Medically reviewed by Kelly Wood, MD — Written by Adam Felman
Diabetes impairs the body’s ability to use blood glucose. The most common types are type 1 and type 2.
To help manage this condition and keep blood sugar in a target range, people with diabetes typically need to follow a strict routine that involves medical treatments, a certain diet, and physical exercise.
Controlling diabetes can be overwhelming and may negatively affect emotional and mental health. Also, having hyper- or hypoglycemic episodes can impact a person’s mood and thinking.
All of these factors can be difficult to navigate and strain relationships. But learning about these effects of diabetes can help a person with the condition and the people around them build stronger, healthier relationships.
Diabetes and rapid shifts in mood
Growing evidence indicates a potential relationship between mood and blood sugar. Fluctuations in blood sugar, whether high or low, may cause a person to experience a variety of symptoms, which can include changes to mood.
The symptoms of low blood sugar that might affect a person’s mood include:
- confusion
- nervousness or anxiety
- hunger
- difficulties with coordination, concentration, and decision making
- aggression, irritability, and impatience
- personality and behavioral changes
Having high blood sugar may also cause symptoms that could affect mood, such as:
- difficulty seeing or concentrating
- feeling unwell
- feeling tired or having low energy
Moreover, during periods of stress, the body releases the hormone adrenaline. The body may also release adrenaline to help a person recover from an episode of low blood sugar.
The release can bring about a fight-or-flight state known as an adrenaline rush. When the body triggers this response, it can cause:
- heightened awareness
- dizziness
- lightheadedness
- vision changes
- restlessness
- irritability
- a nervous, jittery sensation
While blood sugar can affect mood, a person’s mood may also affect their blood sugar levels.
A pre-print paper from 2020 describes research indicating that mood and stress can significantly influence blood glucose levels and glycemic variability. However, as a 2020 systematic review points out, understanding the relationship requires more research.
Having diabetes can lead to what some people call diabetes distress. This stress response may stem from the burden of managing diabetes every day. Some people call this “diabetes-specific” distress or “diabetes-related” distress.
Evidence suggests that this may affect:
- 1 in 4 people with type 1 diabetes
- 1 in 5 people with insulin-dependent type 2 diabetes
- 1 in 6 people with non-insulin-dependent type 2 diabetes
A doctor may use the Problem Areas In Diabetes scale and the Diabetes Distress Scales to help identify the condition and help guide conversations and care.
Potential symptoms of diabetes distress may include:
- anger and frustration about the demanding nature of the condition
- worry about being able to manage it
- a low level of motivation to manage the condition
- avoiding appointments or checking blood sugar levels
- making unhealthy choices
- feeling isolated
The symptoms of diabetes distress may overlap with those of some other mental health conditions, but they are distinct and so require different assessments and management strategies.
Diabetes distress stems from factors that relate to diabetes. As such, medications cannot typically treat it. Improving the diabetes management plan and attending therapy may help reduce the symptoms and underlying stress.
People may also experience “diabetes burnout.” This refers to physical or emotional exhaustion that results from continuous distress related to diabetes management.
A person may feel that despite their best efforts, they are unable to control their blood glucose, leading to a sense of powerlessness. This can negatively affect their management and their health.
Symptoms of diabetes burnout may include:
- disengagement from self-care
- uncontrolled or unhealthy eating
- risk-taking behaviors
- not attending appointments
People with diabetes have an increased risk of depression. Because managing the condition typically involves lifestyle changes and added responsibilities, people may find it burdensome and emotionally draining.
Evidence suggests that people with diabetes are 2 to 3 times more likely to have depression. However, it can be difficult to detect and diagnose depression in people with diabetes. For this reason, it is advisable for people to have regular mental health screenings during their visits to a doctor.
Some symptoms of depression may include:
- lack of interest in activities
- changes in sleep patterns
- sleep disturbances
- changes in appetite
- trouble concentrating
- a loss of energy
- nervousness
- guilt
- feelings of sadness, emptiness, or both
- suicidal thoughts
Depression may appear differently in teenagers, and it may cause:
- declining school performance
- withdrawing from friends and activities
- anger, agitation, and irritability
Like diabetes, depression is treatable. And having both conditions does not one make one less treatable.
