How Diabetes Impacts Your Mood

Sensitive Topic Warning: This article discusses anxiety, stress, depression and mood swings, which may be triggering for readers. If you are having thoughts of suicide, contact the National Suicide Prevention Hotline for support: 1-800-273-8255. You are not alone.

There’s no doubt that blood sugar plays a major role in how you feel physically and mentally. Regardless of diabetes, anyone can experience mood swings, depression or anxiety. When you add diabetes on top of these conditions, they can feel heightened or worsen.

If you live with diabetes, you face an extra set of variables that can affect your mood, in the short term from hour to hour and over the long term of several months or years. From mild stress and anxiety to severe depression, diabetes can play a significant role in your emotional well-being.

This guide explains common ways diabetes impacts your mood and how to manage it.

How low blood sugars impact your mood

Anyone taking insulin or a sulfonylurea is at risk of experiencing low blood sugar (hypoglycemia) and the mood swings that come with it. Low blood sugar can feel scary, regardless of how frequent or severe it is. The fear of a low blood sugar is real and can feel life-threatening—because it essentially is if left untreated. 

If you’re experiencing lows often, it could leave you feeling terrified, overwhelmed and anxiety-ridden daily. Even when the impact on your mood is mild, it’s impossible to avoid. No one wants or deserves to live in that state of fight or flight mode.

If you take insulin or any medication that puts you at risk for low blood sugar and the doses aren’t matched well with your body’s needs, frequent and unpredictable lows can wreak havoc on your mood even when you’re not low. Worrying about the next low and the frustration you might feel because you’re afraid of activities that might cause lows can be all-consuming. It can feel like you’re always waiting for the other shoe to drop.

During a low blood sugar, you may feel:

• Angry
•  Confusion or trouble thinking clearly
• Irritable
• Sad
• Scared
• Panicked
• Overwhelmed
• Anxious
• Tired
•  Jittery or shaky
• Like you are  intoxicated or impaired

In fact, low blood sugars can easily be dismissed as a panic attack if you haven’t been diagnosed with diabetes yet. Surprisingly, low blood sugars can be an early symptom of type 2 diabetes (T2D).

How to address the impact low blood sugars have on your mood

Depending on what you’re doing when a low blood sugar strikes, the impact it has on your mood may be very different. For example, going low when you are juggling two small children might leave you feeling irritable and panicking, while going low when you’re exercising may leave you feeling completely defeated, exhausted or burned out.

If you’re experiencing frequent lows, there are a few steps you should take to get on top of them and stop the cycle:

• Talk to your healthcare team. This is a clear sign you’re getting too much insulin and that your doses need to be adjusted ASAP. 
• Always carry fast-acting carbohydrates with you to treat mild lows.
• Remember to carry emergency glucagon in case you have a serious low blood sugar problem.

How high blood sugar impacts your mood

The way high blood sugars (hyperglycemia) affect your mood can be much more subtle or sneaky than with lows. High blood sugars also don’t usually come with that sudden sense of emergency or panic because they aren’t immediately life-threatening like lows are.

Instead, high blood sugars might leave you feeling:

• Irritable and cranky
• Angry
• Tired
• Lacking enthusiasm for daily activities

While high blood sugar may rise slowly, the symptoms of frustration or anger can still feel sudden, leading to mood swings, too. Sometimes a brisk walk and a tall glass of water can help bring high blood sugar down a bit, but other times it may mean your medications need to be adjusted. Other lifestyle patterns like what you eat and drink and physical activity also impact your blood sugars and are worth reviewing with your care team. 

If you take insulin, you may need a correction dose, or if you have chronically high blood sugar, you may need to adjust your basal (long-acting) insulin dose. Pump users may need to adjust their background insulin settings with support from their healthcare team.

If you are experiencing frequent high blood sugars, talk to your doctor, no matter your diabetes management method! This is a clear sign that your body needs more support to keep your blood sugars in a safe and healthy range.

Anxiety and depression

It’s no surprise that diabetes and mental health struggles go hand-in-hand. Look at what you deal with as a person with this disease—how could it not impact your mood 24/7?

