If living with diabetes is leaving you feeling anxious, overwhelmed, or burned out, you could be experiencing diabetes distress, also called diabetes-related distress. And although you might not get an official diagnosis for it, diabetes distress can still make diabetes management more difficult. However, there are effective strategies to help you overcome it.

How you feel about your diabetes can be directly connected to how well you manage the condition. In fact, according to a study in the November 2012 issue of the journal Diabetes Medicine, people who have type 2 diabetes and diabetes distress have a harder time managing their blood sugar over time. The researchers found a link between diabetes distress and higher A1C results, the test that measures how well you're controlling your blood sugar over a three-month period.

Despite these findings, your doctor may have a hard time bringing up the topic of diabetes distress, and you might feel awkward about letting your doctor know that you're burning out, feeling anxious, or getting overwhelmed. But this is a discussion that should happen regularly as a part of good diabetes care, says Lawrence Fisher, PhD, a diabetes researcher, diabetes distress expert, and professor in the family and community medicine department at the University of California in San Francisco.

“Living with diabetes has big demands,” Dr. Fisher says. “Diabetes puts burdens on people, and these burdens can build over time. Many people also deal with the fear of diabetes complications developing, too.”

Looking for the Cause of Diabetes Distress

Diabetes distress can occur due to the daily responsibilities of diabetes management, Fisher says, but it can also be triggered by significant changes in your condition, such as starting insulin therapy or finding out that you have signs of diabetes complications, such as high blood pressure or eye problems.

Fisher and his team have been looking at approaches to identifying and handling diabetes distress. Results of one of their studies, published in the June 2013 issue of Diabetes Care, showed that interventions specifically designed to reduce diabetes distress and improve self-management led to healthier eating, more physical activity, and better medication adherence.

Fisher also points to the intertwining of diabetes distress and managing the condition. Diabetes distress might make it harder for you to manage diabetes, but it could also be a result of feeling like your efforts to manage diabetes aren’t working.

If you talk to your doctor about feelings of diabetes distress, you might be given a paper scale to fill out or be asked directly how well you think you’re managing your diabetes, how anxious or sad you are about your diabetes, if you feel like diabetes is taking over your life, and if you feel like people around you are supportive of your diabetes management efforts. Answering these questions honestly can help you and your doctor find solutions.

Strategies for Dealing With Diabetes Distress

Fisher notes that many people with diabetes struggle in silence with negative feelings about the condition. Just knowing that diabetes distress is a real and common experience can reduce feelings of guilt or failure. Then you can try these strategies to cope with diabetes distress:

Talk to your doctor. Fisher’s research has shown that addressing diabetes distress directly can help you feel better. But keep in mind that your doctor won’t always see the signs, so let him or her know if you’re feeling anxious, overwhelmed, or burned out, or just tired in general. “Say, 'I need to talk to you about how I feel,' ” Fisher says. Letting your doctor know what's worrying or overwhelming you can lead to better diabetes education and more diabetes management tools.

Involve your family. Concerned family members often try to help with diabetes care but might feel helpless, especially if diabetes distress intensifies. Bring your loved ones with you to medical visits so they can be part of your diabetes management plan, or give them practical ways to help, such as joining you for fun physical activities or trying new, healthy foods.

Join support groups. Getting to know other people who are living with the challenges of diabetes can help you know you’re not alone and that your feelings and experiences are normal. If attending a meeting in person isn't possible, try making an online connection.

Treat diabetes and depression. Diabetes distress and depression are different conditions, but they can occur together. People with diabetes have higher rates of depression than their peers, and depression can complicate diabetes management. If you think you're experiencing emotions that could go beyond diabetes distress to depression, such as hopelessness, sadness, and lack of interest in things you once enjoyed, seek help. Diabetes and depression can both be treated.

If you’re feeling overwhelmed by diabetes, know that this is normal. You’re not alone, and with the help of your doctor you can find relief from these feelings, get your diabetes under control, and live healthier and happier.