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If dealing with your diabetes has got you down, you’re not alone. People with diabetes, particularly those with chronic uncontrolled blood sugar levels or diabetes-related complications, are at increased risk for depression. In fact, researchers estimate that up to a third of people with diabetes are clinically depressed. And it turns out that not only does diabetes lead to depression, but also “it looks like it goes both ways,” says William H. Polonsky, Ph.D., C.D.E., founder of the Behavioral Diabetes Institute and associate clinical professor at the University of California, San Diego. “Someone with significant depression is more likely to develop diabetes.” This can set in motion a vicious cycle of problems with diabetes self-care, which can then trigger more depression, and so on.
Even folks who are able to control their diabetes well and are in good physical shape can experience diabetes burnout, a kind of frustration and feeling of being overwhelmed that comes from handling a chronic disease. “For many people, diabetes burnout is what we call a 24/7 problem,” says Polonsky, author of Diabetes Burnout: What to Do When You Can’t Take It Anymore. “You feel like diabetes is running your life. It feels out of control and there is nothing you can do about it,” he explains. “That is sort of the nugget that lies at the core of diabetes burnout.”
You can, however, gain control over your diabetes and beat the blues. The first step is to understand that the disease doesn’t condemn you to an early death or terrible problems. “It’s often said that diabetes is the leading cause of blindness, amputation and kidney disease,” Polonsky says. “This is completely false! Poorly managed diabetes is the leading cause of those problems. This is the 21st century. With good care and effort, the odds are good that you can live a long and happy life with diabetes.”
But almost no one can control their diabetes without some help. First, you need a doctor who is knowledgeable about diabetes. You may then want to build up a whole support team: a nutritionist to help you establish good eating habits, a certified diabetes educator to help coordinate your care and answer your questions, an exercise physiologist to help you increase your level of physical activity and find ways to make it a permanent part of your life and a psychotherapist for good measure.
Polonsky suggests two steps to counter depression and burnout while you are working with your healthcare team to establish good diabetes control.
Step One: Get Some Insight
If you’re burnt out or depressed, therapy can help you become aware of how you may be sabotaging yourself. “We ask people to challenge their habitually negative ways of thinking that cause them to spiral down into depression,” Polonsky says. “And then we try to help them get reengaged socially to break the isolation that so often accompanies depression.” If a person resumes a job or a volunteer position, they can rediscover a sense of connection and meaning in their lives. The physical act of just getting out of the house or office can help people get back on track with their lives. “There have been some tremendous studies,” he adds, “that show that this can help people recover from depression.”
Step Two: Establish Priorities
“Write out a list of action steps, and then make a plan that doesn’t set your expectations too high,” Polonsky advises. “Remember, you may not be able to do everything all at once. So, with your doctor’s help, decide which actions you can take that you will give you the biggest bang for your buck and focus on those first.” For example, working with your healthcare team, consider making a vow to take your medication on time every day for a month. After that is accomplished, keep it going and add a promise to test your blood sugar levels as many times a day as your doctor recommends. Step by step, you will take control of your diabetes. Feeling better will also help you feel empowered. “If you don’t control your diabetes, it will control you,” Polonsky cautions. “The good news is that you can control it, one positive step at a time.”