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Diapression: Unravelling the Link Between Diabetes and Depression

Diabetes can mess with your blood sugar and your mood - it can be tiring and demanding. Living with diabetes means you should pay special attention to your mental and physical health.

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What is diapression?

Depression can affect anyone. In fact, 1 out of 4 UK1 and 1 out of 5 US adults have had depression or anxiety2. People living with diabetes, however, are up to three times more likely to experience depression than people without. For many, the need for constant self-care and lifestyle adjustments that come with diabetes treatment can be physically and emotionally challenging.

Research suggests that this can lead to a person having symptoms of depression alongside those of diabetes3. This overlap of diabetes and depression led to the term 'diapression4.' 

The term diapression - sometimes called diabetes distress5 - describes the complicated overlap between depression and diabetes. It is not a formal diagnosis, but it acknowledges the psychological issues faced by those living with both.

Understanding the connection between diabetes and depression is a complex issue that is little understood. Diabetes is a long-term condition that affects around 4.3 million people in the UK6 and 38 million in the US.

There are two types of diabetes:

  • People with type 1 diabetes produce very little insulin or no insulin at all.

  • People with type 2 diabetes often produce enough or even too much insulin but the tissues aren't sensitive enough to recognise it.

To manage diabetes, you have to make major changes to your diet and exercise routine7. Also some people may have to take insulin or other types of medication several times a day at specific times8. Managing it effectively to keep yourself healthy can feel like a full-time job.

People with pre-existing symptoms of depression can find they become worse because of the sometimes exhaustive nature of everything that comes with routine diabetes management.

Evidence suggests that depression can increase your chance of developing type 2 diabetes9. Some studies found that having long-term high blood sugar (hyperglycaemia) in type 1 diabetes can affect brain chemistry, which may mean a higher chance of developing depression10.

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How does depression affect diabetes treatment? 

The impact of diapression is significant. It can create a mix of symptoms and unwelcome side effects arising from both diabetes and depression. This can fuel a negative cycle, where each condition worsens the other, making it harder to manage your diabetes.

These symptoms can include:

  • Loss of interest in being around people - which can make it harder to keep up with medical appointments.  

  • Major depressive mood cycles - might mean you neglect your medications, stop checking your blood sugars, or both.

  • Increased tiredness - which is crucial for managing diabetes, can make exercise more daunting.

  • Overeating - can cause blood sugar levels to spike.

  • Skipping meals or under-eating - can lead to low blood sugar (hypoglycaemia), especially if you take insulin or other medications that lower blood sugar.

  • Feeling bad about yourself or having suicidal thoughts - can result in harmful behaviours, which can make managing diabetes even harder 11.

What is the treatment for diapression?  

As healthcare experts better understand the link between physical and mental health, treating these two conditions together is becoming more common.

It's important to pay early attention to these symptoms to improve your chances of treatment and recovery12. Managing diabetes alongside depression takes time but Diabetes UK gives this advice to help lift your mood:

  • Share your feelings with friends and family - helps release built-up feelings and gain a clearer view of your emotions.

  • Talking therapy - such as cognitive behavioural therapy (CBT) may help improve both your mental wellbeing and overall quality of life13. So if what you're feeling seems more than temporary, it’s time to talk to your doctor.

  • Regular activity - even if it's just taking a walk or lifting weights in your living room - helps with weight, blood sugar, and the release of feel-good chemicals (endorphins)14

  • Explore some positive eating guidance - for insights on nurturing both a healthy body and mind.

Diapression is a condition shared by many and there will be other people going through similar health problems. If you think you are affected by diapression, speak to your doctor for further advice and guidance.

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Further reading 

  1. NHS England: One in four adults and one in 10 children experience mental illness, and many more of us know and care for people who do

  2. Villarroel et al: Symptoms of Depression Among Adults: United States

  3. Bădescu et al: The association between Diabetes mellitus and Depression 

  4. Ciechanowski: Diapression: An Integrated Model for Understanding the Experience of Individuals With Co-Occurring Diabetes and Depression 

  5. Skinner et al: Twenty-five years of diabetes distress research 

  6. Diabetes UK: Number of people living with diabetes in the UK tops 5 million for the first time

  7. Fujiwara et al: Relationship between diet/exercise and pharmacotherapy to enhance the GLP‐1 levels in type 2 diabetes 

  8. NIH: What is Diabetes? 

  9. Deleskog et al: Severity of depression, anxious distress and the risk of type 2 diabetes 

  10. Gilsanz et al: The Bidirectional Association Between Depression and Severe Hypoglycemic and Hyperglycemic Events in Type 1 Diabetes

  11. Voiţă-Mekereş et al: A Review of the Level of Depression in Patients with Diabetes 

  12. Owens-Gary et al: The Importance of Addressing Depression and Diabetes Distress in Adults with Type 2 Diabetes 

  13. Abbas et al: Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial 

  14. Narita et al: Physical activity for diabetes-related depression: A systematic review and meta-analysis

Article history

The information on this page is peer reviewed by qualified clinicians.

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