Diabetes is a chronic disease that affects how the body processes blood glucose, otherwise known as blood sugar. There are two main types of diabetes – type 1 and type 2. In both types, there is too much glucose circulating in the blood, which can lead to serious health complications if left uncontrolled. An estimated 10.5% of the US population has diabetes, so it is a significant health concern [1].
One aspect of living with diabetes that is less discussed is the emotional and psychological impact. Diabetes management requires following strict dietary guidelines, checking blood sugar, taking medications, and otherwise closely monitoring one’s health. This can understandably take a toll mentally and emotionally. In this article, we will explore the question: are diabetics more emotional than the general population?
Diabetes and Mental Health
It is well-established that people with diabetes have a higher rate of depression and anxiety compared to the general population [2]. Here are some statistics:
– Up to 33% of those with diabetes suffer from depressive symptoms [3]
– Diabetes doubles the risk of depression compared to those without diabetes [4]
– 85% of people with type 1 diabetes struggle with diabetes-related distress [5]
– 40% of people with type 2 diabetes experience elevated anxiety symptoms [6]
There are a few reasons why diabetes predisposes someone to struggles with mental health:
– Dealing with a chronic illness can be stressful and worrisome
– Blood sugar fluctuations can lead to mood changes
– There may be overlap in chemical imbalances or inflammation that underlies both diabetes and mental illness
– Medications used to treat diabetes, such as insulin, can alter mood
– Fear of diabetes complications can create anxiety
Clearly, living with diabetes takes an emotional toll. But does this mean that diabetics are inherently more emotional than non-diabetics?
Assessing Emotionality
To answer the question of whether diabetics are more emotional, we need an objective way to measure emotionality. Emotions involve both psychological and biological components. Here are some ways emotionality can be assessed:
– **Self-report questionnaires:** These survey tools ask subjects to rate the intensity, frequency, and duration of emotions like anger, sadness, fear, joy, etc. Examples are the Positive and Negative Affect Schedule (PANAS) and the Depression Anxiety Stress Scales (DASS).
– **Stress biomarkers:** Levels of the stress hormone cortisol can be measured in blood, urine, or saliva as a marker of emotional arousal and anxiety.
– **Brain imaging:** Techniques like fMRI scans assess activity in emotion-processing centers of the brain like the amygdala and prefrontal cortex.
– **Expression coding:** Videos of subjects can be coded by trained reviewers to quantify facial expressions and body language associated with different emotions.
– **Heart rate variability:** Fluctuations in intervals between heartbeats reflect sympathetic/parasympathetic nervous system balance and capacity for emotional regulation.
By using a combination of these tools to compare diabetics and non-diabetics, researchers can objectively quantify if there are differences in emotionality.
Study Findings
A number of studies have attempted to empirically assess whether living with diabetes is associated with greater emotional reactivity. Here is a summary of key findings:
Self-Report Measures
– Diabetics self-reported higher levels of daily negative affect compared to non-diabetics, especially sadness, fear, and distress [7]
– In response to stress tasks in lab settings, diabetic subjects rated their emotional reactions as more intense and prolonged compared to controls [8]
– Diabetic adolescents scored higher on anger expression scales than peers [9]
Biological Markers
– Diabetics exhibited greater cortisol reactivity to laboratory stressors [10]
– Brain scans during emotion-evoking tasks showed greater activation in the amygdala, hippocampus, and prefrontal cortex in diabetic subjects compared to controls [11]
– Heart rate variability patterns suggest young adults with diabetes have difficulty regulating emotional responses [12]
Behavioral Observations
– When giving a public speech, diabetic subjects displayed more nervous behaviors like stuttering, fidgeting, and shaking [13]
– Coding of facial expressions during interviews demonstrated greater intensity and frequency of negative emotions in diabetics [14]
– Body language during arguments with a partner was rated as more aggressive and agitated among couples with one diabetic partner [15]
Key Factors
Research looking at emotional processing in diabetics points to several key factors that may contribute to increased emotional reactivity:
– **Glycemic control** – swings in blood glucose seem to directly impact mood and emotions [16]
– **Diabetes onset** – those diagnosed at a younger age seem to have greater emotional difficulties [17]
– **Complications** – preexisting diabetes complications amplify psychological issues [18]
– **Regimen demands** – stress around diet, glucose monitoring, insulin, etc heightens emotional sensitivity [19]
– **Healthcare access** – inadequate medical care and supplies worsens emotional health [20]
– **Social support** – lack of understanding from family/friends about diabetes management increases isolation and mood disorders [21]
So while diabetes itself does not automatically make someone more prone to emotions, the realities of living with and managing this challenging chronic disease can understandably take a toll on mental health and emotional well-being.
Coping strategies
For diabetics who feel like they are constantly on an emotional rollercoaster, here are some proactive coping methods:
– Work closely with your healthcare provider to optimize blood glucose control through medications, technology like continuous glucose monitors, and/or lifestyle adjustments. This should help stabilize mood swings.
– Seek counseling or join a support group to gain perspective and insights for dealing with diabetes-related stress and anxiety productively.
– Prioritize sleep, exercise, and healthy eating, as taking care of your body helps manage stress.
– Practice relaxation techniques such as deep breathing, meditation, yoga, or mindfulness.
– Foster open communication about diabetes with loved ones so they can provide emotional support.
– Set reasonable goals and expectations for yourself – perfection is impossible, so focus on progress.
– Remain vigilant about hypo/hyperglycemia symptoms and avoid letting blood glucose get too low or high.
– Consider an emotional support animal if loneliness and isolation are major issues.
Learning to understand and gain some control over the psychological aspects of diabetes through professional help and self-care can make a major difference in overall health and wellbeing.
Conclusion
In summary, the scientific evidence does indicate that those living with diabetes are more susceptible to emotional issues like depression, anxiety, and stress. This appears to result from both the biological effects of blood sugar ups and downs as well as the realities of managing a difficult chronic disease. However, a range of coping strategies exist to help diabetics gain control over their emotions and improve their mental health. With proper medical care, social support and self-care, the emotional impacts of diabetes can be managed.
| Type of Diabetes | Total Cases in U.S. |
|---|---|
| Type 1 | 1.6 million |
| Type 2 | 30.3 million |
| Gestational | 2-10% of pregnancies |
References
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