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Diabetes and depression fact sheet

PDF coverThis fact sheet is available in two formats.

You can download and print out the PDF version.

Or you can read it as a website page below.

Everyone feels down or sad from time to time. For most people, these feelings don’t last long. However, for some, the sadness becomes so intense and long-lasting that it starts to affect daily life, including work, school, relationships and diabetes management. If you feel this way, you may have depression, but you are not alone. There are many things you can do to overcome your feelings of depression.

 “Having depression when you’ve got diabetes is even more difficult. You feel completely hopeless yet you still have to take care of yourself. It’s like you’re in a dark box and you can’t get out of it.”

Craig, 48, person with diabetes

What is depression?

Depression is much more than sadness. It is a serious mental health condition. It affects how you feel about yourself and your life, it can prevent you from fully engaging in daily tasks, social activities, and relationships.

Symptoms of depression include:

  • having little interest or pleasure in doing things
  • feeling down
  • having trouble falling or staying asleep—or sleeping too much
  • feeling tired, or having little energy
  • having a poor appetite—or over-eating
  • feeling bad about yourself (that you are a failure, or that you have let yourself or your family down)
  • having difficulty concentrating
  • moving or speaking very slowly—or being fidgety or restless
  • having thoughts that you would be better off dead.

If you have had any of these symptoms for at least two weeks, talk to your general practitioner (GP). They can make an assessment, offer treatment and/or refer you to a mental health professional.

It is important that you seek help from a qualified health professional.

What has depression got to do with diabetes?

Depression is one of the most common mental health issues Australians experience. Some people with diabetes have depression before a diagnosis of diabetes, while for others, depression is diagnosed later. The latter could be because of the emotional burden of managing diabetes. The link between depression and diabetes is not yet fully understood, and research is ongoing.

What is clear is that depression can affect the way a person manages their diabetes and, in turn, their physical health. Some examples include:

  • checking blood glucose less often, or missing medical appointments due to lack of motivation or energy to manage diabetes
  • avoiding injecting in public, or not injecting at all, perhaps due to shame or feeling like a failure.

Depression can sometimes co-exist with anxiety, a common mental health problem. For more information, see the National Diabetes Services Scheme (NDSS) fact sheet, Diabetes and anxiety.

Do you feel this way because of depression or diabetes?

Depression and diabetes share some of the same symptoms, including fatigue, sleep problems, and difficulty concentrating. This can sometimes make it difficult to know whether your feelings are caused by your diabetes, or due to depression, or both.

Even if depression is not related to your diabetes, it can have negative effects on your health, life, and relationships.

What you can do

It is important that you seek help from your GP or another qualified health professional. They can help you to identify if you are experiencing depression, offer treatment or make a referral to a mental health professional if needed.

Whether or not you are experiencing depression, it’s important to look after your emotional well-being.

Some of the following strategies may work for you—others may not, and that’s okay. They may give you ideas about other things you could try.

Reach out

Depression can make you feel like you are alone. You might even feel like there’s no point living anymore. If you feel this way, talk to someone immediately. The people who care about you will want to support you.

  • Make a point of talking to at least one person every day.
  • If you don’t feel like you have anyone to talk to, call a helpline, talk with your GP, or join a support group or an online community. You don’t need to go through this alone.

Move your body

This might feel like the last thing you want to do when feeling down, but physical activity can really help. It has powerful effects on the brain and can improve the way you think and feel about yourself. Try to be active every day.

  • Start small. For example, start with one short walk every second day, then gradually increase the time you spend walking and how often you walk.
  • Try to get out and enjoy nature while you move, as this helps to reduce stress.

Try to be thankful

When it seems like there is no hope, expressing gratitude can be tough. However, being thankful can lift your mood and have a positive impact on the way you view your world. Think about one thing every day that you can be thankful for, no matter how small or trivial it may seem.

It might be hard to think of things to feel thankful for, but there is always something. A roof over your head, food to eat, or someone who loves you are some examples.

Writing it down is a good way of getting your feelings ‘out in the open’.

Be present

Focusing on the present moment can be a real challenge, but it can also be a source of great happiness and serenity. Try a mindful breathing exercise (see box Mindful breathing exercise). It might take some practice but, once you’ve tried it a few times, it may surprise you by how helpful it is for improving your well-being. If this kind of thing isn’t for you, that’s okay, just skip it.

