Depression and Diabetes: What Is the Link?

Diabetes and depression are both serious conditions, and they act on the body in very different ways. Yet research keeps finding a connection between them. When a person has one, the odds of developing the other go up. For anyone living with both, or caring for someone who is, that overlap changes how treatment works and how you offer support.

Start with what diabetes actually does. It interferes with how the body turns food into energy. In a healthy person, food is broken down into glucose, which cells either burn for fuel or store as fat. Insulin is the hormone that lets glucose move into cells and become usable energy. In diabetes, either insulin production falters or the body stops responding to the insulin it makes. The result is glucose piling up in the blood while the cells themselves go hungry for fuel.

Depression works on a different level. It changes how a person feels physically and emotionally, and it drags down the ability to get through ordinary days. It tends to show up in people carrying certain genetic risk factors who also hit a wall of stress, trauma, grief, or some other heavy life event. The symptoms run long: stretches of sadness that don't lift, hopelessness, guilt, irritability, trouble holding onto details, restlessness, losing interest in things, shifts in sleep and appetite, aches with no clear cause, a sense of worthlessness, anxiety, numbness, trouble concentrating, and difficulty making even small decisions.

The link between the two is well documented. What stays murky is the direction of it. Does depression raise the risk of diabetes, or does diabetes raise the risk of depression? It seems more likely that a diabetes diagnosis would set off depression than the other way around, but the evidence suggests both paths are real. One thing is not in doubt: diabetes can deepen depressive symptoms.

Depression already makes daily life a grind, so stacking diabetes management on top of it can leave a person feeling buried. They may skip or forget parts of their treatment plan, which then worsens both conditions at once. That feedback loop can spiral into a combined diabetic and depressive crisis.

Supporting a Loved One with Depression

If you're helping someone through depression, lead with understanding. Stay reassuring. Keep the support steady rather than occasional. When both diabetes and depression are in play, there are a few specific things to hold onto. The biggest one: managing diabetes will almost certainly be hard for them. Offer to help track medications, insulin injections, and blood glucose readings. Nudge them to stay with the diet their doctor set out. Treat the whole plan as something you're doing together.

Expect slip-ups, and watch how well the diabetic plan is being followed without turning it into an inquiry. Blame doesn't help. It can push the depression further down and make the person feel you've checked out on them. So instead of 'You haven't been monitoring your blood glucose like you're supposed to,' try something like, 'How can I help you stay on top of your blood glucose? Let's handle it together.'

There's also the medication side. Make sure they talk through their prescriptions with their doctor. Some antidepressants cause weight gain, which complicates diabetes and is worth steering away from. On top of that, many people with diabetes are managing other conditions and taking several drugs at once, so a conversation with the doctor about possible interactions matters a great deal.

These two illnesses feed into each other. Whether diabetes drives the risk of depression or depression drives the risk of diabetes isn't settled, and the research points to both happening. When you're helping someone carrying both, remember that the ordinary day-to-day demands of diabetes will be genuinely tough for them. Keep the doctor in the loop, because drug interactions and side effects can quietly make the diabetes worse. With consistent care and the right treatment, depression can ease, and a person with diabetes can go on to live a full, healthy life.

- Tina Fuster

1. Depression and Diabetes. (n.d.). Retrieved January 8, 2015, from http://www.nimh.nih.gov/health/publications/depression-and-diabetes/index.shtml

2. Diabetes and Depression. (n.d.). Retrieved January 8, 2015, from http://psychcentral.com/lib/diabetes-and-depression/000138