Diabetes is one of the leading causes of disability and death in the United States today. Information about possible physical damage to the body and concern about growing rates of diabetes in children and teens take center stage in most related discussions. But, there are some serious psychological effects as well that must be considered. Handling these might make the difference in whether someone is successful in managing this condition or not.

In a “Wear Blue” campaign, the Diabetes Association of Atlanta and communities across the country are sharing information for National Diabetes Month in November. Many of the over thirty million people affected in the United States and another eighty-four million at high risk of developing Type 2 diabetes may be unaware of how the mind and body work or do not work together to manage diabetes. 

Traditional advice – watch your weight, eat healthy, and get more physical activity – can save many people from progressive, system-wide damage to the entire body, but what works for one person may not work as well for another. What looks like simple solutions may not be simple at all. Without addressing the psychological component, the best exercise and menu plans may be useless, especially if co-occurring illnesses are present. Blood glucose levels rise as a result of stress and other physical problems. Depression, anxiety, and other mental health problems also complicate control.   

We are driven, to a certain extent, by past behaviors and cultural habits of the people around us. In other words, the way we eat and the comfort we seek from food is learned. To tell a patient with consistently high blood sugar levels that he must change what he is used to doing, how he is accustomed to living, can feel threatening, especially if he has to watch others continue to eat and drink in the old ways. Sometimes, there is little support or consideration of the needs and feelings of a person who is struggling.

Foods high in carbohydrates and sugar are everywhere. They taste good, raise serotonin levels in the body and are generally inexpensive and easy to find. Most “grab and go” snacks fall into this category. Intellectually, a diabetic may understand why these foods are dangerous for him, but the demands to resist advertising and product placement, well-meaning cooks and holiday traditions tied to sweet memories of the past may as well ask him to leave his home planet and take up residence on Mars. The life change may seem – to him – almost that drastic. 

New habits can be formed, but the challenges that must be met can be insurmountable at times. Obesity, environment, economic factors, and availability of healthy foods are obstacles that must be overcome daily. In addition, if weight needs to be lost, there are a host of psychological battles involved in that lengthy war. If progress is slow or up and down, discouragement and depression could be the result.

Because of the physical issues in the body, diabetes can affect a person’s mood, causing rapid and severe changes. Adam Felman, of Medical News Today, writes that these changes caused by the stress of living with diabetes can affect relationships as well as potential complications and may also lead to nervousness, anxiety, and confusion. Difficulty in thinking and other symptoms caused by high or low blood sugar hold true for all types of diabetes.

The Centers for Disease Control and Prevention (CDC) recognizes the mind-body connection and recommends getting active, doing relaxation exercises, contacting an understanding friend, taking breaks to do something for fun, and limiting alcohol along with that healthy eating … but also seeing an endocrinologist for diabetes care and adding a mental health counselor, a diabetes educator, and a diabetes support group to your medical team. 

That’s a lot to juggle. Those who take insulin, wear an insulin pump or use continuous glucose monitoring equipment have more complicated issues to handle in their daily routines, but all diabetics need to monitor their glucose levels throughout the day. Testing, using meters and related supplies, finding places to test and even employment and insurance worries are some of the concerns that could keep diabetics up at night. Sleep can be disrupted and have its own undesirable effect on blood glucose levels. 

It’s easy to see how a diabetic’s mind might spin with stress. Overwhelming feelings known as “diabetes distress” can look like depression or anxiety but can’t be treated effectively with medicine. The CDC advises setting small goals and taking care of both mental and physical health, to provide the best outcomes. Community support in the form of classes or groups specifically for diabetics can be one of the best ways to accomplish this. Local hospitals, mental health counselors or even the newspaper will provide lists of these opportunities.

Exercise (especially walking and swimming), drinking water, eating healthy food, remembering to take medications, and regular activities that rest the mind are all things that can help. Expecting and finding ways to deal with overwhelming feelings and symptoms of stress, anxiety, and depression are the companion pieces that just might complete the puzzle of successful diabetes care.