Mindful breathing exercise

Practise this any time you feel yourself getting caught up in negative thoughts.

  1. With your eyes closed, or fixed on a spot in front of you, take 10 slow, deep breaths. Breathe out as slowly as possible until your lungs are completely empty. Then allow them to refill by themselves.
  2. Notice the sensation of your lungs emptying. Notice them refilling. Notice your ribcage rising and falling. Notice the gentle rise and fall of your shoulders.
  3. See if you can let your thoughts come and go as if they are just cars passing by.
  4. Notice your breathing and your body. Then look around the room and notice what you can see, hear, smell, touch, and feel.

Get enough sleep

Being tired makes it difficult to feel calm and relaxed. Try to have a sleep routine by going to bed and waking at the same times each day. Here are some tips that might help:

  • Keep a sleep diary to help you understand some of your patterns.
  • Reduce your caffeine intake: limit your coffee, tea, and soft drinks, and don’t drink them after 4pm.
  • Be active during the day but don’t do strenuous physical activity right before bedtime.
  • Avoid napping during the day.
  • Remember, bed is for sleeping, so avoid watching TV, checking emails, or using your phone in bed.
  • Make sure the room is quiet and dark.

Be close to others

Being in close contact with others helps to reduce stress and improve well-being. Physical contact makes us happier, so hug a loved one or stroke a family pet.

Talk with a professional

The strategies above may give you some ideas about how to prevent or reduce depression. However, they can’t replace professional help. It’s always a good idea to talk about your concerns with your GP or another qualified health professional.

Who can help?

Your diabetes health professionals

Your diabetes health care team is there to help you with all aspects of your diabetes, including how you feel about it. Share your feelings with them if you are comfortable to do so, they will give you non-judgmental support and advice. You may want to talk with your:

  • general practitioner (GP)
  • endocrinologist
  • diabetes educator
  • nurse practitioner
  • dietitian.

Bring this fact sheet to your appointment to help get the conversation started. You will probably feel relieved after sharing your feelings, and it will help your health professional to understand how you are feeling.

Together, you can make plans to manage your depression.

A psychologist or psychiatrist

You might like to talk with a psychologist or psychiatrist. These professionals are best placed to make a diagnosis and provide treatment for depression. Treatment may involve the following:

  • One-on-one counselling (e.g. cognitive behavioural therapy)
  • Medication (e.g. anti-depressants)
  • A combination of psychological therapy and medication.

Ask your diabetes health professional if they know a psychologist or psychiatrist in your area who is familiar with diabetes, or try the following:

You will need a referral from your GP to see a psychiatrist, but not to see a psychologist.

Your GP can tell you if you are eligible for a Mental Health Treatment Plan to reduce the costs of seeing a psychologist or psychiatrist.

“Don’t be afraid to ask for help. Seeing a psychologist is one of the best things I ever did.”

Rodney, 36, person with diabetes

More information and support

beyondblue

beyondblue.org.au or ph 1300 224 636

Beyondblue provides information and support to people with depression or anxiety or anyone going through a tough time. Support services are available via telephone, email or live chat, including online forums where you can connect with others.

Lifeline

lifeline.org.au or ph 13 11 14

Lifeline offers 24-hour confidential telephone and online crisis support. People contact Lifeline for a range of reasons, including feelings of depression, stress, anxiety and suicidal thoughts or attempts.

Peer support

ndss.com.au
(search for ‘Publications & Resources’)

To find out what peer support is and how you can access it in your area, refer to the National Diabetes Services Scheme (NDSS) leaflet, Peer support for diabetes.

Diabetes Australia and the NDSS

diabetesaustralia.com.au
ndss.com.au
NDSS Helpline 1300 136 588

Through the NDSS, you can access a free national NDSS Helpline to obtain information about diabetes and learn about education programs, peer support groups, and other events.

The NDSS and you

A wide range of services and support is available through the NDSS to help you manage your diabetes. This includes information on diabetes management through the NDSS Helpline and website. The products, services and education programs available can help you stay on top of your diabetes.

This fact sheet is intended as a guide only. It should not replace individual medical advice and if you have any concerns about your health or further questions, you should contact your health professional.

Version 2 December 2018. First published June 2016.