The need for constant vigilance to make sure you don't have an episode of hypoglycemia (low blood sugar), rounds of doctor's visits, dietary constraints, medical costs—it's easy to see why a person with diabetes can become depressed. And if you have a complication, the risk can be even higher. While most people who have diabetes don't suffer from depression, it's not uncommon for diabetes and depression to go hand in hand.

The Link Between Diabetes and Depression

"The risk of depression is significantly higher in people with diabetes than in the general population," says Ami Baxi, MD, assistant director of the Division of Inpatient and Emergency Psychiatry in the Department of Psychiatry at Lenox Hill Hospital in New York City. "There is a sense of loss when you receive the diagnosis, and it can continue as you have to make major lifestyle changes to care for yourself if you want to stay healthy. Having diabetes can alter the quality of a person's life."

Over time, people with diabetes may have vascular (blood vessel) changes, and this can prompt an episode of depression, Baxi says. (Blood vessel damage caused by diabetes can lead to complications like eye problems and pain in the limbs.) And poor control of your blood sugar can cause symptoms that look like depression: For instance, having a low or high blood sugar at night can disrupt your sleep and make you exhausted the following day, and daytime tiredness and anxiety are also common when blood sugar is high or low.

Symptoms of Depression

While some physicians routinely screen their diabetes patients for depression, it's important for patients themselves to be alert to the warning signs. If you or someone close to you has diabetes, there are a variety of symptoms that signal depression. They include:

  • Pervasive feelings of sadness
  • Changes in sleep habits and appetite
  • Loss of interest in activities that would normally be enjoyable, such as seeing friends
  • A pessimistic attitude or sense of hopelessness
  • Suicidal feelings (in serious cases)

More subtle symptoms include changes to a person's self-care routine, says Xavier Jimenez, MD, of the Cleveland Clinic. If the individual stops testing his or her blood sugar and no longer eats right, it could signal depression. "If a physician finds that the individual's hemoglobin A1C [which shows how well a patient’s diabetes is being controlled] has risen, this could be a sign of depression, since it can mean the person isn’t trying to keep the blood sugar in the normal range," he explains.

Managing Depression and Diabetes

If you suspect you're depressed, the good news is that the condition is very treatable. Here's what to do:

  • Share your feelings with someone you trust. The first and most crucial step is to tell someone you're feeling depressed. Your doctor can refer you to a mental health specialist. Short-term or long-term counseling, sometimes coupled with medication, can help you feel better. If your doctor can't refer you to a counselor, contact your local chapter of the American Diabetes Association, or the American Psychological Association for a referral.

    Note that you may not necessarily be referred to a mental health expert: "In milder cases of depression, the focus may be more on self-care and on learning how to manage," Jimenez says. "You may just need help adjusting to the lifestyle changes that you have to make." If your doctor thinks this is the case, you may be referred to a nutritionist who can help with dietary changes and getting the blood sugar into the normal range.
  • Find a health care provider you like. "It’s crucial to have a good relationship with your doctor, since communication and trust are key when you have diabetes," Jimenez says.
  • Get support. Consider joining a support group for individuals with a chronic illness, Baxi recommends. "Very often, it can make you feel better just knowing that there are others out there in the same boat," she says. "Those patients with diabetes often find management of diabetes very stressful, and talking about it with others and sharing tips and advice can help."

Ami Baxi, MD, reviewed this article.


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  2. "Prevent Diabetes Problems: Keep Your Eyes Healthy"." National Diabetes Information Clearinghouse (NDIC). Page last updated September 18, 2013.