How does depression relate to diabetes?

Sad feelings, researchers suspect, can make you want to do some pretty unhealthy things—like pig out before bed, sack out on the couch all day or maybe even smoke or drink. And those are all things that could put you on the road to diabetes. But bad habits are only part of the picture, experts note. Even in the absence of bad habits, depressed people are still more likely to develop diabetes.

Dr. Reza Yavari, MD

Low blood sugar can trigger reactions in the body similar to fear and anxiety, and the stress of managing diabetes can also cause depressive symptoms. Watch endocrinologist Reza Yavari, MD, discuss how blood sugar is linked to anxiety and depression.

Across the globe, researchers continue to research and debate the complex relationship between diabetes and depression. Recent research has confirmed the bi-directional nature of this co-morbid disorder. For persons with diabetes (type 1 or type 2), the prevalence of depression is increased significantly, compared to those without diabetes; those with diabetes are at least twice as likely to be depressed as those without diabetes. And, oppositely, depression appears to significantly increase the likelihood of developing type 2 diabetes.

Untreated depression will make it less likely that you will be able to care for yourself and properly manage your diabetes. This poor self-care—which includes non-adherence to diet, less exercise, smoking, and not taking medications as directed—results in poor overall health and complications.

Various treatments—medication and therapy—can be successful in managing depression symptoms if you have diabetes. Treatment should be delivered collaboratively between diabetes and mental health service providers, or by primary healthcare providers trained to treat both diabetes and depression. Education and self-empowerment are also critical; empowerment can improve outcomes, including control over diabetes and the quality of life.

Every­body—regardless of whether they have diabetes—goes through periods of feeling down, when they have low energy and don’t care to be involved in things going on around them. Depression is serious when these feelings go on for long periods or when they interfere with your quality of life or your ability to care for your diabetes.

Just like denial, depression can get you into a vicious cycle. It can block good diabetes self-care. If you are depressed and have no energy, chances are you will find such tasks as regular blood sugar testing too much. If you feel so anxious that you can't think straight, it will be hard to keep up with a good diet. You may not feel like eating at all. Of course, this will affect your blood sugar levels.

If you suspect that you may be experiencing depression, seek help right away. Talk to your health care provider or ask to be referred to a mental health specialist.

William Lee Dubois

It's almost normal for diabetics to be depressed, and the reasons spring both from our bodies and our minds. Let’s start with the body. Diabetes can interfere with serotonin levels in the brain, which in turn triggers depression. So diabetes can cause the blues in a physical, mechanical way.

But beyond simply having our bodies set up for depression, it also sucks to have diabetes. Diabetes requires constant attention, it affects what we can eat, how me need to move. There is testing, and medications, and worries about complications, and…

So yeah. We d-folks are at much greater risk of depression than people who don’t have diabetes. Some estimates place the rate of depression amongst diabetics as high as 50 percent.

I think that this is one of those things that you just have to accept goes hand-in-hand with having diabetes. You need to first recognize the fact, and then accept it. If you are depressed you need to treat it, just the same as you need to treat your blood sugar, blood pressure and cholesterol.

There are a variety of anti-depressants, and you should not be ashamed to take one. It is simply part and parcel of the treatment of diabetes.

So if you are depressed, bummed, blue, out-of-sorts, talk to your doctor about whether an anti-depressant is right for you.

Donna Hill Howes, RN
Family Practitioner

If you have diabetes, look for the following symptoms of depression:

  • loss of interest in things you once liked 
  • trouble sleeping or sleeping more than usual
  • tiredness (fatigue)
  • eating more or less than usual
  • difficulty concentrating
  • anxiety
  • feeling as though you are useless
  • morning sadness
  • having suicidal thoughts

If you suspect you have depression, talk to your doctor or mental health provider. Treatment is available.

Bob Greene
Physiology Specialist

The conventional wisdom is that having diabetes triggers depression and vice versa—but a recent review of the research challenges that assumption, at least when it comes to type 2 diabetes. The joint University of Michigan-Ann Arbor and Johns Hopkins University in Baltimore review found that being depressed raises the risk of type 2 diabetes by 60 percent, but having type 2 diabetes doesn't increase your odds of developing depression.

It's possible depression is also a trigger of prediabetes. Research is showing that depression often leads to weight gain, particularly of visceral fat, the type of belly fat that leads to insulin resistance, prediabetes and type 2 diabetes. Being depressed also causes the release of higher levels of cortisol, the so-called stress hormone. This, in turn, promotes the accumulation of visceral fat—the more cortisol you have in your body, the more visceral fat gets laid down. Plus, inflammation is on the upswing and other systems go awry during depression, which may worsen insulin resistance and spur on type 2 diabetes and prediabetes. But why is depression more prevalent in type 1 diabetes? Unlike type 2, in people with type 1 diabetes, it's the disease that may be driving the blues.

If you're a woman with diabetes, you're more likely to have depression than a man with the same diagnosis. However, regardless of gender, having a low educational status and living without a partner are both significantly associated with depression in people with diabetes.

The Best Life Guide to Managing Diabetes and Pre-Diabetes

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The Best Life Guide to Managing Diabetes and Pre-Diabetes

Bob Greene has helped millions of Americans become fit and healthy with his life-changing Best Life plan. Now, for the first time, Oprah's trusted expert on diet and fitness teams up with a leading...

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.