Diabetes and Mental Health in the UK: Strategies for Coping and Support

Developing diabetes is an experience that can change your world forever. It puts you at an increased risk of encountering emotional struggles. Having a better understanding of diabetes, as well as access to mental health care resources in the UK, may make it easier for you to find a solid strategy for coping and support.

In this article, we'll explore the services available in the UK for managing diabetes and mental health, from the NHS to charities and various self-help mechanisms. Our comprehensive guide to coping with the mental health implications of diabetes can help steer your emotional wellbeing in the right direction.

Receiving a diabetes diagnosis often means making major lifestyle changes. You also face a risk of complications, which can cause health anxiety.

One study reveals that people with type 1 diabetes are three times more likely to have mental health problems than the general population. People with type 2 diabetes are twice as likely to struggle with mental health.

When it comes to gestational diabetes, there’s a complex connection with mental health problems. Evidence shows that women with the condition are more likely to experience postnatal depression. However, it may also be the case that anxiety and depression increase a woman's risk of receiving a diabetes diagnosis.

Diabetes distress is a term used to describe how the disease may affect someone's emotional health. It can include:

• Emotional strain: Managing diabetes can induce frustration, fear, and helplessness.
• Treatment distress: Some people find that attending multiple diabetes-related medical appointments feels exhausting and chaotic. For others, events such as insulin injections become wearing.
• Complication worries: Poorly managed diabetes can cause adverse consequences. When patients become aware of the risks, they may develop health anxiety.
• Social problems: Adjusting to new eating regimens and other elements of self-management can affect your social life, such as limiting how and where you can go out for a meal.
• Financial concerns: If your diabetes diagnosis affects your ability to work, you may experience financial anxiety.

While diabetes distress may be a brief experience for some, others find that it causes long-term mental health issues that require further care.

Mental health conditions stemming from diabetes distress can include:

• Depression: According to research, people with diabetes are two to three times more prone to depression than the general population. It's also worth noting that already having a depression diagnosis can make self-care challenging, resulting in poor glycaemic control.
• Anxiety: At least one in six people with type 2 diabetes have moderate-to-severe anxiety issues. This may create psychological barriers to engaging with treatment.
• PTSD: Although diabetes isn't a direct cause of PTSD, you may develop it if you experience a traumatic incident: for example, diabetic ketoacidosis or an accident caused by your condition. There is some overlap between the symptoms of PTSD and diabetes-related distress.

The relationship between diabetes and eating disorders is often referred to as 'diabulimia'. This condition is used to describe someone who has type 1 diabetes alongside an eating disorder.

Individuals who suffer from diabulimia may stop using insulin as they worry about putting on weight. As a result, their glycaemic control is poor and they're at risk of conditions such as a DKA. This also worsens their risk of long-term diabetes complications.

An individual with diabulimia may or may not have a history of eating disorders. Alongside withholding insulin, they might engage in disordered eating, binge eating, and restricting their food intake.

If you're worried about your emotional wellbeing, you can request mental health screening from your GP or a member of your diabetes care team.

The psychological support you receive will depend on your condition. Your options may include:

• CBT: Cognitive behavioural therapy is an intervention that addresses depressive symptoms and anxiety. Your therapist may introduce you to techniques that promote better emotional wellbeing. They'll also help you learn how to manage stressors and overcome worries related to managing diabetes.
• Clinical health psychology services: Some NHS trusts offer access to CHPS. These healthcare professionals can help you address depressive symptoms as they relate to your condition. They also manage anxiety disorders, usually via a program of therapy sessions.
• CAMHS: Child and adolescent mental health services manage a range of mental health comorbidities and can include nurses, psychologists, and psychiatrists.
• Medication: Your GP or other care team members may recommend using an antidepressant medication to limit your psychological distress. When doing so, they'll ensure that those medications don't interact with those required to manage your blood glucose levels.
• Psychiatrist: It’s also possible to receive a psychiatric referral, usually outpatient.

The type of services you can access to manage psychological problems will vary according to your local NHS trust. The charity Diabetes UK has a comprehensive guide detailing what's available in each area.

