Depression and Diabetes

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Depression and Diabetes

Depression can strike anyone, but people with diabetes, a serious disorder that afflicts an estimated 16 million Americans, (1) may be at greater risk. In addition, individuals with depression may be at greater risk for developing diabetes. Treatment for depression helps people manage symptoms of both diseases, thus improving the quality of their lives.

Several studies suggest that diabetes doubles the risk of depression compared to those without the disorder (2). The chances of becoming depressed increase as diabetes complications worsen. Research shows that depression leads to poorer physical and mental functioning, so a person is less likely to follow a required diet or medication plan. Treating depression with psychotherapy, medication, or a combination of these treatments can improve a patient's well-being and ability to manage diabetes.



Depression Facts

Depression is a serious medical condition that affects thoughts, feelings, and the ability to function in everyday life. Depression can occur at any age. NIMH-sponsored studies estimate that 6 percent of 9- to 17-year-olds in the U.S. and almost 10 percent of American adults, or about 19 million people age 18 and older, experience some form of depression every year (4,5). Although available therapies alleviate symptoms in over 80 percent of those treated, less than half of people with depression get the help they need (5,6).


Diabetes Facts









Managing Diabetes 

Research has shown that tight glucose control is the best way to prevent serious complications of diabetes, so the goal of diabetes management is to keep blood glucose levels as close to the normal range as possible. Healthy eating, physical activity, insulin injections, or using an insulin pump are basic therapies for type 1 diabetes. Blood glucose levels must be monitored through frequent checking. In recent years, research has led to better ways to manage type 2 diabetes and treat its complications with improved monitoring of blood glucose, new drugs, and weight control management. Blood pressure drugs called ACE (angiotensin-converting enzyme) inhibitors help to prevent or delay heart and kidney disease.

People with diabetes try to keep blood glucose (also called blood sugar) from rising too high or falling too low. When blood glucose levels drop too low from some medicines—a condition called hypoglycemia—a person can become nervous, shaky, and confused. Judgment can be impaired, and if the level is low enough, a person can faint. High levels of blood glucose, called hyperglycemia, cause tissue damage and lead to debilitating complications. Associated with acute long-term complications, the disease can lead to blindness, heart and blood vessel disease, strokes, kidney failure, amputations, and nerve damage. Uncontrolled diabetes can complicate pregnancy. Because a large part of the population is aging and Americans are increasingly overweight and sedentary, the prevalence of diabetes is predicted to increase.

Researchers continue to search for the causes of diabetes and ways to prevent and cure the disorder. Scientists are looking for genes that contribute to the different forms of diabetes, are testing new drugs, and are using bioengineering techniques to try to create artificial beta cells that secrete insulin.

Get Treatment for Depression

While there are many different treatments for depression, they must be carefully chosen by a trained professional based on the circumstances of the person and family. Prescription antidepressant medications are generally well-tolerated and safe for people with diabetes. Specific types of psychotherapy, or "talk" therapy, also can relieve depression. However, recovery from depression takes time. Antidepressant medications can take several weeks to work and may need to be combined with ongoing psychotherapy. Not everyone responds to treatment in the same way. Prescriptions and dosing may need to be adjusted.

In people who have diabetes and depression, scientists report that psychotherapy and antidepressant medications have positive effects on both mood and glycemic control.2 Additional trials will help us better understand the links between depression and diabetes and the behavioral and physiologic mechanisms by which improvement in depression fosters better adherence to diabetes treatment and healthier lives.

Treatment for depression in the context of diabetes should be managed by a mental health professional—for example, a psychiatrist, psychologist, or clinical social worker—who is in close communication with the physician providing the diabetes care. This is especially important when antidepressant medication is needed or prescribed, so that potentially harmful drug interactions can be avoided. In some cases, a mental health professional that specializes in treating individuals with depression and co-occurring physical illnesses such as diabetes may be available. People with diabetes who develop depression, as well as people in treatment for depression who subsequently develop diabetes, should make sure to tell any physician they visit about the full range of medications they are taking.


Other mental disorders, such as bipolar disorder (manic-depressive illness) and anxiety disorders, may occur in people with diabetes, and they too can be effectively treated. For more information about these and other mental illnesses, contact NIMH.

Remember, depression is a treatable disorder of the brain. Depression can be treated in addition to whatever other illnesses a person might have, including diabetes. If you think you may be depressed or know someone who is, don't lose hope. Seek help for depression.


1Diabetes statistics. NIH Pub. No. 99-3892. Bethesda, MD: National Institute of Diabetes and Digestive and Kidney Diseases, March 1999.

2Anderson RJ, Lustman PJ, Clouse RE, et al. Prevalence of depression in adults with diabetes: a systematic review. Diabetes, 2000; 49(Suppl 1): A64.

3Ciechanowski PS, Katon WJ, Russo JE. Depression and diabetes: impact of depressive symptoms on adherence, function, and costs. Archives of Internal Medicine, 2000; 160(21): 3278-85.


