How diabetes can impact your mental health
Earlier diabetes diagnosis increases the risk of mental health disorders
To better gauge the effects of type 2 diabetes on the body and brain, a team of researchers in Hong Kong compared the length and causes of hospital stays among those with and without metabolic disease.
Using data from the Hong Kong Hospital Authority, they assessed 1,516,508 individuals, exactly half of whom had type 2 diabetes and half did not. Data from these individuals were “matched” one-to-one according to age, sex, and index year (when they were admitted).
Researchers collected information concerning hospital admissions between 2002 and 2018 and followed up with participants for a median of 7.8 years until 2019. During this time, those with type 2 diabetes spent more days in the hospital. People diagnosed at an older age were more likely to be admitted due to circulatory and respiratory conditions.
However, among those diagnosed with diabetes before age 40, a significant 38.4% of hospital “bed days” were due to mental health disorders. A higher number of women were admitted for mental health concerns than men. Some of the more common mental health disorders that those with type 2 diabetes entered the hospital for included schizophrenia, bipolar disorder, and depression.
The link between diabetes and mental health
Previous studies have highlighted the significant association between type 2 diabetes and mental health disorders. For instance, those with diabetes are 2-3 times more likely to experience depression as they share common mechanisms. These mechanisms include the overactivation of the nervous system and lead to higher cortisol levels which can make both diseases worse.
Meanwhile, around 40% of diabetes patients encounter anxiety, and people with schizophrenia have a 2-5x times greater likelihood of developing type 2 diabetes compared to the general population. Numerous elements potentially contribute to this two-way relationship.
How age and gender factor into diabetes and mental health
The latest study found that younger and female individuals with diabetes were more likely to be hospitalised for mental health reasons.While the majority of type 2 diabetes diagnoses occur in those aged 45 and above, the opposite is true for mental health. This may help explain why researchers in the new study saw a large number of younger individuals with diabetes hospitalised for mental health disorders with 50% of mental illness beginning by 14 and 74% by 24 years of age.
There are various physiological health discrepancies between men and women, some of which may influence diabetes. These include differences in hormones, insulin sensitivity, and risk profiles for concerns such as cardiovascular disease.
Stress, diabetes, and mental health
Diagnosis of a chronic condition at any age is challenging enough, and ongoing stress and anxiety can quickly evolve into mental health disorders. From remembering to take medications and check blood sugar to closely monitoring diet and exercise levels, the strain of this self-management — especially when some aspects of diabetes are not fully within a person’s control — can negatively impact mental health. Stress could also negatively impact diabetes outcomes, as the stress hormone cortisol may be linked to decreased insulin sensitivity.
The role inflammation plays in depression and anxiety
High levels of inflammation in the body are associated with health concerns ranging from cardiovascular disease to arthritis. However, it’s also believed to be a key player in both diabetes and some mental health disorders. Inflammation’s impacts on the central nervous system are thought to contribute to depression, while inflammation in the brain is linked to anxiety. Depression and other mental disorders are associated with immune dysfunction, which can set off inflammation leading to higher blood glucose, insulin resistance, and possible diabetes.
How insulin alters neurotransmitters in the brain
While insulin is perhaps best known for its effect on blood glucose, it also plays a key role in regulating neurotransmitters in the brain. Neurotransmitters like serotonin and dopamine can impact mood regulation. Insulin resistance may disrupt these levels, leading to changes in mood and emotional well-being.
The complicated effects of medications for diabetes and mental health
Medications are a vital component in managing both diabetes and mental health symptoms. However, many antipsychotic medications can lead to weight gain and metabolic problems, which lead to the risk of developing insulin resistance. On the other hand, medications to manage type 2 diabetes can lead to low blood sugars. This, in turn, can lead to symptoms that may impact mental well-being — such as rapid heartbeat, shaking, sweating, anxiety, and confusion, amongst others.
How people with diabetes can support their mental well-being
As highlighted, it’s vital for those with type 2 diabetes to take steps to aid their mental well-being. Recommendations are:
Engage in good “daily hygiene,” such as regular exercise, grooming, adequate sleep, and eating a healthy diet.
Consider working with a nutritionist, trainer, or other specialists to help keep these habits in check.
Work with practitioners well-versed in mental and physical health conditions and their comorbidity. This will allow for informed conversations about medications and other factors that may escalate the onset of mental illness.
Reduce stressors where possible.
Create structured daily rhythms and routines for work and social life.
If you feel your mental health has taken a hit, don’t be afraid to seek professional help.
Extracts taken from Chantelle Pattemore & Kelsey Costa, MS, RDN from https://www.healthline.com