It's normal to wonder whether you need help to manage the psychological impact of diabetes. If you're experiencing the following, you may need to consider seeking help:

• You're lacking the motivation needed to check your blood sugar levels or manage other aspects of your diabetes.
• You no longer feel able to spend time around other people.
• You're avoiding things that are usually important to you, including hobbies, personal development, and socialising.
• Your relationships are becoming difficult.

Seeing a private practitioner can make it easier to find the right specialist at a time that suits you. Usually, this care is self-funded.

You can find private mental health professionals by:

• Asking your GP for a private referral.
• Searching the British Association for Counselling and Psychotherapy website
• Searching for psychiatrists in your area. If you want to ensure a mental health professional is fully qualified, you can search the General Medical Council's list of registered medical practitioners.

Many people with diabetes access professional care via the third sector: charities or various advocacy groups. Such organisations can help you access psychological support outside of both the NHS and the private sector.

Using a charity to manage emotional problems can significantly improve your health outcomes. According to one study, people who experience loneliness are at greater risk of developing type 2 diabetes. This suggests that making personal connections could improve your diabetes management.

Diabetes UK is the country's largest diabetes charity. Apart from providing online resources, they also offer local support groups.

Some of the services available include fun groups, peer support, and type-specific meetings. You can search for what's available in your locale via this link.

Struggling with diabetes control can place significant strain on you and your family members. This is an issue that the Insulin-Dependent Diabetes Trust recognises and helps with. Their confidential helpline is available to people with diabetes, as well as their support network.

SEEK offers dedicated support to members of the BAME community in the Midlands and surrounding areas. They participate in interfaith community events, making it easier to take a holistic approach to diabetes management.

Managing your diabetes and mental health may feel challenging at first. However, there are certain strategies you can employ to make your journey easier:

• Start learning: Education is a core element of diabetes care. If your doctors or nurses recommend learning packages, engage with them. Knowing more about your condition can increase your sense of control and make you feel confident. If you feel as though you don't understand your condition well enough, ask for learning recommendations.
• Create a network: People with diabetes are more likely to thrive with the right support. Ask your friends and family for help. Consider joining local social, hobby, or diabetes support groups so you can connect with people who understand you.
• Set realistic goals: You don't need to conquer all your diabetes self-management techniques at once. Doing so often requires major lifestyle adjustments, and expecting to handle all of them immediately can heighten your frustration. Instead, set small and measurable goals and reflect on the progress you're making.
• Stress management: Begin exploring some anxiety-reducing techniques that you can use when feeling under pressure. Deep breathing, meditation, and mindfulness can all prove useful.
• Sleep well: Not getting enough sleep can make even the smallest problems feel insurmountable. Aim for a consistent sleep routine and ask your GP for advice if you're struggling.
• Exercise: Many people with diabetes use physical activity as a part of their self-management plan. It can help you balance your blood sugar levels and raise the hormones that increase your happiness levels. Fitness routines are also excellent for reducing stress.
• Food: Eating the right diet isn't just an important diabetes treatment. It also boosts your mood. Try meals that keep your energy levels balanced so you feel healthier throughout the day.
• Mindfulness: Try exploring mindfulness techniques to reduce your likelihood of experiencing diabetes distress. For example, you can spend a few minutes each day acknowledging your emotions and reflecting on the progress you're making.
• Celebrate: Spend some time each day making a note of the achievements you’ve made thus far. Strategies such as journaling can help your emotional health, as they help you remember how far you've come on your journey.
• Limit certain substances: While alcohol and caffeine are fine in small to moderate measures, they can play havoc with your mental health. Coffee may increase your anxiety levels, as it raises your heart rate. Alcohol feels enjoyable while drinking it, but in the long run, it disrupts the neurotransmitters responsible for balancing your mood.
• Communicate: Maintain an open dialogue with those who support you. When you experience stress, tell your GP, diabetes nurse, friends, and family. The more knowledge they have, the easier it is for them to offer support.

Treating depression and other mental health concerns can feel challenging for people with diabetes. Still, the struggle will be much easier with a good idea of all the strategies and resources available.

However, there’s always more you can do to help your condition, improve your outcome, and relieve the overall physical and mental struggle associated with diabetes.

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