Research has established a connection between diabetes and depression. Studies have found that people living with diabetes are twice as likely to experience depression as those without the condition. The connection between these conditions goes both ways — those with depression are also at an increased risk of developing diabetes.

Living with either diabetes or mental health issues alone can be difficult, but living with both can have a greater impact on your quality of life and pose the risk of more significant complications. That is why it’s crucial to understand how depression and diabetes are connected and how you can take steps to improve your mental and physical health. Talk to your doctor if you believe you may be experiencing depression. They can work with you to find the best way to maintain your emotional well-being while living with diabetes.

How Do People With Diabetes Experience Depression?

Members of DiabetesTeam have shared their feelings of stress and burnout around diabetes management. As one member shared, “Sometimes, it’s just too much. I feel like my whole life is revolving around health issues. Then, I do something for others and stop being so self-centered (it helps).”

For some, external circumstances contribute to feelings of depression. As another member wrote, “I, too, have been struggling with depression, the pandemic, social isolation. With depression, it casts a gray pall over everything.”

Other members have offered their advice and support when it comes to managing their depression on top of everything else they’re dealing with. “It’s OK to feel sad or frustrated at times,” wrote one member to another. “Try to think of just one thing you’re grateful for, and tomorrow will be better.” Another wrote, “I try to be grateful to still be alive and able to do many things rather than struggle with what I’ve missed out on.” Another wrote, “I have to work hard every day to stay positive. Going outside, water, being in my yard. My dog helps me with depression. Hang in there.”

Rates of Depression Among People With Diabetes

Several studies have been conducted on the rate of depression in people with diabetes. One found that the prevalence of depression among those with diabetes mellitus (which includes type 1 diabetes and type 2 diabetes) ranged between 8 percent and 15 percent, compared to 3 percent to 4 percent in the general population (not limited to those with diabetes).

Another study, which was conducted on 422 people with type 2 diabetes and received 397 completed responses, showed that 37 percent had depression. This study also determined that those with low education, significantly low income, family history of diabetes, and poor diet and exercise also had an increased risk of developing depression.

What Can Cause Depression in Diabetes?

Although the relationship between depression and diabetes is not completely understood, there are risk factors associated with diabetes that can increase your likelihood of developing depression.

People with diabetes may experience increased stress related to diabetes care. Chronic stress, or the disturbance of the stress system, has been considered the “common pathway” that leads to depression in those with diabetes. Aside from stress, certain lifestyle behaviors have been linked to depression, including unhealthy eating, lack of exercise, poor sleep, and smoking.

The truth is that although all of these factors can lead to depression in those with diabetes, depression can also cause (or lead to) these feelings and behaviors. This, in turn, can put you at a higher risk of developing diabetes, leading to a “negative feedback loop” between the causes and symptoms of diabetes and depression.

Life With Diabetes

Living with diabetes can change many of the ways you live your day-to-day life, from the food you eat and the activity you get to monitoring your blood glucose levels and the medications you take as part of your diabetes treatment. Especially right after your diagnosis, it can be stressful to manage your health in a new and complicated way.

Living with diabetes can have negative impacts on stress, work, social activities, and overall well-being without support from a health care provider, diabetes educator, or other resources. This is why it is so important to seek medical advice and support after a diagnosis of diabetes. Diabetes will likely change many areas of your life, but with a little insight, the proper medical and emotional support, and the right tools in your arsenal, you can begin to navigate your “new normal” more easily.

Biological Connections Between Diabetes and Depression

Although diabetes and depression are known comorbidities (health conditions that occur alongside each other), there remains some uncertainty as to why. Some researchers speculate this co-occurrence is due to behavioral issues shared between the conditions. However, others have identified potential biological mechanisms at play in the conditions’ relationship.

Both diabetes and depression are associated with hypothalamic-pituitary-adrenal axis dysfunction, which affects the production of cortisol (the stress hormone) in the brain. Excessive cortisol in one’s system can lead to increased glucose and insulin resistance and may also increase the risk of metabolic syndrome — both of which increase one’s risk of developing type 2 diabetes. Similar associations have been shown between increased levels of inflammation and the development of depression and type 2 diabetes.

Treating Depression

If you or a loved one has been experiencing feelings of depression while living with diabetes, talk to a doctor. Your health care provider can determine the cause of these symptoms and work with you to find the best way of treating them.

Manage Your Diabetes

Although it will not treat mental health conditions like depression, managing your diabetes well is one of the first steps toward feeling better overall. You can work with your doctor to better understand your condition and how diabetes affects you — both mentally and physically.

Therapy or Counseling

Psychotherapy (commonly referred to as talk therapy or counseling) with a licensed mental health professional is a form of mental health care proven to greatly affect those living with mental disorders, including major depressive disorder, for the better. One study from the journal Cognitive Therapy and Research found that psychotherapy led to overall improvements in mood, thinking, and overall physical function, as well as reduced stress responses. A meta-analysis conducted by Cambridge University found that psychotherapy for depression is often tied to significant improvement in overall quality of life.

Several different types of therapy are effective for depression, including cognitive behavioral therapy. Your primary care provider or another doctor may provide a referral for a mental health specialist if you are unsure where to start. You can also check with your insurance company or visit online resources like Psychology Today.

Physical Activity

Although depression can often leave you feeling drained and without motivation, making it harder to work up the energy to get moving, research shows that any form of physical activity — not just structured exercise — can reduce stress, improve mood, and improve a range of health conditions including diabetes. This is because physical activity not only burns calories and can help support weight loss, but it also releases endorphins that can help improve your mood.

Getting active is also a recommended tool in combating diabetes, as it makes your body more sensitive to insulin. Increased insulin sensitivity can help manage diabetes while also helping to lower your risk of other serious health problems, including heart disease, obesity, and nerve damage.

Antidepressants

Antidepressants are a type of prescription medication that addresses the neurological causes of depression. When compared to psychotherapy, medication treatment options (also called pharmacotherapy) work a bit quicker. This is because they work to treat the symptoms of depression, rather than acknowledging and working through the root causes of depression (like psychotherapy does).

As with any new medication, consult your doctor before beginning any new treatment option, and be sure to keep them informed of any side effects or symptoms that arise from taking antidepressants.

Support Groups

Similar to psychotherapy, support groups offer individuals the chance to connect and share with others who may be experiencing similar hardships or conditions in life. The goal is to bring people with shared experiences together, building bonds of community and solidarity while also sharing coping mechanisms or firsthand treatment experiences.

Some people might consider support groups a happy medium between medical treatment and psychotherapy. Support groups can address both the emotional impacts of depression and related conditions while also introducing helpful stress, pain, and emotional management strategies. Joining a community of others who understand what you are going through can also help ease stress and feelings of isolation, which, in turn, can help manage some symptoms of depression.

Find Your Team

Being diagnosed with diabetes can be life-changing. However, you don’t have to go through it alone. DiabetesTeam is the online social network for people with diabetes and their loved ones. On DiabetesTeam, more than 123,000 members come together to ask questions, give advice, and share their stories with others who understand life with type 1 and 2 diabetes.

Have you experienced depression while living with diabetes? Share your story, thoughts, or tips in the comments below or by posting on your Activities page.