“You have diabetes.” Hearing these words and getting to grips with the risks and possible complications of the condition can seem overwhelming – and on top of coping with the physical challenges you may well develop depression or other mental disorders as a result of the stress and strain.
In honour of November being World Diabetes Month, we take a look at what this all means and how you can cope.
Depression is common in patients with diabetes, particularly those with poorly controlled diabetes, says Dr Bavi Vythilingum, a psychiatrist at Akeso Clinic Kenilworth in Cape Town.
“Anxiety disorders are also common, including panic disorder and post-traumatic stress disorder (PTSD), which is sometimes related to the stress of medical complications,” she adds. “Anxiety symptoms can overlap with hypoglycaemia or low blood sugar.
“Younger patients with diabetes, particularly those with type 1 diabetes, are also at risk of developing acting-out behaviours and eating disorders. Adolescence is a time of rebelling and testing limits. Many adolescents with diabetes express this by becoming non-compliant. It’s important to be aware of this so it can be detected as well as understood and managed appropriately.”
In an article titled Diabetes and Depression: A devastating duo, mental health advocate Zane Wilson points out that studies have shown people with diabetes have a greater risk of depression – although depression is not generally listed as a complication of diabetes.”
Signs of psychological problems
Dr Vythilingum says poor diabetic control, withdrawal, anger and irritability, stopping or refusing treatment and failure to stick to the advised diet can all be signs of psychological illness as a result of diabetes.
“Being supportive and non-judgmental and suggesting and facilitating that the person seeks professional help can go a long way to help a patient in trouble,” she says.
Binge-eating disorders can lead to a high Body Mass Index (BMI), which is a risk for diabetes. “Any eating disorder impacts on diabetic control,” Dr Vythilingum stresses.
“One study found as many as 31 percent to 40 percent of women between the ages of 15 and 30with type 1 diabetes have eating behaviours, including binging and purging. This places them at high risk of hyper and hypoglycaemia and long-term complications of diabetes.
“The necessary focus on eating, blood sugar and symptom control places diabetics at risk of eating disorders as well as for anxiety disorders.”
“Sometimes diabetics can be viewed as weak, unfit and unhealthy. This is part of the stigma of the illness. They are often judged on what they eat and what they weigh and are blamed for their illness. There is the perception that they didn’t diet or exercise, so it’s their fault that they have diabetes,” Dr Vythulingum adds.
This should not deter diabetics from trying to manage their condition. “It doesn't matter if you make mistakes or don't get your treatment perfect - as long as you don't give up. Also, seek support – Diabetes Support South Africa (https://www.diabetessa.org.za/) is a good source of information and support,” she concludes.
Psychological therapy is also key. It helps contribute to a healthy mind and positive outlook.