Diabetes and Depression: Overview

Is there a link between diabetes and depression? Researchers have found that diabetes and depression occur about twice as often together as they do without.

Depression is more than just the normal stressors of everyday demands. It is a medical illness that causes feelings of sadness and can interfere with your daily home and work life. It often leads to a loss of interest in things you once enjoyed and may also interrupt how well you manage your diabetes. 

Risk of Depression With Diabetes

There are several risk factors for depression alone and additional ones specific to people with diabetes. Risk factors for depression, whether you have diabetes or not, include a personal or family history of depression, having had major life changes, trauma or stress, having certain physical illnesses, or taking certain medications.

If you have diabetes, additional risk factors for depression include needing increased treatment for type 2 diabetes, such as taking insulin (compared with other medications or dietary or lifestyle interventions alone), developing diabetes complications, having recurrent hypoglycemia, and poor glycemic control.

Does It Matter if It’s Type 1 or Type 2?

Regardless of the type of diabetes you have, there is an increased risk of depression. Researchers have found that significant depressive symptoms affect approximately 1 in 4 adults with either type 1 or type 2 diabetes. However, only about 10% to 15% of people with diabetes receive a formal diagnosis of depressive disorders.

There are not many studies regarding depression in children and adolescents with diabetes, but in those few studies, it has been found that rates of depression are also higher in children and adolescents with either type 1 or type 2 diabetes.

Can Depression Cause Diabetes? 

Researchers have found an increased risk of diabetes in people with depression, though the link remains unclear.

A review in the American Journal of Psychology discussed how inflammation is often seen in people with depression and can negatively impact both mental and physical health, leading to further inflammation. Additionally, chronic inflammation is characteristic of diabetes.

Researchers have also hypothesized that lifestyle factors often seen in people with depression, such as poor diet and physical inactivity, may play a role in increasing the risk for diabetes. Some medications taken for depression might also contribute to a higher risk of diabetes, though there has only been an association found and not causation.

Symptoms of Depression

Diabetes can be an overwhelming diagnosis and symptoms of depression may arise when struggling to cope with and manage the disease. If the blues stick around for longer than a few weeks, you might have depression. Symptoms include:

• Feelings of sadness
• Tiredness and fatigue
• Irritability
• Little or no interest in favorite activities
• Changes in appetite, such as loss of appetite or overeating 
• Changes in sleep patterns, such as tossing and turning all night or sleeping too much
• Difficulty concentrating or making decisions
• Feeling hopeless, irritable, anxious, or guilty
• Unexplained physical aches or pains, headaches, cramps, or digestive problems
• Having thoughts of suicide or harming yourself

Poor Diabetes Management and Depression

When diabetes is not well managed, blood sugar can be outside of normal ranges, which comes with a range of symptoms.

Symptoms that arise because of blood sugar being too low or too high can mimic depression, such as fatigue, digestive upset, irritability, or difficulty concentrating. When blood sugar is too low, you might feel shaky and sweaty, which can also happen with anxiety.

If you notice any of these symptoms, be sure to check your blood sugar. If it is outside of normal ranges, follow your healthcare provider’s recommendations for correcting it.

If your blood sugar is within normal ranges and you are still experiencing these symptoms, talk with your doctor about the possibility of being screened and treated for depression.

Diagnosing Depression

If you think you are experiencing depression related to diabetes, contact your healthcare provider for an appointment as soon as possible. Getting the proper treatment early on can help prevent depressive symptoms from getting worse.

Exam: What to Expect

There is no need for any special preparations before a depression screening. Try to get enough sleep the night before your appointment and remain calm and relaxed so you can fully answer any questions your doctor might ask you.

Your primary care provider may give you a physical exam and ask you about your feelings, mood, sleep habits, and other symptoms. You might also be asked to fill out a form or questionnaire about these symptoms.

Also, your doctor might order blood tests to make sure that another disease or disorder isn’t the cause of your depressive symptoms. 

If your primary care provider officially diagnoses you with depression, they may refer you to a mental health provider, such as a psychiatrist, psychologist, social worker, or counselor, for more specialized treatment. If so, ask your doctor to refer you to one who specializes in chronic health conditions.

If a mental health provider is screening you, you will most likely be asked more in-depth questions about your behaviors and feelings. 

Treating Depression

For the most part, treatment for depression in people with diabetes is the same as in people without diabetes. If you are diagnosed with both diabetes and depression, it is best to work with a multidisciplinary team to receive the best care for each condition.

Working with healthcare professionals familiar with and/or specialize in each condition will help give you the best care and most current treatment options.

Medication

Your healthcare provider may need to make sure that the medications you take for each condition do not interact with one another. Antidepressants are the main type of medication used to treat depression.

You may need to trial several different antidepressants before finding the one that best improves your symptoms while having the least amount of side effects. Antidepressants usually take about two to four weeks to work.

Symptoms such as appetite, sleep, and concentration often improve before mood, so it is important to give your medication a chance to work before quitting it. If you are taking antidepressants, do not stop taking them without the guidance of your healthcare provider.

Some medications for treating depression might influence diabetes risk, and therefore diabetes management. Talk with your doctor if you are concerned about your antidepressant medication and how it may influence your blood sugar levels.

Psychotherapy

There are several different types of psychotherapy and counseling used to treat depression, many of which may also be beneficial for diabetes. Some evidence-based approaches used to treat depression include cognitive behavioral therapy (CBT), interpersonal therapy (IPT), and problem-solving therapy.

Lifestyle Changes

Many lifestyle changes that are beneficial for depression also have a positive impact on diabetes. Getting regular physical activity and exercise have been shown to improve both depressive symptoms, as well as glycemic control. Improving your diet may also improve symptoms of depression and help with diabetes management.

Coping

Everyone copes differently. Engaging in healthy coping strategies is important to both depression and diabetes management. Spending time with other people and confiding in a trusted family member or friend can be a good way to reduce stress and cope for many people.

Participate in self-care on a regular basis and realize that your symptoms will not improve overnight, but gradually instead. Set realistic goals for yourself and focus on one or two at a time.

Being flexible and knowing that you will have ups and downs on your wellness journey will help you ultimately be successful in the long run.

A Word From Verywell

While it may seem overwhelming to care not only for one condition but two, know that help is available. You don’t have to do it alone.

Advocate for yourself and your care with your healthcare providers. Working with a team of healthcare professionals who are on your side is one of the best decisions you can make in caring for your diabetes and depression.

While some treatments for diabetes and depression are different and treated by separate providers, some treatments will overlap and benefit both conditions. If one mode of treatment doesn’t work for you, let your provider know. They will help guide and support you in finding the best treatment that works for you.