managing your health is to talk to your doctor or a qualified health professional.
There are also steps you can take every day to improve your overall sense of wellbeing when living with diabetes:
- Stay connected – keep in touch with family and friends and get involved in social activities
- Engage in regular physical activity – taking a dog for a walk, chatting to other dog owners can be a great way to exercise and socialise
- Learn about diabetes and mental health – understand the how and why to better manage diabetes
- Eat healthily and include a wide variety of nutritious foods in your diet
- Aim to achieve and maintain a healthy weight
- Limit alcohol intake
- Get help, support and encouragement from family and friends
- Visit your doctor or health professional regularly and maintain your diabetes management plan
For more information about living with diabetes and mental health access Diabetes Australia resources. If you need help with anxiety, depression or other mental health issues, contact Psychological Health Care.
Our clinical psychologists can help determine your diagnosis and find strategies and a treatment program to benefit you. Book an appointment today.