Managing diabetes and depression: what you need to know

Depression is a frequently overlooked condition and can be a common challenge for people living with diabetes.¹ People with diabetes are 25% more likely than the general population to develop depression, and depression may increase the risk of developing type 2 diabetes.^1–3 However, depression goes undiagnosed almost half the time in people with diabetes,³ so it’s important to know the most common depression symptoms.

Subtle mood shifts

Depression can be sneaky and hard to detect, so it’s important to pay attention to subtle mood changes or mood swings.

If you or a loved one is experiencing long episodes of sadness, anxiety, or irritability, or you notice they’re feeling increasingly depressed or lonely, it could be an early sign of depression.⁴ 

Be on the lookout for feelings, thoughts, and comments about hopelessness, death, or suicide, and seek help.

More than a bad mood

Changes in your ability to focus or make decisions, as well as a loss of interest in activities you enjoy, can also be considered depression symptoms.

Depression frequently has an impact on other aspects of life, including eating and sleeping. It’s important to be aware of changes in your normal patterns. Too little or too much sleep, as well as undereating and overeating, can all be signs of a larger mental health issue.⁴

People often associate depression with a feeling of sadness or apathy. But it’s more than that. Struggling with depression can take a toll on your daily functions and blood sugar levels.⁵
 

Researchers don’t have a complete picture yet, but studies have identified some important factors that can contribute to the connection between diabetes and depression.

Diabetes and depression share biological origins that go beyond surface symptoms. Stress, a common factor in both conditions, may trigger immune system activation, inflammation, and hormone imbalance, which could lead to type 2 diabetes or depression.^6,7 Diabetes and depression can both cause changes in brain structure, which may contribute to the development of mental disorders.^7–9

Then, there are the everyday challenges of managing diabetes . From checking your blood sugar and taking diabetes medications to watching what you eat, staying active, and maintaining a healthy weight, diabetes management can feel overwhelming at times, and this stress can lead to depression.³
Depression can make it harder to manage diabetes physically, mentally, and emotionally. Common depression symptoms, such as insomnia or hypersomnia, changes in weight, loss of appetite, or lack of energy, can lead to poor lifestyle choices.¹⁰

Stress, unhealthy eating, not getting enough exercise, smoking, and weight gain are all risk factors for both diabetes and depression.

Even though depression is a mental health condition, it has physical symptoms too.

Feeling increasingly weak or exhausted is a sign that your body is experiencing mental agitation.⁴ Similarly, those who struggle with depression often experience aches and pains, including headaches, cramps, and digestive issues.¹¹

Now that you know what depression symptoms to look for, what do you do if you suspect that you or a loved one is experiencing depression?
It is possible to manage your diabetes and depression together. The first step is recognizing the risk. If you’re concerned that you’re dealing with symptoms of depression, talk to your doctor. Your healthcare team should include mental health professionals with experience in diabetes who can help reach the right diagnosis.

Treatment usually involves a combination of medication, therapy, and lifestyle changes. It may take time to see the impact of those changes, but seeking help from professionals is a crucial step in helping you make a difference in your diabetes management and overall quality of life.

Ask your diabetes care team about a therapist referral or other resources to help you cope. You may find different types of therapy helpful:

• Cognitive behavioral therapy (CBT) helps you understand how your thoughts, feelings, and behaviors interact with one another.¹²
• Dialectical behavioral therapy (DBT) helps you regulate emotions and accept uncertainty.¹³
• Family therapy helps parents and children learn to communicate more effectively and resolve conflicts.¹⁴

Therapy and medication for anxiety symptoms, mood disorders, or depression also work well together, though it does take time for the medication to take effect.¹⁵ Taking action to manage your mental health is a worthwhile effort for your overall health and well-being.

If your doctor wants to prescribe medication, talk to them about any family history of mental illness and your experience with diabetes.

Along with medication and therapy, consider other helpful approaches to manage your mental well-being, such as monitoring your behavior patterns, practicing breathing techniques, and journaling your thoughts, feelings, and concerns.^16,17

But the most important part of this experience is being aware of the signs of depression and seeking help if and when they appear.

