The Connection Between Diabetes and Mental Health Concerns
If type 2 diabetes has been a part of your life for a while, you know the routine. You know about the doctor appointments. You know about the needles and the tests. You know about the diet and exercise. You definitely know about stress.
As someone with type 2 diabetes, stress is a normal part of your life. Not only do you have to maintain all of the facets of your everyday life, but you have to do it while managing your diabetes.
Going to work, paying bills and shuttling the kids to activities is challenging enough for anyone. When you pair these tasks with diabetes, the level of difficulty increases exponentially.
During periods of stress, people use their coping skills to reduce or eliminate the amount of stress they experience. If you have a healthy supply of coping skills, you can handle most stressful situations. When the stress ends, your coping skills recharge.
The problem with type-2 diabetes is that the stress does not end. Since it is a chronic medical condition, its repercussions usually last forever. Chronic stress leads to mental health issues like depression and anxiety.
Depression and Diabetes
One of the most common mental health issues for people with type 2 diabetes is depression. Gaining awareness into the symptoms of depression gives you the ability to look in on yourself to track the changes. Oftentimes, it is helpful to ask others in your life if they have noticed changes in you. Symptoms of depression include:
- Increased feelings of sadness, hopelessness, and worthlessness with poor self-esteem.
- Less interest in doing things and having less energy to do things you would like to.
- Changes in weight; significant weight gain or loss.
- Changes in sleep, including sleeping too much or too little.
- Increased difficulty focusing, concentrating and maintain attention.
- Thoughts of suicide or thinking the world would be better off without you.
Depression begins to creep into the life of a person with diabetes slowly and typically begins with grief and mourning. The majority of people experience a loss when they receive a chronic medical diagnosis. This is logical and expected because your former way of life is changed and gone forever.
The grief process triggers feelings of sadness, confusion, hopelessness, guilt and shame. If left unresolved, these feelings grow and change into full depression. The above process mostly happens unconsciously without your awareness. Without awareness, it is difficult to change.
Some things that you can change, though, are your thoughts and self-talk. Your self-talk is the internal dialogue that you have with yourself throughout the day. Everyone has a steady stream of communication in their minds and what you say to yourself can trigger depression.
If you say to yourself that diabetes is the worst thing that could ever happen to you, you will never be able to deal with it, your life is going to be terrible now, and other similarly negative things, depression builds. Negative self-talk over an extended period of time will create depression where none existed before.
Anxiety and Diabetes
Some people with diabetes are likely to experience increased depression. Others are more likely to experience symptoms of anxiety.
As with depression, knowing the symptoms of anxiety gives you the ability to recognize these issues in yourself before they grow out of control. Symptoms of anxiety include:
- Increased worry about aspects of your life. The worry might be related to a specific activity, item or situation or it could be widespread to all aspects of your life.
- Problems paying attention and concentrating. Feeling that your mind is blank.
- Feeling tense and restless.
- Feeling more irritable and having a shorter temper.
- Being fatigued with less energy.
- Problems falling asleep or staying asleep.
Like with depression, what you say to yourself can highly influence what you feel. People that lean towards depression are more likely to think negative and pessimistic notions while people that are anxious will be overly fearful of real or imagined stressors.
Anxious self-talk is problematic because it is faster and more repetitive than depressed self-talk.
A cornerstone of anxious self-talk is the question “What if..?" When anxiety begins, you make ask yourself “What if my diabetes gets worse?" or “What if I misjudged what I ate and how much insulin I need?"
These questions are natural but anxiety begins to speed them up and repeat them endlessly. Then, the questions mutate to become less rational and more fear-based. Your body becomes tense, and you become more irritable.
Reducing Stress
Since the symptoms of anxiety stem from stress, reducing the overall stress you experience is a great method to improve your symptoms and your life.
For the best results, focus on improving the positive aspects of your life as well limiting the negatives. Here’s how:
Manage Your Diabetes
Obviously, this is easier said than done, but if you can find new and different ways to monitor and react to your symptoms, your life will be more enjoyable and less stressful.
Be sure to follow your doctor’s recommendations and let him or her know if there are struggles that you cannot seem to overcome. Perhaps, they will have great advice that you have never considered.
Environmental Positives
What is your favorite smell, sound, sight, taste or touch? Adding these into your day reduces stress by triggering positive associations in your brain.
Watching a favorite funny movie, spending time in nature or hearing a motivating song has power to influence your mood and energy levels. Use your senses as tools to fight back against stress.
Physical positives
Get plenty of sleep. Eat balanced meals centered on proteins and vegetables. Exercise daily. These simple necessities are too often overlooked. Rather than feel helpless to change your habits, take control. Understand the restrictions diabetes puts on you and push yourself to the limit.
Sleep, diet and exercise work closely together and provide many desirable chemicals to your body when in harmony. If one of the trio is lacking, experiment with the others to gain balance. Success is possible; you just haven’t found it yet.
Social Positives
Family, friends and online relationships offer support and comfort daily. Do you allow them to soothe you? Many people with high stress paradoxically push away positives. Be willing to accept verbal and physical affirmations from people in your life. Slow yourself down to pay attention to the positives.
Treating Depression and Anxiety with Therapy
If your best attempts to reduce stress have not resulted in less depression and anxiety, it may be time to seek professional assistance. A range of professionals are available, but great treatment almost always starts with a therapist.
A therapist, especially one trained in cognitive behavioral therapy (CBT), looks at your thoughts, feelings and behaviors to understand the connections and to look for opportunities for change.
In CBT, if you are having feelings of depression or anxiety, the goal is to change your thinking and/or behaviors to positively impact the unwanted feelings. As mentioned above, negative self-talk is a main contributor to unwanted feelings.
To change the flow of negativity, a CBT therapist will help you to monitor, challenge and replace your harmful self-talk with more desirable self-talk. Improved self-talk leads to improved moods.
After addressing cognitive changes, a CBT therapist will help you find behavioral solutions to lower your stress and improve your mood. Both depression and anxiety rob you of your motivation. A therapist can help you gain back your motivation by focusing energies towards positive and valuable activities.
Going for walks, meeting with friends, completing household tasks are a few examples of ways to begin changing your behavior. Another way to improve your behaviors is through relaxation training. A therapist will teach you ways to calm your body and mind through deep breathing and muscle relaxation. These are paramount if anxiety is your main complaint.
Along with improving your feelings, CBT has been shown to improve compliance with diabetes treatments and doctor’s recommendations. With this being true, seeking cognitive-behavioral therapy will help with the negative outcomes of diabetes while attacking the source of the stress. CBT is a fantastic fit for anyone with type-2 diabetes.
Another way to address depression and anxiety is through medication. A psychiatrist or other medication prescriber will assess your situation and choose a medication or combination of medications that are right for you. Be sure to tell your prescriber about your diabetes as some medications will not be appropriate for you.
Medications like tricyclics, monoamine oxidase inhibitors (MAOIs), Paxil and Remeron can bring about weight gain as a side effect. With diabetes, these medications may do more harm than good. Don’t fear, though, there are a range of medications that modify serotonin and norepinephrine in your brain to assist with improved symptoms.
Conclusion
Diabetes is a menace to your physical and psychological wellbeing. Do your best to watch for symptoms of long-term stress so that you can end problems before they escalate. If you were too late catching the stress, bring in the professionals. Therapists and psychiatrists have the training and experience to bring down your symptoms.
Don’t accept stress, depression and anxiety. Take control of your diabetes and mental health. Fight back for a better you.