Like other chronic physical health conditions, diabetes brings a higher risk of mental health concerns such as anxiety and depression. It can also complicate the management of other behavioral health conditions.
According to the CDC, 37.3 million people in the United States have diabetes, more than 11 percent of the population. With so many people living with this condition, clinicians must understand how behavioral health and diabetes can interact.
Mental Health Risks With Diabetes
Individuals with mental health symptoms may have a harder time taking care of themselves. They may experience:
- Difficulty sleeping (which may affect blood sugar)
- A desire to overeat or skip meals
- Low energy and lack of activity
- Forgetfulness that may cause them to miss medications or blood sugar checks
For those with diabetes, this can turn into a life-or-death situation. Poor diabetes management can damage the heart, eyes, kidneys, and nerves, and raise the risk of early death.
Mental and physical health symptoms can sometimes overlap, creating further complications. For example, anxiety may be confused with low blood sugar, making it more difficult to treat properly. Both low blood sugar and anxiety can cause sleep difficulties. Work with your client to help them understand the differences and correctly address symptoms.
Following a strict diet due to diabetes may also increase the risk of an eating disorder. Research has found that women with type 1 diabetes have almost twice the risk of developing an eating disorder as women without diabetes. This can create worse blood sugar control. If you have a behavioral health client with diabetes, keep an eye out for signs of disordered eating.
Patients with diabetes often experience related health complications even when they are already doing their best to manage their condition. This can be upsetting, frustrating, and discouraging, leading to a condition known as diabetes distress.
Consider helping your client set small, specific, manageable health goals. Encourage clients to keep up with health appointments, such as seeing an endocrinologist, or join a diabetes support group.
Substance Misuse and Diabetes
Patients with diabetes are also not immune to substance misuse. According to an article in Endocrine News, a 2012 study found that, of 504 people with type 1 diabetes who responded to an anonymous survey, 77 percent had used recreational drugs at least once. Of those, 24 percent reported daily drug use, including marijuana, ecstasy, and speed.
Substance misuse can create complications in the treatment of diabetes and addiction recovery. Drug use makes it more likely to forget to check blood sugar, administer the right insulin dose, or eat properly. Substance misuse also may worsen co-occurring disorders, such as nerve damage. (Nerve damage may also increase the risk of abusing pain medications.) Changes in blood sugar may trigger substance cravings that are difficult to resist.
Chronic diseases can take a significant toll on mental health, and metabolic conditions can complicate recovery. If you have behavioral health clients with diabetes, be sure to incorporate disease management into their treatments and recommend additional support when necessary.
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