The mental health effects of type 1 diabetes

Type 1 diabetes can affect a person’s mental health in many ways. Research indicates that people with type 1 make between 180 to 300 decisions about their medical care daily. This constant decision making about managing their condition can be emotionally and physically draining, and it can lead to burnout, anxiety and depression.

How diabetes and mental health are connected

Having diabetes requires significant changes to your daily routine due to managing the constant fluctuations in blood sugar. This entails important behaviors, including eating the right foods, exercising regularly and taking medication. Diabetes can also make a person feel unsettled physically, or like you have less energy to deal with these new concerns.

Changes in blood sugar can also cause rapid changes in mood, fatigue and trouble thinking clearly. These and other factors put people with diabetes at a higher risk for mental health problems, including:

• Anxiety — Research suggests people with diabetes are 20% to 30% more likely to have anxiety because of the constant burden of monitoring blood sugar levels, managing insulin and worrying about complications.
• Depression — Conservative estimates are that 30% of people with diabetes are at an increased risk due to the stress of managing their condition.
• Eating disorders — Dietary restrictions and the complexities of managing type 1 diabetes can make some people more susceptible to eating disorders, such as “diabulimia” (withholding insulin to lose weight).

Self-care practices for type 1 diabetes management

Being newly diagnosed with diabetes can be overwhelming. To help maintain emotional stability and prevent anxiety and depression triggers, focus on the basics of diabetes management, which include:

• Eating healthy — focus on a balanced diet with focus on nutrient dense food
• Learning to read nutrition labels, particularly sources of carbohydrates and where they hide
• Following your insulin/medication as determined by your health care provider, despite the complexity and dynamic nature of blood sugar
• Regularly monitoring and adjusting your blood sugar
• Getting physical activity — aim for at least 30 minutes of moderate exercise on most days of the week. This can include walking, swimming or cycling.
• Managing stress — learn ways to manage stress, because it can affect your blood sugar levels

Mindfulness is an effective tool that can help manage stress by teaching you ways to be in the present moment instead of in your head worrying about the future. The Ohio State Integrative Health Mindfulness in Motion program provides access to a variety of free mindfulness recordings to combat burnout while increasing resiliency and overall quality of life.

How caregivers and loved ones can support type 1 diabetics

The support and empathy of family and loved ones for people with type 1 diabetes is critical to success. Here are ways that family and friends can help:

• Get educated about type 1 diabetes and how it affects your loved one.
• Avoid making judgments or assumptions about their diagnosis. Understand that insensitive comments about their eating habits, weight or inactivity are hurtful and can contribute to feelings of anxiety and depression.
• Help with daily tasks, such as checking blood sugar, administering medicine and preparing healthy meals.
• Be a good listener and encourage them to share their worries and frustrations.
• Encourage healthy habits like having a healthy relationship with food and staying active to help manage blood sugar levels, lower stress and prevent other health issues.
• Track appointments, ask questions at doctors’ appointments and be there for moral support.

When to seek mental health support

People with type 1 diabetes who are experiencing frustration in managing their condition shouldn’t ignore their feelings. Make your loved ones and health care team aware so they can watch for other possible signs of anxiety, depression and burnout.

As a behavioral health provider of people with type 1 diabetes, I believe in early and frequent screenings to analyze and assess mood symptoms. The earlier we can intervene and treat anxiety, depression or an eating disorder, the less chance there is of worsening diabetes management and negatively impacting a patient’s overall health.

New program at Ohio State addresses the mental health needs of diabetics

A new program at The Ohio State University Wexner Medical Center called the Type 1 Diabetes Experience (T1DE) addresses the unique emotional, behavioral and physical challenges of diabetes. The program provides:

• Individual therapy to help manage mood symptoms, burnout and other stressors that may accompany diabetes care
• Support for families dealing with the impact of a type 1 diabetes diagnosis
• Coping strategies for dealing with daily blood sugar fluctuations, dietary challenges and navigating the health care system
• Group therapy sessions to foster community and shared experiences among individuals living with diabetes