The Silent Strain: Understanding Diabetes and Mental Health

By Kevin Shrum, MA, LPC-A

When most people think about diabetes, they picture glucose monitors, insulin injections, and dietary changes. But behind the daily routines lies a quieter, often overlooked reality: the profound effect diabetes has on mental and emotional well-being. Living with diabetes—whether Type 1, Type 2, Type 3, or gestational—is not just a medical condition to manage; it’s a continuous psychological journey that requires resilience, attentiveness, and support.

The Emotional Toll of Constant Management

Managing diabetes is a round-the-clock responsibility. Every day involves counting carbs, checking glucose levels, planning meals, and anticipating how stress, sleep, or exercise might influence your next reading. This constant monitoring can feel overwhelming.

Decision fatigue is a common experience. Making hundreds of health-related decisions each day can drain your mental energy and lead to burnout. For many, it feels like there’s never a moment to fully relax—no true “off” switch.

Diabetes Distress: More Than Ordinary Stress

There’s a specific term for the emotional burden that comes with this lifestyle: diabetes distress. It’s not exactly depression or anxiety, but a unique emotional strain caused by the relentless demands of diabetes self-management. It may look like:

• Feeling discouraged about diabetes care
• Worrying about long-term complications
• Fearing hypoglycemic episodes
• Experiencing guilt or shame about food choices or glucose fluctuations
• Feeling defeated when readings don’t match your effort

Diabetes distress is common and can affect anyone, no matter their type of diabetes or how long they’ve been diagnosed.

Depression and Anxiety: Higher Risks That Matter

Research consistently shows that individuals with diabetes are two to three times more likely to develop depression or anxiety. This increased risk can stem from:

• The stress of long-term health management
• Physical symptoms that overlap with mood disorders
• Feeling pressure to stay constantly “in control”
• Fears about future complications
• Social isolation or stigma

For many, anxiety is tied to the real and present fear of low blood sugar episodes. That fear may influence everyday choices, sometimes limiting exercise, social activities, or even sleep.

Self-Image and Lifestyle: A Changed Identity

A chronic condition can reshape how someone sees themselves. Devices like pumps, continuous glucose monitors, or frequent medical appointments can create feelings of frustration, embarrassment, or loss of autonomy.

Young people, in particular, may wrestle with these emotional challenges as they navigate identity, independence, and their relationships with peers.

Caregiver Stress: The Unseen Emotional Load

Parents and caregivers of those living with diabetes often experience significant stress of their own. The responsibility of monitoring glucose levels, preparing meals, and responding to urgent situations can lead to anxiety, disrupted sleep, and emotional exhaustion.

Supporting caregivers is just as vital as supporting the person diagnosed with diabetes.

Finding Support and Strength

The emotional strain of diabetes is real—but it is manageable with the right tools and support. Here are a few helpful approaches:

1. Build a Supportive Community

Connecting with people who understand—support groups, diabetes educators, therapists, or online communities—can reduce feelings of isolation.

2. Integrate Mental Health Into Your Diabetes Care

Mental health professionals familiar with chronic illness can help you navigate emotions, build coping strategies, and manage anxiety or depression.

3. Practice Self-Compassion

Blood sugar levels fluctuate for many reasons beyond your control. Be gentle with yourself and recognize your efforts, even on difficult days.

4. Explore Mind-Body Techniques

Mindfulness, yoga, breathing exercises, and other relaxation methods can lower stress levels and may even support more stable glucose control.

5. Partner With Your Healthcare Team

A well-rounded care team—physician, dietitian, therapist, and diabetes educator—can help create a plan that feels supportive rather than overwhelming.

A Final Thought

Diabetes undeniably affects daily life, but it doesn’t have to dictate your emotional world. Acknowledging the silent strain of diabetes is the first step toward creating a healthier, more compassionate relationship with your condition—and with yourself.

If you’re ready to talk about the mental health side of managing a chronic illness, please reach out to Kevin Shrum, MA, LPC-A at 469-907-4683 or kevinshrumcounseling@gmail.com. I look forward to supporting you on your journey.