Managing type 1 or type 2 diabetes, chronic autoimmune diseases, can be highly challenging due to setbacks and many challenges along the way. The constant vigilance required to manage blood sugar, navigate health care services, medication side effects, and other related health conditions can lead to an increased risk of depression. Left untreated, depression can result in poor lifestyle choices that worsen physical health.

If you have diabetes, or someone you love does, it’s important to be aware of the risk of developing depression. Researchers have found that the two conditions occur twice as frequently as you would predict based on chance, meaning that diabetes and depression affect each other in some ways. 1  The relationship between type 2 diabetes and depression is bidirectional, meaning that each can put a person at risk for the other. 2 If a person has depression, they are at a higher risk of leading a sedentary lifestyle and eating foods that are sugary or fatty, which can lead to type 2 diabetes. If they already have type 2 diabetes, the burnout that can come with managing the disease, can lead to depression. Meanwhile, people with type 1 diabetes— which is not caused by diet or lifestyle factors, but rather a result of a pancreas that cannot manufacture insulin—can also be incredibly challenging to manage, which puts one at risk for developing depressive symptoms. 3 Once depressive symptoms develop, it can become increasingly difficult to manage diabetes and can lead to physical complications and decreased life expectancy.

If you’re not sure whether you might be suffering from depression, you can look for these signs: 4

  • Lack of interest in activities
  • Depressed mood or irritability
  • Changes in sleep patterns
  • Changes in appetite
  • Feelings of guilt or despair
  • Lack of energy
  • Trouble concentrating
  • Suicidal thoughts

Risk Factors Associated with Diabetes and Depression

There are many environmental factors which can affect the risk of developing both conditions. 5 These can include:

  • Poverty
  • Childhood adversity
  • Poor social environments
  • Lower physical activity
  • Maternal stress prior to birth

It is not known whether taking antidepressant medication puts a person at risk for diabetes, but relationships have been observed between the two. If you take antidepressants or are considering them, talk to your doctor about the risks of weight changes and hyperglycemic and hypoglycemic effects that can put you at risk for developing type 2 diabetes. 6

Researchers also have found that people with type 2 diabetes who use insulin are at higher risk for developing depression compared to people those take non-insulin medications or only adjust diet or lifestyle habits. This is because these people may experience additional stress in managing the diabetes and accessing health care services. 7

If you have diabetes, be sure to tell your doctor if you begin to notice that you’re losing interest in things you once found pleasurable or you experience feelings of hopelessness or a lower mood. Talk to them if you have a history of depression in your family or find the challenges of managing your diabetes to be tiring.

Treatment Options

Common interventions for depression include cognitive behavioral therapy, which helps people correct harmful thought patterns and behaviors which can increase depressive symptoms, as well as interventions such as structured problem solving, motivational interviewing, and interpersonal and psychodynamic approaches. 8  Medication may also help with lifting mood and managing symptoms.

Treatment options for diabetes in addition to standard medical care may include behavioral self-management programs that help people increase healthy habits and improve control over their blood sugar. Both diabetes and depression may improve with focus on lifestyle changes, such as improving diet and exercising regularly.

Many patients may find that having treatment teams communicate and collaborate with each other (i.e. nurse practitioner, diabetes educator, doctor, psychologist, counselor etc.) may prove helpful in addressing the challenges unique to those with both conditions. 9

If you’re not sure where to start, talk to your doctor about your family’s medical and psychiatric as well as your own concerns. Engage with diabetes educators about healthy habits that lower risk of depression and don’t hesitate to ask for a referral to a counselor or psychologist in your area. If you have depression and are concerned about developing diabetes, you may want to talk to your doctor about building a collaborative team to address risk factors and how antidepressant medications could potentially influence physical health such as weight or blood sugar levels.

With the right tools and the right team, people with type 1 or type 2 diabetes can lead emotionally and physically healthy lives, as can those with depression. Consider today who you can recruit to help you develop healthy lifestyle habits for your mind and body.

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Last Updated: Jun 26, 2017