Introduction

When you have diabetes, your mental health may also be affected. You may feel overwhelmed and anxious or exhausted and angry, and at Smile we understand that sometimes you need some support to manage both your physical and mental health in order to live well alongside your diagnosis.

It worries you as you spend your days more exhausted than usual, feeling tired all the time. It confuses you how you can drink plenty of liquids and still only minutes later, need more. And you are deeply concerned by the amount of unexplainable weight you have lost. So you go to see a doctor and anxiously wait to find out what is happening to your body. 

According to the World Health Organisation, 422 million people worldwide are likely to have experienced these symptoms of diabetes, to then be told that they have either type 1 or type 2 diabetes. A lot of people have, or will know someone, who has had a diabetic diagnosis, and whilst it is a common condition, those managing it may find it tricky both mentally and physically at times.

Diabetes and the effect on your mental health

There are many emotional effects of a diabetes diagnosis, including shock, overwhelm and anger, all of which could alter your mood and make day to day life more difficult to navigate. According to Diabetes UK, 1 in 5 people with diabetes also have depression, whilst 1 in 6 people with diabetes have anxiety. Your general wellbeing may be affected by these emotional changes, so you should try to make sure you are doing things like staying active, eating healthily and doing everything you need to do when you are diabetic, such as injecting insulin, even if you feel like you are fine and don’t need to.

Managing your diabetes

There are many common factors that can affect your mental health when you have diabetes. One of these is how overwhelming managing your condition can be. There is a lot of information that you have to remember, and lots of adjustments that need to be made to your daily routine. It may feel stressful having to remember everything that needs to be done in order to manage your diabetes well, things like monitoring your blood glucose levels throughout the day and eating the right foods to keep those levels balanced.

It is a great idea to create a plan that will help you get into a new routine so that you are more likely to remember everything you need to and then this will help to alleviate some of the overwhelm you may be feeling.

Worries that may occur when having to inject insulin

Having to inject insulin into the body is something that might make you feel anxious alongside your diabetes, and this can be for multiple reasons. One of the most common is needle phobia. A fear of needles is something that could make a diabetes diagnosis very scary. There are ways to overcome needle phobia, and one of Smile’s therapists, Dr Francesca Sawer says, “something that I'd encourage you to do is make a list of all of your beliefs about what might happen and what beliefs you have that you can't manage this procedure. Write that in a long list and then for every single thought or belief next to it, reframe that into something more realistic.” 

You may not be worried about actually doing the injections, instead feeling overwhelmed about the prospect of having to do them several times every day or possible side effects such as weight gain. It is also common to feel ashamed of your diabetes and like you are being judged if you have to administer insulin in public, like when you go out for meals. This may cause you to feel upset or distressed, but it is important not to let your worries stop you from doing everything you need to do for your diabetes, as neglecting these could cause negative health implications.

How does diabetes affect those around you

One of the main ways that your diabetes might affect other people is that those around you might notice changes in your mood. You might be feeling more irritable and angry because of how overwhelming managing diabetes can be and your loved ones might retaliate with similar emotions or try and give you some space.

They might also notice that they have more responsibilities as a result of your diagnosis. Whilst you may feel vulnerable and upset that you have to ask for help, sometimes those around you may be able to offer valuable assistance in what might be a difficult circumstance, like low blood glucose levels in the night. Early in your diagnosis, you may be unfamiliar with the changes happening in your body and therefore have more difficulty managing them, so you may need some help sometimes. It is important to have good support from your loved ones so they can help you effectively.

Those around you may feel upset that there is, as of yet, no cure for your condition and that you will have to manage diabetes for the rest of your life because of this. Seeing you doing injections daily or experiencing the effects of low blood glucose levels may also be upsetting for them to witness or it might make them feel anxious, and this could affect their own mental health.

How parents of a child with diabetes are affected

If you are the parent of a child who has diabetes, you may find that you are also emotionally affected. It can be difficult if you are supporting a child with diabetes, as you may have a lot of responsibility and it is not unusual if you feel a lot of pressure. It can be challenging to have to give them their injections or check their blood glucose levels, as it may worry your child and cause them to react negatively by crying or becoming agitated, and you don’t want to see them struggling.

You may also feel more protective over your child because of their condition, but it is important to give them the support that they need as well as the freedom to live as any other child would. Sometimes it can be hard to find this balance, and you may find yourself becoming stressed or anxious about whether you are being a good enough parent.

Feelings of guilt are not uncommon when supporting a child. Dr Francesca Sawer offers content within the Smile app to help combat these emotions, by asking you “how is your guilt helping you?” and “what is the function of the guilt?” whilst encouraging you not to punish yourself, especially when you are doing so much to support your child. These difficult feelings you may be managing might cause you to need emotional support as well.

The importance of social support when you have diabetes

Sometimes if you are managing diabetes, you may try to avoid social situations. This is especially common if you have just been diagnosed, as you may feel insecure about having to do things like injections or checking your blood glucose levels regularly. If you know someone who has diabetes, you may notice that this person is not as social as they were before their diagnosis, and your relationship with that person might change as a result.

Where possible, you should offer as much support as you can for anyone you know with diabetes. Dr Sula Windgassen says that “some research has shown that social support has a big influence on all-cause mortality and health related quality of life, in the direction that the more socially connected and socially supported someone is, the more likely they are to live a longer and healthier life.” This shows just how important it is to have people around you when you have a chronic physical health condition like diabetes, and how valuable it is to make an effort to maintain social contact even when someone may be pushing you away because of their condition.

How to get mental health support when managing diabetes

Currently, only 1 in 4 people are getting the mental health support they need for the emotional effects that may occur as a result of a diabetes diagnosis. Diabetes can be a very emotionally draining condition, mostly because it is ongoing and you have to manage it every single day of your life.

It is really important that if you have diabetes and are finding it difficult to manage any emotional changes, that you are able to access resources that might help. If you are feeling overwhelmed, reach out to your loved ones and talk through all your emotions, as this is really simple but can be really helpful. Finding small techniques to help you can make all the difference to your wellbeing.

The Smile app is able to offer lots of content and expert-led workshops that may help you with any difficult emotions you may be experiencing. We have a small team of therapists who offer advice on how to manage feelings and situations you associate with your diabetes, including needle phobia, understanding the importance of having social support, managing parent/carer guilt and discussing your child's health, in the event of you supporting a child who has had a diabetes diagnosis.

Diabetes may be overwhelming at times, but when you have the right support, it might not feel so tricky to manage. It is very possible to live well with diabetes and manage both your physical and mental health effectively

Smile is a mental health app for people managing chronic physical health conditions. To access the resources mentioned above, download the app now from Google Play or ​Apple App store.