Your Emotions and Diabetes

Is depression more common among people with diabetes? Most studies find that depression is more common, that it recurs more frequently, and that it lasts longer among people with diabetes than in the general population. Whether you believe this applies to you probably depends on whether you think “depression” is having the occasional “blues” or if you use the more clinical definition of chronic feelings of hopelessness. Everybody, diabetes or no diabetes, goes through periods of feeling down, along with low energy and not caring to be involved in things going on around them. Depression is serious when these feelings go on for long periods or are interfering with your quality of life or your ability to care for your diabetes.

Erratic blood glucose levels can also cause some of these feelings. Having high blood glucose for a long stretch brings on fatigue and sleepiness. It can sap your energy and keep you from getting involved with activities. It can be hard to tell if you are feeling depressed or feeling bad because your blood glucose is high. So in addition to the fact that having to deal with diabetes day in and day out can give you the blues, high blood glucose levels can add to the blues. It can become a vicious cycle.

The only way to stop it is to seek help.

Can diabetes affect my sense of self-worth? Having a chronic disease like diabetes can make it harder to feel good about yourself. You may feel “damaged,” just because of diabetes. Being different can make the teenage years even more painful than usual.

How you feel about yourself can affect how you care for your diabetes. Do you believe you deserve to spend the time, effort, and money it takes to care for your diabetes? How do you show yourself respect? If you do it by making choices, others will respect your needs, too. If you need to check your blood glucose right now, do it. Don’t be worried about asking others to wait for you while you check.

Can stress affect blood glucose control? Yes. Stress affects your body’s hormone balance. Your body produces powerful hormones in response to a difficult or “fight or flight” situation.

These hormones get your body ready for quick action by breaking down stored forms of glucose into blood glucose.  This sends your blood glucose levels up. If you have type 1 diabetes, you probably don’t have enough insulin on board to cover the higher glucose levels. If you have type 2 diabetes, your levels are likely to remain too high because of insulin resistance. Your body also releases stress hormones in response to situations such as illness or surgery.

Can stress cause diabetes? Stress doesn’t directly cause diabetes.
However, for people already headed in that direction, it can push them along a little faster. Perhaps you’ve heard stories of people whose diabetes began after a stressful experience, such as a severe illness or a car accident.

In type 1 diabetes, the immune system mistakenly destroys the insulin-producing cells of the pancreas. This is a process that usually takes many months, perhaps even years, before enough cells are lost so that diabetes starts. A person on the way to getting type 1 diabetes makes less and less insulin. A stressful experience increases the need for insulin. So, the insulin demands brought on by a stressful experience could overwhelm the body’s ability to produce insulin.

In type 2 diabetes, the body loses its ability to respond to insulin.  As this happens,  the pancreas makes less and less insulin. Adding stress-produced hormones, which create more resistance to insulin, could bring on the first symptoms of diabetes.

Why do my feelings change so quickly? Is it because of my diabetes?  Trying to meet the never-ending demands of life with diabetes can make anyone feel frustrated, or up one minute and down the next. It’s easy to feel cheated when you’ve met your end of the bargain by doing all that you can but your blood glucose levels don’t reflect your efforts.  Wide swings in blood glucose levels can also cause your emotions to change.

If you suspect that this is happening, consider doing some investigative testing. If your mood swings are related to blood glucose fluctuations, talk to your health care team about other ways to manage your diabetes.

Tell the people close to you who want to support you about how you feel. And if you need more help to deal with mood swings, ask for a referral to a psychologist or other mental health counselor. You don’t have to be alone with diabetes.

There is help and support available if you ask for it.

Martha M. Funnell, MS, RN, CDE
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Robert M. Anderson, EdD
Michigan Diabetes Research and Training Center
University of Michigan Medical School
Ann Arbor, Michigan

Shereen Arent, JD
National Director of Legal Advocacy
American Diabetes Association

American Diabetes Association Complete Guide to Diabetes

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