“You have diabetes.” Hearing these words and getting to
grips with the risks and possible complications of the condition can seem
overwhelming – and on top of coping with the physical challenges you may well
develop depression or other mental disorders as a result of the stress and
In honour of November being World Diabetes Month, we take a
look at what this all means and how you can cope.
Depression is common in patients with diabetes, particularly
those with poorly controlled diabetes, says Dr Bavi Vythilingum, a psychiatrist
at Akeso Clinic Kenilworth in Cape Town.
are also common, including panic disorder and post-traumatic stress disorder
(PTSD), which is sometimes related to the stress of medical complications,” she
adds. “Anxiety symptoms can overlap with
hypoglycaemia or low blood sugar.
“Younger patients with diabetes, particularly those with
type 1 diabetes, are also at risk of developing acting-out behaviours and
eating disorders. Adolescence is a time
of rebelling and testing limits. Many adolescents with diabetes express this by
becoming non-compliant. It’s important to be aware of this so it can be
detected as well as understood and managed appropriately.”
In an article titled Diabetes and Depression: A devastating
duo, mental health advocate Zane Wilson points out that studies have shown people
with diabetes have a greater risk of depression – although depression is not
generally listed as a complication of diabetes.”
Signs of psychological problems
Dr Vythilingum says poor diabetic control, withdrawal, anger
and irritability, stopping or refusing treatment and failure to stick to the
advised diet can all be signs of psychological illness as a result of diabetes.
“Being supportive and non-judgmental and suggesting and
facilitating that the person seeks professional help can go a long way to help
a patient in trouble,” she says.
Binge-eating disorders can lead to a high Body Mass Index
(BMI), which is a risk for diabetes. “Any eating disorder impacts on diabetic
control,” Dr Vythilingum stresses.
“One study found as many as 31 percent to 40 percent of
women between the ages of 15 and 30with type 1 diabetes have eating behaviours,
including binging and purging. This places them at high risk of hyper and
hypoglycaemia and long-term complications of diabetes.
“The necessary focus on eating, blood sugar and symptom
control places diabetics at risk of eating disorders as well as for anxiety
“Sometimes diabetics can be viewed as weak, unfit and unhealthy.
This is part of the stigma of the illness. They are often judged on what they
eat and what they weigh and are blamed for their illness. There is the
perception that they didn’t diet or exercise, so it’s their fault that they
have diabetes,” Dr Vythulingum adds.
This should not deter diabetics from trying to manage their
condition. “It doesn't matter if you make mistakes or don't get your treatment
perfect - as long as you don't give up. Also, seek support – Diabetes Support
South Africa (https://www.diabetessa.org.za/) is a good source of information
and support,” she concludes.
Psychological therapy is also key. It helps contribute to a
healthy mind and positive outlook.