Type 2 Diabetes and Your Mental Health

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Being diagnosed with a chronic illness can be tough. Living with a lifelong condition like Type 2 Diabetes can often feel like a lonely journey. The constant worry about your blood sugar levels, medicines, lifestyle changes, and the dreaded diabetes complications can be incredibly stressful and isolating. Can all this worry and stress affect your mental health? How does chronic stress affect your blood sugar levels? In this article, we discuss the effects of diabetes on your mental health, and also what you can do to lower stress and preserve your mental health.

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How Does Diabetes Affect Your Mental Health?

When diagnosed with a chronic condition like Type 2 Diabetes, most people report feeling worried and distressed. The idea of having to take medication for the foreseeable future, possibly having to give up their favourite foods, exercising regularly, frequently having to undergo an array of tests and doctor’s appointments, etc. can feel overwhelming to people who are already dealing with the pressures of modern life. 

This, along with the worry about developing complications associated with diabetes, like vision loss, kidney damage, heart disease, etc. can cause severe psychological stress, which if unaddressed, may lead to anxiety and depression in some people. This worry and stress can lead to the development of the following conditions if left untreated.

Diabetes Distress

Dealing with the constant demands of managing diabetes, like taking medicines on time, planning and eating a healthy diet, increasing physical activity, and keeping up with tests and doctor’s visits can make you feel overwhelmed. This can give rise to feelings like anger, guilt, frustration, and sadness, which can cause you to neglect your condition and well-being. This is known as diabetes distress or burnout.

The following are some of the symptoms of diabetes distress that you need to look out for:

  • Feeling lonely or isolated.
  • Feeling angry or guilty about having diabetes.
  • Feeling frustrated with the daily tasks and activities of diabetes management.
  • Having no motivation to take care of yourself despite being worried.
  • Making unhealthy dietary choices.
  • Avoiding tests and doctor’s appointments.

Diabetes distress is common in people that are newly diagnosed with the condition. Recognising the signs and dealing with diabetes distress as soon as possible can help you manage your diabetes and mental health in a much better way.

If you are experiencing any of these signs, consult your physician or primary healthcare team.

Diabetes and Depression

Stress, anxiety, and diabetic distress, when not handled quickly or properly can lead to the development of depression. Several studies show that people with Type 1 and Type 2 Diabetes are much more vulnerable to mental health disorders like depression, with the incidence being 2 to 3 times higher in diabetics than in people without diabetes.

Depression is a condition that can be debilitating. It can cause you to feel a lack of motivation to perform daily tasks like self-care, exercise, socialising, etc. This is particularly problematic in diabetics, who need to make active changes to their lifestyle in order to manage their condition.

The following are some telling symptoms of depression that you need to be aware of:

  • Feeling sad, hopeless, or devoid of feelings
  • Loss of interest in previously pleasurable activities
  • Increased or decreased appetite
  • Feeling tired or fatigued
  • Sleeping too much or too little
  • Nervousness and irritability
  • Fluctuations in weight
  • Unexplained aches, pains, and cramps.

If you are experiencing any of the above symptoms, consult your physician or healthcare team. Your physician may advise you to talk to a mental health professional such as a psychologist in order to improve your mood and mental health.

 

Can Stress and Anxiety Worsen Your Blood Sugar Control in Diabetes?

When you experience stress, your body releases the hormone cortisol. Cortisol and other stress hormones prepare your body to deal with stress by increasing your energy levels. To do this, cortisol increases the availability of glucose (sugar) in your blood in the following ways:

  • Inducing your liver to break down protein into glucose (gluconeogenesis).
  • Counteracting the action of insulin on your cells.
  • Inhibiting the release of insulin from your pancreas.

All of this results in increased blood glucose levels (hyperglycaemia), which can be especially harmful to diabetics. Uncontrolled hyperglycaemia and stress can lead to short-term complications like diabetic ketoacidosis, and long-term complications like heart disease, stroke, loss of vision, kidney failure etc.

 

Long-term anxiety can also cause you to lose interest in activities that are important for diabetes self-management like eating healthy, regular exercise, taking medications as prescribed, etc.

Chronic stress can also lead to unhealthy coping mechanisms like binge eating, smoking, and excessive alcohol consumption, which can worsen your diabetes.

What Can You do to Better Handle Mental Health in Diabetes?

Adopting the following measures into your daily routine can help you handle diabetes-related stress and anxiety in a better way:

Exercise regularly

Regular physical activity and exercise are key for diabetes management. When you work out, your muscles use the glucose (glycogen) stored in your body to fuel your activity, and then begin to take up the glucose in your blood to replenish the stores. This leads to improved glycaemic control.

 

Exercise is also a great way to lower the levels of stress hormones like cortisol and adrenaline in your body. When you are physically active, your body releases endorphins, which are chemicals that lift your mood and help you relax. Thus, exercise can help you relieve stress and anxiety.