If you recognize any of the subtle mood shifts or symptoms of depression in yourself or a loved one living with diabetes, it's crucial to reach out to your healthcare providers. If you are having suicidal thoughts or are worried about a friend or loved one, call a helpline or contact your local emergency services.

Mental health is as important as your physical health, and managing diabetes and depression together is possible. You can better manage your mental health and diabetes with the support of therapy, medication, or a lifestyle change.^4,18 

Sources:

1. Tomic D, Shaw JE, Magliano DJ. The burden and risks of emerging complications of diabetes mellitus. Nat Rev Endocrinol. 2022;18(9):525-539.
2. Mezuk B, Eaton WW, Albrecht S, Golden SH. Depression and Type 2 Diabetes Over the Lifespan. Diabetes Care. 2008;31(12):2383-2390.
3. Egede LE, Ellis C. Diabetes and depression: Global perspectives. Diabetes Res Clin Pract. 2010;87(3):302-312.
4. Depressive disorder (depression) [Internet]. WHO. 2023 Mar 3  [cited 2025 Jul 9]. Available from: https://www.who.int/news-room/fact-sheets/detail/depression
5. Lustman PJ, Clouse RE. Depression in diabetic patients. J Diabetes Complications. 2005;19(2):113-122.
6. Pickup JC, Crook MA. Is Type II diabetes mellitus a disease of the innate immune system? Diabetologia. 1998;41(10):1241-1248.
7. Subba R, Sandhir R, Singh SP, Mallick BN, Mondal AC. Pathophysiology linking depression and type 2 diabetes: Psychotherapy, physical exercise, and fecal microbiome transplantation as damage control. Eur J Neurosci. 2021;53(8):2870-2900.
8. Gold SM, Dziobek I, Sweat V, et al. Hippocampal damage and memory impairments as possible early brain complications of type 2 diabetes. Diabetologia. 2007;50(4):711-719.
9. Kleinridders A, Cai W, Cappellucci L, et al. Insulin resistance in brain alters dopamine turnover and causes behavioral disorders. Proc Natl Acad Sci U S A. 2015;112(11):3463-3468.
10. American Psychiatric Association, ed. Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TRTM. Fifth edition, text revision. American Psychiatric Association Publishing; 2022.
11. De Heer EW, Gerrits MMJG, Beekman ATF, et al. The Association of Depression and Anxiety with Pain: A Study from NESDA. Sun HS, ed. PLoS ONE. 2014;9(10):e106907.
12. Abbas Q, Latif S, Ayaz Habib H, et al. Cognitive behavior therapy for diabetes distress, depression, health anxiety, quality of life and treatment adherence among patients with type-II diabetes mellitus: a randomized control trial. BMC Psychiatry. 2023;23(1):86.
13. Saito E, Tebbett-Mock AA, McGee M. Dialectical Behavior Therapy Decreases Depressive Symptoms Among Adolescents in an Acute-Care Inpatient Unit. J Child Adolesc Psychopharmacol. 2020;30(4):244-249.
14. Henken T, Huibers MJH, Churchill R, Restifo KK, Roelofs JJ. Family therapy for depression. Cochrane Common Mental Disorders Group, ed. Cochrane Database Syst Rev. Published online July 18, 2007.
15. Cuijpers P, Noma H, Karyotaki E, Vinkers CH, Cipriani A, Furukawa TA. A network meta‐analysis of the effects of psychotherapies, pharmacotherapies and their combination in the treatment of adult depression. World Psychiatry. 2020;19(1):92-107.
16. Fincham GW, Strauss C, Montero-Marin J, Cavanagh K. Effect of breathwork on stress and mental health: A meta-analysis of randomised-controlled trials. Sci Rep. 2023;13(1):432.
17. Keng SL, Smoski MJ, Robins CJ. Effects of mindfulness on psychological health: a review of empirical studies. Clin Psychol Rev. 2011;31(6):1041-1056.
18. Diabetes [Internet]. WHO. World Health Organization. 2024 Nov 24 [cited 2025 Jul 9].  Available from: https://www.who.int/news-room/fact-sheets/detail/diabetes

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