The two-way link between mental health and diabetes

Without adequate support, the emotional toll of managing a chronic health condition can be significant. People with diabetes face higher rates of depression, anxiety disorders, and eating disorders. At the same time, living with a mental health concern can make it harder to manage your physical health, including diabetes. Fortunately, there’s some good news about the two-way link between diabetes and mental health. Strengthening your mental health can help you manage your diabetes, and, in turn, managing your diabetes can help improve your mental health.

The emotional toll of diabetes

Whether you have Type 1 or Type 2 diabetes, both can take an emotional toll. Getting a diagnosis can be a stressful experience and may cause you to wonder:

• “Will I ever be able to eat the foods I enjoy?”

• “What if I can’t manage my blood sugar on my own?”

• “How am I going to get used to taking insulin?”

• “What if I don’t get enough daily exercise?”

• “How will all these changes impact my daily life?”

• “Will I have to give up activities I enjoy?”

• “Will people see me differently or judge me?”

These worries are collectively referred to as diabetes distress. Diabetes distress is a common experience that can make it harder to manage your health. 

Severe diabetes distress is believed to affect:

• 1 in 4 people with Type 1 diabetes

• 1 in 5 people with insulin-treated Type 2 diabetes

• 1 in 10 people with non-insulin-treated Type 2 diabetes

Sometimes, diabetes distress can be mistaken for depression. This can be confusing because fluctuating blood sugar levels can cause rapid mood swings and other mental health symptoms. For example, they can cause fatigue, confusion, and anxiety. That’s why it’s so important to discuss mental health within the context of diabetes care.

The impact of mental health on diabetes

When it comes to managing diabetes, your medical providers will likely tell you to exercise, eat a balanced diet, take your insulin and other medications, and monitor your blood sugar. And these are all important tasks. But managing diabetes also requires examining the mind-body connection. This term is used to describe the ways that our physical and mental well-being interact. 

Left untreated, diabetes can make your mental health worse, and this is true for other chronic conditions. But if you have a pre-existing mental health concern, that can also make it harder to maintain your physical well-being. Fortunately, if one improves, the other will often get better.

Barriers to mental healthcare for people with diabetes

One of the greatest barriers to mental healthcare for people with diabetes is identification. Approximately 45% of people being treated for diabetes don’t receive the mental healthcare they need. 

This might be due to:

• Not being screened regularly for mental health concerns by their medical provider(s)

• Thinking that anxiety or depression symptoms are due to blood sugar levels being too high or too low (which can happen)

• Stigma that can make it hard for people with diabetes to talk about mental health with their providers

• Lack of access to clinics or medical facilities for diabetes management that provide whole-person care

Managing diabetes and mental health challenges

If you’re living with diabetes and co-occurring mental health challenges (or you suspect that you might be), here are some tips that can help:

• Seek an evaluation as soon as possible. Diabetes isn’t always preventable, and the same is true of the mental health concerns that often accompany it. However, the sooner you receive an accurate diagnosis, the sooner you’ll have access to the care you need to manage your physical and mental health.

• Talk to a therapist with chronic disease experience. Therapy can provide a safe, confidential space to process your experience with diabetes. You can discuss whatever emotions you’re feeling (like anger, grief, or frustration), set achievable goals, and learn coping strategies to help you effectively manage both your mental well-being and your diabetes.

• Consider a mental health medication. While there’s no medication that can cure diabetes, there are medications that can help you maintain your mental health. If you’re feeling anxious or depressed and it’s negatively affecting your ability to care for yourself, talk to a psychiatric provider. They may be able to prescribe medication that can help. There’s even some evidence that certain mental health medications may have a positive effect on blood sugar management. It’s important to note that these medications don’t directly control blood sugar levels. They can help with increasing your mood which can be helpful for blood sugar management.

• Keep an eye on your stress level. Increased stress can affect your blood sugar and make it harder to manage your diabetes. So try to incorporate some stress-management activities into your day. This can include things like getting adequate rest, light movement, or spending time with friends and family.

Clinician's take

A common challenge people with diabetes face when addressing mental health is the impact of their blood sugar. It’s important that their blood sugar levels are stable, because if they aren’t, this can directly impact mental health and well-being. Seeking support from a mental health professional can help you take better care of yourself, which in turn can improve your physical health.

Halee Fullerton, PMHNP-BC

Clinical reviewer

Find care with Rula

Living with diabetes can be challenging both physically and emotionally. Many people experience diabetes distress due to the emotional strain of living with a chronic condition. This added stress can make it harder to manage your diabetes. And at the same time, without treatment, diabetes can negatively affect your mental health.

The good news is that whole-person care can help you maintain your mental and physical well-being. With early detection, ongoing stress management, and support from a therapist and/or psychiatrist with experience in chronic disease management, you can lead a fulfilling life with diabetes.

At Rula, we’re committed to delivering a comprehensive behavioral health experience that helps people feel seen and understood so they can get back to feeling their best. 

Rula makes it easier to find a licensed therapist or psychiatric provider who accepts your insurance so you don’t have to choose between affordable care and excellent care. With a diverse network of more than 15,000 providers, 24/7 crisis support, and appointments available as soon as tomorrow, we're here to help you make progress — wherever you are on your mental health journey.