Practise deep breathing techniques

The stress hormone adrenaline can cause your heart to beat faster and increase your respiratory rate. The best way to counteract this is to practise deep breathing exercises, which can help you calm down and lower your stress and anxiety levels. This can lower the levels of stress hormones in your body and improve control over your blood glucose levels.

 

Deep breathing exercises can also help you combat inflammation and oxidative stress, which are known to worsen diabetes complications. Breathing exercises also improve blood circulation, which can help delay or avoid diabetes-associated complications like peripheral artery disease and poor wound healing. 

Try progressive muscle relaxation

Progressive muscle relaxation (PMR) is a relaxation technique that involves tensing and relaxing groups of muscles, one by one. It is known to be effective in relieving stress and anxiety, improving sleep in insomniacs, and alleviating chronic pain.

Studies have shown that PMR is effective in controlling high blood sugar levels caused by anxiety, and may also help in relieving pain caused by diabetic neuropathy.

Perform mindfulness activities

Practising meditation, mindfulness, or yoga are effective ways to relieve stress in diabetics. These practices can not only help lower your blood sugar levels, but also help you manage your blood pressure and prevent complications related to your heart.

Studies have noted that diabetics who practise meditation and mindfulness regularly have been shown to make better lifestyle choices, which improved their health outcomes.

Find other activities that relax you

Any activity or hobby that helps you relax can aid in stress management. Make more time in your schedule to indulge in activities that improve your mood. It can be any activity you enjoy, such as walking, gardening, dancing, painting, singing, etc. 

Relaxing by participating in your favourite hobbies can help improve your general outlook towards life, with the added benefit of lowering stress levels and contributing to improved diabetes self-management.

Be more social

Forming closer bonds with your family, friends, colleagues, etc. can go a long way in bettering your mental health. Discussing your condition and your experiences in managing it with your family or friends can help you feel less lonely in your journey to better health. 

Positive social interactions have also been shown to improve mood and decrease your chances of developing anxiety disorders and depression.

Are There Any Mental Health Resources for Diabetics and Their Caregivers?

If you or your loved ones need support to better deal with the mental health ramifications of diabetes, your foremost resource would be your primary health care team. Discuss your apprehensions and mental state with your physician, who will be able to guide you on how to handle stress in a productive way.

You can also consult a psychologist or psychiatrist who is experienced in helping chronic disease patients. Additionally, you can also join local or online support groups for diabetics and their caregivers. 

Don’t Have Time To Read?

  • Being diagnosed with a chronic condition like Type 2 Diabetes, along with its management, can cause a lot of stress and worry.
  • In diabetics, unresolved stress and anxiety may lead to diabetes distress or depression.
  • Both of these conditions can cause you to neglect your health and the activities required to manage your diabetes.
  • Stress can also increase the levels of cortisol hormone in your body, which can elevate your blood sugar levels by breaking down protein in your liver, decreasing the effectiveness of insulin, and preventing the release of insulin from your pancreas.
  • You can manage stress effectively by exercising regularly, indulging in mindfulness activities, practising deep breathing or progressive muscle relaxation techniques, making more time for your hobbies, and being more social.
  • You can also seek mental health support from your primary care doctor or a psychologist or psychiatrist who is experienced in diabetes patient care.
  • Use the Phable Care App to consult India’s leading diabetologists, order medicines, book lab tests, integrate blood sugar monitoring and other devices to get real-time remote care from the comfort of your home. Also, check out our Diabetes Management program which provides ‎360º care. Let’s treat diabetes together.

Friendly Asked Questions

How does diabetes affect your mental health?

Being diagnosed with a chronic illness like diabetes often causes distress and worry among patients. Most diabetics find adapting to the required lifestyle changes stressful, as it necessitates a deviation from their established routines. All of this can lead to stress, anxiety, and depression, which is 2 to 3 times more common in diabetics, when compared to people without diabetes.

Does mental stress affect diabetes?

Yes, chronic stress can have a negative effect on your blood sugar levels. When under stress, your body releases the stress hormone cortisol, which increases the availability of sugar in your blood. Cortisol accomplishes this by inducing your liver to break down protein into glucose, reducing the production of insulin from your pancreas, and inhibiting the function of the insulin that has been released.

Is there a link between diabetes and depression?

Yes, numerous studies have found that diabetics are at an increased risk (2 to 3 times more likely) of developing depression. According to some studies, about 10% to 15% of all people with Type 1 or Type 2 Diabetes experience depression. People with depression are also more likely to develop Type 2 Diabetes due to poor dietary habits and a sedentary lifestyle that is observed in individuals with poor mental health.

How does stress management help diabetes?

By effectively managing stress, you can lower your cortisol levels. This helps in enhancing insulin function in your body, improving your glycaemic control, and lowering your risk of diabetes-related complications.

Can reducing stress reverse diabetes?

Type 2 Diabetes is a chronic condition that cannot be reversed currently. However, managing stress in a healthy way can help you better control your diabetes and reduce your dependency on diabetes medications. Stress management can be helpful in reversing prediabetes.