You’re not feeling like yourself—and you can’t remember the last time you did. You used to love the outdoors: fly fishing, hiking, goofing around at the beach. You used to live for weekends, and would spend yours with friends and family, trying new things. But now you spend your Saturdays glued to the couch, blinds drawn, limbs like lead, mind numb. Maybe it’s related to your diabetes—or were you always this way? When did your life change? Untangling the complicated web of depression and diabetes can feel a bit like playing chicken or egg.
Here’s what we know: statistics indicate that people with both Type 1 and Type 2 diabetes are two to three times more likely to suffer from depression than those who are healthy. This isn’t just because being chronically ill makes a person depressed, although that’s often a facet of it.
The more carefully and consistently you manage your diabetes, the better you emotionally feel. However (and this is a big however), many patients don’t understand what’s causing their depression—over the years, these feelings become the chronic pain of living. For these patients, breaking bad habits and improving their emotional state seems impossible. Depression and poor diabetes maintenance grow into a self-destructive cycle, whereby poor management becomes a means of self-punishment, which leads to even greater feelings of hopelessness and inadequacy.
How does this cycle begin? It has to do with the blurry line between depressive symptoms and cognitive symptoms of diabetes. Side by side, the cognitive effects of depression and high blood sugar look almost identical: lethargy, brain fog, lack of inertia—all of these could indicate depression, diabetes, or both. Most mental health professionals don’t rule out diabetes before making a diagnosis of depression. As a result, many people live for years with undiagnosed Type 2 diabetes, suffering from the cognitive and physical symptoms. For these individuals, a diabetes diagnosis can be a crushing blow after years of depressive decline.
If you struggle with depression and diabetes, seek help by contacting a therapist or certified diabetes educator (CDE). Although your diabetes may or may not have caused your depression, without a doubt, it has made it worse—and proper maintenance can make it better. Keep your friends and family in the loop about how your health is affecting you emotionally. While they may not be able to offer a solution, they can provide support, kindness, and understanding.
How do you keep positive and avoid self-destructive behaviors? Share your experiences in the comments section!
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.