A member of a diabetes care team might refer a person to a mental health specialist, who can help create a treatment plan. This plan might include therapy, medications, and stress management.
Suicide Prevention
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.
Click here for more links and local resources.
If you know someone at immediate risk of self-harm, suicide, or hurting another person:
- Ask the tough question: “Are you considering suicide?”
- Listen to the person without judgment.
- Call 911 or the local emergency number, or text TALK to 741741 to communicate with a trained crisis counselor.
- Stay with the person until professional help arrives.
- Try to remove any weapons, medications, or other potentially harmful objects.
If you or someone you know is having thoughts of suicide, a prevention hotline can help. The National Suicide Prevention Lifeline is available 24 hours per day at 800-273-8255. During a crisis, people who are hard of hearing can use their preferred relay service or dial 711 then 800-273-8255.
Click here for more links and local resources.
Anxiety disorders are a group of mental health conditions that can cause persistent feelings of nervousness and worry.
Managing a long-term condition, such as diabetes, can be a major source of anxiety. And experiencing anxiety can affect a person’s diabetes self-management. Some evidence suggests that having one condition may increase the risk of developing the other.
Moderate to severe symptoms of anxiety may affect 1 in 5 people with insulin-dependent type 2 diabetes or 1 in 6 people with either type 1 diabetes or non-insulin-dependent type 2 diabetes.
It can be difficult to diagnose anxiety disorders, as people may mistake the symptoms for those of hypoglycemia. Anxiety symptoms vary, but they can include excessive, persistent worry, panic attacks, irritability, confusion, sweating, and disrupted sleep.
Potential treatments include therapy, medications, and strategies such as staying physically active, practicing relaxation techniques, and taking steps to improve sleep.
Effects of diabetes on relationships
Having type 1 or type 2 diabetes may place strain on relationships due to the factors that we describe above. Also, having any chronic condition can increase the need for emotional support and the potential for frustration and tension, which can lead to conflict.
Understanding diabetes’ range of potential effects can help loved ones provide support and help strengthen the relationship.
A 2020 study highlights the effects of spousal influence on diabetes management and health behavior. This emphasizes the roles that healthy intimate relationships can play in self-care and improving diabetes outcomes.
Also, diabetes can impact a person’s sex life. Possible complications can include erectile dysfunction, vaginal dryness, and a lower sex drive. Communication is essential. Discussing any sexual effects and finding ways to work with them together can help.
Tips for helping someone cope
A person with diabetes and their loved ones may benefit from strategies such as:
- Paying attention to feelings: Regularly experiencing frustration and stress may suggest that a person needs more help managing their condition.
- Talking about feelings and concerns: Members of a healthcare team, friends, and family may be able to help. They might, for example, help think about ways to manage feelings of judgement.
- Allowing loved ones to help: A person does not need to bear all the responsibilities of managing diabetes alone. Those closest to them can help remind them to take medications, monitor their blood glucose, and do physical activities together.
- Talking to others with diabetes: Others with diabetes are likely to understand and may provide helpful advice.
- Doing one thing at a time: To reduce stress, people may benefit from making a list of tasks and working through each point individually. This can also help a person recognize which tasks are more immediate and which can be done in time.
- Taking time out for fun: It is important to set aside time to enjoy activities.
- Asking for help: Healthcare professionals may be able to connect people with programs that help cover the costs of diabetes care medications and supplies.
If a person notices rapid fluctuations in their mood or any other symptoms that might indicate a mental health condition, it is advisable to contact a doctor.
A healthcare professional can review a person’s diabetes management plan and recommend tips or different medications. They may also be able to diagnose a mental health condition and suggest appropriate treatment or issue a referral to a doctor who can.
A person should seek immediate medical attention or call 911 if they or someone they know is experiencing suicidal thoughts or thoughts of self-harm.
Summary
Diabetes is a chronic condition that can affect both physical and mental health. Fluctuations in blood sugar may lead to rapid changes in mood, for example. And a person may find managing diabetes every day overwhelming, and this stress can have various effects on mental health.
By learning how diabetes can affect relationships, loved ones can provide support. Encouraging communication is key.
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