Is there a connection between depression and diabetes?
Some studies show that having diabetes doubles your risk of developing depression. If diabetes-related health problems emerge, your risk for depression can increase even further. It remains unclear exactly why this is. Some researchers suggest that this could be due to diabetes' metabolic effect on brain function as well as the toll day-to-day management can take.
It’s also possible that people with depression are more likely to develop diabetes. Because of this, it’s recommended that people who have a history of depression be screened for diabetes.
Keep reading for more on the connection between diabetes and depression, as well as information on diagnosis, treatment, and more.
What the research says
Although more research is needed to fully understand the link between diabetes and depression, it’s clear that there’s a connection.
It’s thought that alterations in brain chemistry tied to diabetes may be related to the development of depression. For example, damage resulting from diabetic neuropathy or blocked blood vessels in the brain may contribute to the development of depression in people with diabetes.
Conversely, changes in the brain due to depression may cause an increased risk for complications. Studies have shown that people with depression are at higher risk for diabetes complications, but is has been difficult to determine which causes which. It hasn’t been determined if depression increases the risk for complications, or vice versa.
Symptoms of depression can make it more difficult to successfully manage diabetes and prevent diabetes-related complications.
A 2011 study found that people who have type 2 diabetes and experience symptoms of depression often have higher blood sugar levels. Additionally, the results of a separate 2011 study suggest that people who have both conditions are 82 percent more likely to experience a heart attack.
Are the symptoms of depression different for people with diabetes?
Just trying to cope with and properly manage a chronic disease like diabetes can feel overwhelming for some. If you feel depressed and your sadness isn't relieved within a few weeks, you may be experiencing depression.
Common symptoms include:
- no longer finding pleasure in activities that you once enjoyed
- experiencing insomnia or sleeping too much
- loss of appetite or binge eating
- inability to concentrate
- feeling lethargic
- feeling anxious or nervous all the time
- feeling isolated and alone
- feeling sadness in the morning
- feeling that you "never do anything right"
- having suicidal thoughts
- harming yourself
Poor diabetes management can also prompt symptoms similar to those of depression. For example, if your blood sugar is too high or too low, you may experience increased feelings of anxiety, restlessness, or low energy. Low blood sugar levels can also cause you to feel shaky and sweaty, which are symptoms similar to anxiety.
If you’re experiencing symptoms of depression, you should consult your doctor. They can help you determine if depression is causing your symptoms and make a diagnosis, if needed. They can also work with you to develop a treatment plan that best suits your needs.
What causes depression in people with diabetes?
It's possible that the demands of managing a chronic disease such as type 2 diabetes lead to depression. This may ultimately result in difficulty managing the disease.
It seems likely that both diseases are caused and affected by the same risk factors. They include:
- family history of either condition
- coronary artery disease
However, it may be that your depression is making it more difficult for you to manage your diabetes physically as well and mentally and emotionally. Depression can affect all levels of self-care. Diet, exercise, and other lifestyle choices may be negatively impacted if you’re experiencing depression. In turn, this can lead to poor blood sugar control.
Diagnosing depression in people with diabetes
If you’re experiencing symptoms of depression, you should schedule an appointment with your doctor. They can determine whether your symptoms are the result of poor diabetes management, depression, or tied to another health concern.
To make a diagnosis, your doctor will first assess your medical profile. If you have a family history of depression, be sure to let your doctor know at this time.
Your doctor will then conduct a psychological evaluation to learn more about your symptoms, thoughts, behaviors, and other related factors.
They may also perform a physical exam. In some cases, your doctor may do a blood test to rule out other underlying medical concerns, such as problems with your thyroid.
How to treat depression
Depression is typically treated through a combination of medication and therapy. Certain lifestyle changes may also help relieve your symptoms and promote overall wellness.
There are many types of antidepressant medications. Selective serotonin reuptake inhibitor (SSRI) and serotonin norepinephrine reuptake inhibitor (SNRI) medications are most commonly prescribed. These medications can help relieve any symptoms of depression or anxiety that may be present.
If your symptoms don’t improve or worsen, your doctor may recommend a different antidepressant medication or a combination plan. Be sure to discuss the potential side effects of any medication your doctor recommends. Some medications may have more severe side effects.
Also known as talk therapy, psychotherapy can be effective for managing or reducing your symptoms of depression. There are several forms of psychotherapy available, including cognitive behavior therapy and interpersonal therapy. Your doctor can work with you to determine which option best suits your needs.
Overall, the goal of psychotherapy is to:
- recognize potential triggers
- identify and replace unhealthy behaviors
- develop a positive relationship with yourself and with others
- promote healthy problem-solving skills
If your depression is severe, your doctor may recommend that you participate in an outpatient treatment program until your symptoms improve.
Regular exercise can help relieve your symptoms by boosting the “feel good” chemicals in your brain. These include serotonin and endorphins. Additionally, this activity triggers the growth of new brain cells in the same manner as antidepressant medications.
Physical activity can also assist in diabetes management by decreasing your weight and blood sugar levels and increasing your energy and stamina.
Other lifestyle changes include:
- eating a balanced diet
- maintaining a regular sleep schedule
- working to reduce or better manage stressors
- seeking support from family and friends
Coping with diabetes and depression
How can I cope if I have diabetes and depression? What should I do?
First, know that it’s very common for people with diabetes to experience depression. Talking to your doctor about this and making sure to follow up on any treatments they recommend is crucial. Many people feel they should just “pull themselves up by their bootstraps” and believe that they can just “get over” being sad. This isn’t the case. Depression is a serious medical condition, and it needs to be treated as such. If you don’t feel comfortable talking to your doctor, talk to a loved one to get support. There are groups available online and in person that can also help you explore the best treatment options available, which you can then discuss with your doctor.Peggy Pletcher, MS, RD, LD, CDEAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
Recognizing your risk for depression is the first step to getting treatment. First, discuss your situation and symptoms with your doctor. They can work with you to make a diagnosis, if necessary, and develop a treatment plan appropriate for you. Treatment usually involves psychotherapy and some form of antidepressant medication.