Diabetes and mental health: How to cope
A diabetes diagnosis can be a life-altering reality. Whether it is type 1 diabetes, where the body does not make any insulin at all, or type 2 diabetes, when the pancreas makes some insulin but not enough, it can mean changes to your lifestyle that you may not be ready for and can also impact your relationships with friends or family.
As you establish a new routine, it is important to establish good habits in managing your mental health. Proper diabetes management requires awareness of your symptoms. Just as you take insulin to ensure your blood glucose levels are where they should be, it is important to apply measures to prevent mental health crises by being aware of how you are feeling mentally and emotionally.
Just like taking care of your body, taking care of your mind is equally as important to living a healthy life. When left untreated, mental health conditions like depression and anxiety can make diabetes worse. Likewise, existing diabetes can make mental health conditions worse.
Certain added responsibilities like tracking blood glucose and insulin can be hard to remember at first, doctors’ appointments can take time away from work, and the costs of appropriate care may be burdensome. These changes can be emotionally draining, and you might start to notice that you are feeling a bit off or have very little energy left to carry out important tasks to managing your condition.
Importantly, people living with diabetes are likely to experience the following mental health situations:
• People living with type 1 or type 2 diabetes are at increased risk for depression, anxiety and eating disorders.
• Rates of depression across the lifespan are two times greater for people with diabetes than in the general population.
• People with type 1 diabetes are twice as likely to live with disorderly eating habits.
The fear of blood sugar fluctuations can be very stressful. Changes in blood sugar can cause rapid changes in mood and other mental symptoms such as fatigue, trouble thinking clearly, and anxiety.
Having diabetes can cause a condition called diabetes distress, which exhibits some traits of stress, depression and anxiety.
Unlike depression, diabetes distress can be linked back to causal factors related to diabetes. For example, fear of hypoglycaemia or a very low level of blood sugar may cause significant worry. Diabetes distress can also be affected by external factors like family and societal support and healthcare services.
LOW RATES OF DETECTION
One of the biggest challenges to the treatment of mental health conditions for people with diabetes is low rates of detection. Up to 45 per cent of mental health conditions and cases of severe psychological distress go undetected among patients being treated for diabetes.
However, it is estimated that only around one-third of people with diabetes and mental health conditions receive a diagnosis and proper treatment. This may be because the signs and symptoms that people experience when their blood sugar is too high or too low can be mistaken for those associated with depression or anxiety. People with diabetes also may face stigma in talking about their feelings of depression and tend not to talk about them at appointments.
The American Diabetes Association standards of care recommend that treatment teams include a mental health professional with expertise in dealing with the disease, and for people to be regularly screened. However, the reality is that few diabetes clinics provide mental health screening or integrate behavioural health services.
Therapy is an extremely helpful treatment option and people with and without mental health conditions can benefit from it. Talk therapy is not only for discussing your problems, it is also for finding solutions. Professionals can help you work through the many things that may be causing you to stress, understand your mental health condition and identify triggers that may make things worse and learn coping skills.
In addition to therapy, there a number of different medications that can help. When deciding on a mental health treatment plan involving medication, talk to your mental healthcare provider about your family history of mental health and your own diabetic condition.
A diabetes diagnosis can cause prolonged stress, which may possibly cause a rise in blood sugar. Stress can also make following your diabetes maintenance routine more difficult. Experts suggest looking for patterns; be aware of your stress level each time you log your blood sugar and see if a pattern emerges. If you notice a pattern, you can learn to spot your stress warning signs and take action to prevent stress and keep your blood sugar low. This may mean working with a professional to learn relaxation and coping techniques.
SOURCE: American Diabetes Association, Medical News Today, Healthy Living – Diabetes