On any given day, regardless of how well self-managed you are, you may deal with:

• Blood sugar fluctuations
• Constant fear of hypoglycemia
• Stigma and judgment from others
• High-maintenance medications
• Constant fear and threat of complications
• Managing diabetes technology
• Constant attention to food and exercise
• Constant attention to weight management
• Managing existing complications
• The financial burden of affording meds and supplies
• Frequent doctor visits

These are just the parts of diabetes we can put easily into words—there’s so much more to living with this disease that can wear on your daily mental health, resilience and stress tolerance.

How anxiety impacts people with diabetes

The National Institute of Health describes anxiety as feeling intensely worried about something that might happen or something you feel you can’t control. Anyone can feel moments of anxiety throughout their life. Still, when that anxiety starts to impact day-to-day activities and is consuming more hours of your day than not, you may be suffering from what’s known as generalized anxiety disorder (GAD).

The anxiety that comes with type 1 diabetes (T1D) and T2D could easily stem from a huge number of variables that we juggle every day. Diabetes is often about managing those variables so you can more easily predict your blood sugar, especially if you take insulin. If so few things in life are easy to control, it can easily lead to a constant anxiety-ridden battle.

People with T1D may experience anxiety that isn’t related to their diabetes but significantly impacts it.

Research from 2019 determined that young people with T1D had significantly more difficulty keeping blood sugars in a safe and healthy range while struggling with anxiety and depression. Studies show anxiety and depression affect T2D and vice versa. This can mean having T2D with anxiety and depression can impact your  quality of life. Dealing with anxiety on top of diabetes is important because it could help with the daily demands of diabetes management too.

How depression impacts people with diabetes

Like anxiety, everyone goes through rougher phases of life or smaller periods of depression. You know your depression has become more significant when it starts to affect how you care for your diabetes, how you show up in other parts of your life—like your work, with your friends and family—and your overall enthusiasm to be alive.

In diabetes, depression can also look like burnout—which means your depression is mostly focused on diabetes management, not other parts of life outside of diabetes. Of course, higher blood sugar levels could also increase general feelings of depression, a lack of energy and a lack of enthusiasm for the usual joys of life, which  can take a toll on your mental health.

Fortunately, there’s a great deal of research starting to focus on how significant the impact of diabetes is on mental health, and greater efforts are being made to screen people of all ages with T1D and T2D for mental health struggles more frequently. 

While depression can feel impossible to tackle, especially when it’s about something that isn’t temporary—like diabetes—you do not have to struggle alone. Resources are available to support you and help you work through it alongside professionals, or possibly even with medication, if advised by those professionals.

Resources for depression and anxiety

If you are struggling with depression or anxiety while managing diabetes, seek help. 

Here are some resources and tips for support:

• Talk to your healthcare team about how you feel and potential medications, therapy and testing for other conditions—like hypothyroid—that can cause anxiety-like symptoms.
• Visit the American Diabetes Association’s Mental Health Professional Directory for resources and connect to professional support from therapists who specialize in care for people living with diabetes .
• Connect with other people who have diabetes (PWD) through Beyond Type 1’s Community Apps for T1D and T2D support.
• Tell your closest friends or family that you’re struggling, and let them support you! Asking for help is hard, but it’s even harder if the people who love you most don’t know you need it.
• Start a new hobby. Whether it’s going for a walk with your coworker every day at lunch or joining a book club, find something new that you enjoy and look forward to!
• Listen to supportive podcasts like Your Best T1D Year or Juicebox Podcast.
• Read books on diabetes burnout like “Diabetes Sucks and You Can Handle It” or “Dealing with Diabetes Burnout.”

You deserve support

Your emotional well-being is important, and your concerns deserve to be meaningfully addressed. Depression, anxiety and burnout aren’t uncommon for many people navigating diabetes. If you are feeling challenged by diabetes’s impact on your mood, seek help from your healthcare team, friends and family members. They want to see you thrive in life with diabetes!

Join a community that understands what it’s like to navigate life’s ups and downs with diabetes. Participate in Beyond Type 1’s Community Apps.