Diabetes and Emotions

Learn about the emotions you may experience coping with diabetes

For anyone with diabetes, experiencing negative emotions such as anger, frustration, hopelessness, fear, guilt and shame is very common.

According to NICE (NICE, 2005) when a person is first diagnosed with diabetes, they will often go through similar psychological stages as that of bereavement: disbelief, denial, anger and depression.

We look at how these emotions can affect your life and diabetes management:

• Anger
• Anxiety
• Guilt
• Depression
• Diabetes burnout

Higher HbA1c levels have been found to be associated with physical symptoms including hyperglycemic score, mood including levels of displeasure, depression, tension and fatigue and with worse general well-being.

The relative association varied between 1.02 and 1.36 for each percentage difference in HbA1c. The relation between HbA1c and some mood states have been found to be modified by neuroticism a patient who is less inclined to complain was associated with worse glyceamic control. ^[45]

Mindfulness training has been shown to address depression, stress, anxiety, chronic pain all of which have been implemented with better glycaemia control, diabetes management and greater reported quality of life:

• Mindfulness and hypoglycemia
• Mindfulness' effect on blood gluose levels and blood pressure
• Mindfulness and sleep
• Mindfulness and back pain

More likely to suffer from depression

According to the NHS people with diabetes are twice as likely to suffer with depression.

Evidence presented by the National Diabetes Support Team indicate that 'recovery from depression is associated with reductions in HbA1c levels of between 0.5% and 1% suggesting that treating depression can not only improve quality of life but could also significantly reduce the risk of complications.'

Some stressors may emerge after many weeks, months or years following diagnosis. Alternatively, there may be difficulties that arise upon initial diabetes diagnosis and continue without being resolved.

These may include:

• Coping with your diabetes diagnosis
• Understanding your relationship with food and why you overeat
• Communicating openly and effectively with healthcare professionals
• How to deal with compulsive behaviours
• Managing low moods and depression
• How to increase your motivation
• Sex, diabetes and relationships
• Needle phobia and overcoming it
• Fear of long term complications
• Dealing with denial
• Anxiety with hypoglycemia
• Tackling lifestyle changes

A NHS Confederation briefing paper has highlighted the importance of integrating the treatment of physical and mental healthcare and acknowledges the increased prevalence of mental health needs amongst people with physical health conditions. The paper also accepts that treatment of the mental health needs has a positive impact on physical wellbeing (NHS Confederation, 2009).