MENTAL HEALTH Resources
TYPE 1 DIABETES AND MENTAL HEALTH
Meredith O’Connor, MA, MHC-LP
Depression, Stress and Anxiety
The chronic nature of Type 1 Diabetes, the need for continuous self-care, and the unpredictability of blood glucose levels can result in increased stress, anxiety, and depression. Individuals with Type 1 Diabetes are at a higher risk of developing mental health disorders, such as depression and anxiety, compared to the general population. Depression can make it challenging to manage blood glucose levels and adhere to self-care routines, while anxiety can make it difficult to manage the fear of hypoglycemia. Additionally, diabetes distress, which refers to the emotional burden associated with living with diabetes, can lead to burnout, where individuals may become disengaged with self-care activities and experience poor diabetes management. Regular mental health screenings can help identify potential mental health issues and develop appropriate interventions.
While depression, stress and anxiety are some of the most common mental health issues associated with Type 1 Diabetes, there are many others as well.
Obsessive Compulsive Disorder (OCD)
One common mental health issue is Obsessive-Compulsive Disorder (OCD), which can manifest in obsessive thoughts and compulsive behaviors related to diabetes management, such as constant checking of blood glucose levels or excessive monitoring of food intake. This can lead to increased stress and anxiety, making it difficult to manage blood glucose levels and adhere to self-care routines. Recommend treatment for OCD includes Exposure Response Prevention (ERP) and/or Acceptance Commitment Therapy (ACT), both of which are forms of the therapeutic orientation called Cognitive Behavioral Therapy (CBT).
Blood Sugar Levels and Moods
The relationship between Type 1 Diabetes, blood sugar levels, and moods has been studied extensively, with research highlighting several key findings. Low blood glucose levels have been linked to negative mood states, while high blood glucose levels were often associated with negative mood states such as anger and sadness. Positive mood items were frequently associated with high blood glucose levels. It's crucial to work with a mental health therapist to identify triggers and techniques to regulate mood and emotions, as automatic changes can make regulation difficult.
Eating Disorders
Another mental health challenge that individuals with Type 1 Diabetes may face is body image dissatisfaction. The need to regularly monitor and manage weight and food intake can lead to negative body image, which can contribute to the development of disordered eating behaviors, such as binge eating or restricting food intake. This can negatively impact glycemic control and increase the risk of developing long-term diabetes complications.
Research shows that there is an increased prevalence of eating disorders in adolescents with Type 1 Diabetes, estimated at 7%. Despite this, screening for eating disorders is rarely carried out. Seeking the help of a mental health professional can be beneficial, with Cognitive Behavioral Therapy being one form of therapy that can help individuals manage their mood, anxiety, and emotional regulation.
Adolescents and Sleep
Adolescents with Type 1 Diabetes are particularly vulnerable to poor glycemic control due to disrupted sleep patterns. Late-night phone and electronic usage and inconsistent sleep patterns are common culprits. Revenge Bedtime Procrastination, which describes the desire to stay up late due to feelings of an inadequate amount of down time during the day or resentment over lack of control in daily routine, can also be detrimental to healthy sleep patterns. It's essential to identify obstacles or unmet needs that prevent healthy sleep patterns and schedule time blocks throughout the day to meet these needs to avoid disruptions in sleep.
Additionally, individuals with Type 1 Diabetes may also experience social isolation and stigma, which can contribute to poor mental health. Managing diabetes in social situations, such as at school or work, can be challenging and may result in feelings of shame or embarrassment. This can lead to avoidance of social situations and feelings of loneliness and isolation.
It's important to recognize these mental health issues and seek support from mental health professionals. Specific treatment approaches such as Cognitive Behavioral Therapy (CBT) can help individuals develop coping strategies and improve their emotional well-being. Diabetes management should also include regular mental health screenings to identify potential mental health issues and develop appropriate interventions. By addressing mental health issues, individuals with Type 1 Diabetes can improve their overall quality of life and diabetes management.
REFERENCES
Gonder-Frederick LA, et al. "Blood glucose monitoring in diabetes." Diabetes Care. 1989;12(10):627-634. doi:10.2337/diacare.12.10.627
Bergner EM, et al. "Disruptions in sleep patterns and glycemic control in adolescents with type 1 diabetes." Journal of Pediatric Psychology. 2018;43(7):758-767. doi:10.1093/jpepsy/jsy011
Winston AP. "Eating disorders in diabetes: an update." Current Diabetes Reports. 2020;20(3):7. doi:10.1007/s11892-020-1304-x
Polonsky WH, et al. "Diabetes distress: a new condition or diagnosis?." Clinical Diabetes. 2015;33(2):49-52. doi:10.2337/diaclin.33.2.49
Fisher L, et al. "Mental health in diabetes research agenda: executive summary." Diabetes Care. 2017;40(7):863-870. doi:10.2337/dc17-1137
American Diabetes Association. Mental Health. Retrieved from https://www.diabetes.org/diabetes/mental-health
Contact information:
Meredith O’Connor, MA, MHC-LP
(631) 316-1738
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