Depression and diabetes: What’s the connection?

Though depression and diabetes are distinctive conditions, with unique symptoms and effects, research suggests that there are strong links between them.

Below is an overview of depression and diabetes, including risk factors, possible ways they are connected, and suggestions for coping with symptoms of both.

What is diabetes?

Diabetes is a common condition that affects blood sugar levels. Food consumption helps the body produce natural sugar, or glucose, which serves as fuel and is controlled through a hormone known as insulin. Insulin helps the body turn glucose into cells that become energy. When the body doesn't produce enough insulin, it loses energy due to glucose buildup in the blood. These disruptions in insulin production can vary based on which type of diabetes an individual experiences, type 1 or type 2.

The two types of diabetes

Type 1 diabetes is a condition in which insulin production is limited. It is common among young adults and children. People with this condition often must increase their insulin levels daily through injections or a pump. Genetics and environmental factors may play a role in how this type of diabetes develops in the body, but research into the condition’s causes is ongoing. Symptoms of type 1 diabetes include extreme fatigue, frequent urination, increased thirst, weight loss, consistent hunger, and blurred vision. A person may experience more severe, life-threatening effects if their glucose levels get too low.

Type 2 diabetes is more common among people aged 40 and above, though its symptoms can arise earlier. Weight is considered a primary factor in this form of the condition. People with type 2 diabetes may also have high blood pressure and insulin resistance. Some may not process insulin properly or experience a decrease in its production. Symptoms are similar to type 1 diabetes but also include nausea, risk of urinary infections, and slow healing of bruises, sores, and wounds.

Sometimes, type 2 diabetes is present without symptoms, so a person may have it and not know. If you suspect you may have diabetes, or you are experiencing related symptoms, consider talking to your doctor. Diabetes is typically diagnosed through a blood test to check glucose levels. 

What is depression?

Depression is one of the most common forms of mental illness—it is estimated that 5% of adults globally live with the condition. Depression encompasses several different depressive disorders, including major depressive disorder, persistent depressive disorder, postpartum depression, and seasonal affective disorder. Though each disorder has unique characteristics, the symptoms of depression are often similar and include:

• Low mood
• Lack of pleasure in activities once enjoyed
• Trouble sleeping at night or the desire to sleep more during the day
• Waking up early and not being able to go back to sleep
• Changes in weight, such as losing or gaining too much in a short time period
• Trouble concentrating
• Irritability or anger
• Feelings of worthlessness
• Thoughts of self-harm

If you or a loved one is experiencing suicidal thoughts, reach out for help immediately. The 988 Suicide & Crisis Lifeline can be reached by calling or texting 988 or chatting with a representative.

Sometimes, depression is related to significant life events, such as a death, a job loss, or divorce, though it can also occur without a discernable cause. Having low self-esteem, lack of social support, and a family history of depression may also increase the risk of developing the disorder. While it can present significant challenges, depression is a treatable condition that can be successfully managed with the right approach.

Understanding the diabetes-depression connection

There is a substantial amount of research linking diabetes and depression. It is thought that this relationship is bidirectional, meaning the existence of either condition can increase the risk that an individual will develop the other. Studies suggest that the conditions have many biological and behavioral similarities. However, there are not thought to be any genetic links. 

Researchers are still examining the mechanisms behind this connection. While the exact reasons for the high level of comorbidity are unknown, there are indications that stress is a common factor. The emotional impacts of living with diabetes, along with the stress of controlling the condition, may lead to depression symptoms. People living with type 1 diabetes, which can be more difficult to manage than type 2, may be at more at risk of experiencing stress. Additionally, diabetes may lead to other health complications that can worsen stress, particularly if it isn’t properly managed. 

Stress caused by depression, on the other hand, may lead to insulin resistance, which can be a factor in type 2 diabetes. Stress can also cause insulin resistance through impacts to immune functioning. Depression’s physical effects are also thought to contribute to diabetes. Because depression can cause symptoms like altered eating habits and weight gain—and may lead to maladaptive coping mechanisms like smoking, a potential contributor to type 2 diabetes—diabetes can become a significant risk. 

Another factor implicated in the connection between the two conditions is inflammation. Inflammation helps the body fight infections, but with depression and diabetes, it has been implicated as a potential contributor. In diabetes, it is thought to influence insulin levels; and in depression, it can create alterations in brain structure, which are increasingly being considered a primary cause of the condition. 

How to cope with diabetes and depression

If you’re living with diabetes and depression, know that you’re not alone. There are many methods of addressing symptoms of both conditions and fostering physical and mental wellness in your life. Many individuals have been able to reduce diabetes symptoms through a treatment plan established by their doctor, self-care methods, and support from family and friends. Additionally, treatment methods like therapy, medication, and support groups can be effective ways to cope with depression. Below are some strategies for coping with diabetes and depression. 

• Learn the signs of depression and diabetes – Understanding how symptoms of both conditions typically manifest can be the first step toward addressing them. 
• Consider therapy – If you think depression is a concern in your life, consider working with a specialist. Therapists can provide support, connect you with useful tools, and give you guidance if you’re living with the emotional effects of diabetes, depression, or both. 
• Review programs for diabetes self-care – There are self-management programs to help people focus on their diabetic needs, including assessing fitness levels, controlling metabolism, and managing weight. These programs may help you determine whether you’re at risk for developing other health concerns, such as heart disease. 

• Understand medication side effects – Talking with a mental health or medical professional about how a medication for on condition may affect the other (e.g., how depression medication can affect blood sugar levels) can be helpful. Always consult with a healthcare provider prior to starting or stopping any medication. 
• Identify potential lifestyle changes – Consider assessing your daily habits and setting goals for what you want to improve. Developing a schedule can help with routine actions such as taking medication, participating in therapy, and exercising. You can also work with a healthcare professional to identify foods that are recommended for both conditions and incorporate them into your diet. Other lifestyle changes may include avoiding stressful situations, when possible, and learning common stress management techniques.

Managing symptoms of both depression and diabetes can be vital to your mental and physical health, particularly when they’re comorbid. Controlling depression symptoms can make it easier to cope with or reduce the risk of diabetes, and managing diabetes can reduce the risk that you’ll experience mental health complications.

Managing diabetes-related depression with online therapy

Studies suggest that online therapy can help individuals with diabetes manage symptoms of depression. In a study published in the Journal of Medical Internet Research, researchers found that, following an online therapy program for those with comorbid depression and diabetes, 87% of participants no longer met the criteria for major depressive disorder. The study also notes that these improvements were sustained at a 3-month follow-up. 

If you’re living with the emotional effects of depression or diabetes, know that help is available. Online therapy through BetterHelp allows you to address challenges related to comorbid diabetes and depression from the comfort of home, through video call, voice call, or in-app messaging. BetterHelp works with thousands of mental health professionals—who have a range of specialties—so you’ll have a good chance of connecting with someone who can address your specific concerns regarding diabetes, depression, or similar health challenges.