Is mental health pretty low on your list of priorities for managing diabetes? This may change your mind.
When people think of diabetes and concomitant conditions they often think of physical issues like diabetic neuropathy with its associated nerve pain in their feet. They might even think of diabetic retinopathy which affects one’s eye sight. Perhaps even cardiovascular issues because high blood sugar damages blood vessels and increases risks for cardiovascular conditions. However, few people associate mental health issues with diabetes.
While diabetes has a profound effect on the people’s daily lives, so do mental health issues. Mental health issues of course affect how one thinks and feels, processes stress, interprets interpersonal interactions and ultimately lives their daily life. Adding the rigors of diabetes management on top of mental health issues can be very overwhelming.
The Connection between Mind and Body
Conversely, mental health issues and difficulty managing one’s thoughts, feelings, beliefs, and attitudes can have a major impact on one’s physical health. According to the CDC, “untreated mental health issues can make diabetes worse, and problems with diabetes can make mental health issues worse. But fortunately if one gets better, the other tends to get better, too.”
Depression: It’s not Just Feeling Down
Depression is a diagnosable, medical illness that causes loss of interest in things that have otherwise been enjoyable or pleasurable. It often presents itself with debilitating feelings of sadness. These feelings can be so strong that it affects one’s ability to function at home, school or work. It can even impact your ability to manage your diabetes. Consequently, when your ability to manage diabetes is compromised, your risk goes up for diabetes complications like heart disease and nerve damage.
Many people are shocked to find out that a person with diabetes is 2 to 3 times more likely to have depression than a person without diabetes. Unfortunately, the problem often goes undetected as only ¼ to ½ of people with diabetes who also have depression end up getting diagnosed and treated for their depression. The good news is that if someone is diagnosed with depression, medicine and talk therapy, can be very effective in treating their condition. For those that are go undiagnosed, and untreated, their depression often gets worse.
Depression can range from mild to severe and the associated symptoms also vary in severity as a result:
• Feeling empty, sad or morose
• Loss of interest in activities that were previously pleasurable
• Overeating
• Loss of appetite
• Sleeping too much
• Not being able to sleep consistently or enough to feel rested
• Difficulty making decisions or concentrating
• Feeling exhausted, mentally/physically tired
• Feeling of guilt, irritability, hopeless and anxiety
• Upset stomach, cramps, or digestive problems
• Headaches
• Tight muscles
• Thoughts of suicide or death
If you suspect you are suffering from depression it is imperative that you consult with a health care provider immediately. The earlier depression is treated, the better for you and your overall well being. Early intervention of depression also has a correlation to better management of your diabetes.
Stress and Anxiety
Stress is unfortunately an indelible part of life as we have to deal with issues things like relationships, work, school, finances or even traffic. Stress can impact your diabetes as stress hormones make blood sugar levels fluctuate unpredictably. In addition, stress from injuries or sickness can increase your blood sugar levels as well. Being stressed for a long time can lead to other health problems or make them worse.
Anxiety, defined as a feeling of fear, dread, and uneasiness relates to the way you process and carry feelings of worry and fear. It can be thought of as the way your mind and body react to stress or perceptions of stress. Interestingly, people with diabetes are 20% more likely than those without diabetes to have anxiety. Managing diabetes in of itself can be a significant source of anxiety for some people.
Multiple clinical studies have proven that therapy for anxiety is the most effective means for treating it. However, sometimes both medicine and therapy together works best.
Anxiety can sometimes mimic the feeling of low blood sugar levels and conversely, low blood sugar levels can sometimes make a person feel like they have anxiety. Because these two things can feel similar, it can be quite difficult to understand what is actually happening. It may be hard for you to recognize which it is and treat it effectively.
Diabetes Distress
Managing diabetes on a daily basis can be exhausting and lead to feelings of being stressed, frustrated and discouraged. This is known as diabetes distress, which can lead a person to become less engaged or invested in the steps necessary to manage their diabetes. For example, a person may stop checking their blood sugar, make unwise choices with their diet or even skip doctor’s appointments. Diabetes distress is extremely common, with 1/3 to ½ of people with diabetes experiencing this in any given 18 month period
Although diabetes distress may seem like anxiety or depression, there aren’t any medicine based treatments for it. The most important action items if one is experiencing diabetes distress is to see their endocrinologist for diabetes care and a mental health counselor, experienced in chronic health conditions, for your emotional well being.