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Mental health issues

Living with diabetes can be burdensome and can provoke anxiety, with the constant demands taking a toll on your mental health. As a result, many people experience distress, decreased mood and disabling levels of anxiety.

Mental health disorders can affect your ability to cope with and care for your diabetes. It is just as important to look after your mental health as it is your physical health.

Common feelings about diabetes

When you are first diagnosed with diabetes, you will likely feel a wide range of emotions, such as shock, anger, sadness and fear. It is normal to feel this way and to go through several emotional stages as you come to grips with having a chronic disease.

It is important to recognize your emotions and talk to your friends, family and members of your diabetes health-care team about how you are feeling. Your team can help you to learn effective coping skills and direct you to support services that can make a difference for you.

Shock/Denial

You may feel overwhelmed, confused and perhaps a bit numb by your diagnosis. You may even pretend that the diagnosis is incorrect and refuse to take any steps to manage the disease. Recognizing that diabetes will play an important role in your life is a major step towards accepting your condition.

Anxiety

Anxiety disorders cause excessive or unrealistic anxiety and worry about life circumstances, usually without a readily identifiable cause. You may be afraid because you don’t know very much about diabetes and you are not sure what is going to happen next. Or you may fear the complications of diabetes. You can reduce your anxiety by taking charge of your health, learning about diabetes and understanding how you can postpone or prevent complications.

Signs & symptoms of anxiety

The signs and symptoms of generalized anxiety disorder can vary in combination or severity. They may include:

  • Restlessness
  • Feeling of being tense or on edge
  • Feeling a lump in your throat
  • Difficulty concentrating
  • Fatigue
  • Irritability
  • Impatience
  • Being easily distracted
  • Muscle tension
  • Trouble falling or staying asleep (insomnia)
  • Excessive sweating
  • Shortness of breath
  • Stomach ache
  • Diarrhea
  • Headache

Treatment of anxiety

The two main treatments for anxiety disorders are medication (anti-anxiety drugs and/or anti-depressants) and psychotherapy ("talk therapy"), either alone or in combination.

If you have difficulty controlling your worries, or if anxiety interferes with your daily life, speak with your doctor, diabetes health-care team or mental health professional.

Anger

You may feel that it’s not fair that you have to deal with diabetes; you may resent the healthy behaviour changes that are an important part of diabetes management. Anger can also be a consequence of low blood glucose (sugar) levels. Talk to your health-care team if anger is interfering with your diabetes management.

Grief

After your diagnosis, you may feel grief similar to that experienced when a loved one dies. You may feel that your life has changed forever, and you mourn the loss of the lifestyle you had before your diagnosis. Having diabetes may make you feel vulnerable or weak, especially if you also have complications of the disease. Talking to someone who understands these feelings – perhaps another person with diabetes or a health-care professional/counsellor – can help alleviate your grief.

Depression

Although a period of grieving is normal with the diagnosis of any chronic disease, prolonged sadness may be a sign of depression. Depression is twice as common in people with diabetes as in the general population, and it is also associated with poorer blood sugar management, health complications and decreased quality of life.

Depression may develop because of stress and anxiety related to managing diabetes. Depression often goes undiagnosed and untreated. Individuals with diabetes should be regularly screened by their health-care provider for psychological distress and psychiatric disorders (e.g. depression and anxiety).

Symptoms 

Talk to your doctor if you continue to feel ‘down’ for more than a couple of months after your diagnosis or if you have other signs of depression:

  • Feeling tired most of the time
  • Changes in sleeping patterns
  • Changes in eating habits
  • Having trouble making decisions
  • Feeling hopeless or helpless.

Treatment

Depression can be effectively treated with medication, counselling or both. Prescription antidepressant medications are generally well tolerated and safe for people with diabetes. Specific types of psychotherapy can also relieve depression However, recovery from depression takes time. Antidepressant medications can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted.

If you think you may be depressed or know someone who is, don’t lose hope. Seek help.

Acceptance

Accepting the realities of having diabetes won’t happen overnight, or all at once. The most important thing to remember is that you are not alone. Talking to your family, a friend, someone else with diabetes or a health-care professional will help you deal with the ups and downs of your new life with diabetes.

Once you have accepted the realities of diabetes, it will be easier to make healthy behaviour changes – like increasing your activity level and making healthy food choices – that not only improve your diabetes management but your overall physical and emotional health as well.

To find out about opportunities in your community to learn more about diabetes and connect with other people living with it, check your local events listings.

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Resources

Diabetes Canada is Canada's largest resource hub for people with diabetes. Get the information and support you need to help manage diabetes.

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