It is a massive understatement to say that diabetes can be “stressful”.

Living with any type of diabetes is a non-stop chore that inevitably takes a toll on your emotional wellbeing. 

Some days the toll it takes is subtle and easy to dismiss. Other days that toll feels so heavy and insurmountable that you feel like you’d be better off giving up. And there are days that easily fall somewhere in between. 

Managing type 1, type 1.5, or type 2 diabetes is no joke. To an outsider, it may look like a long game of counting carbohydrates, dosing insulin, and snacking on candy when you’re feeling a little “off.” 

But we know the truth: living with diabetes can easily lead to burnout or depression.

How do you know which one you might be personally facing…and then, what to do about it?

Burnout vs. Depression

It’s estimated that 20 to 30 percent of people with diabetes are struggling with a type of depression, according to a 2014 study published by Endocrine magazine — and 10 percent of those could be diagnosed with a “major” depressive disorder.

This means one particular thing: You are not alone.

But there is a big difference between burnout and depression.

• Burnout is specifically focused on how you feel about diabetes and the endless tasks required to manage it. When you think about other parts of your life, you still feel like yourself and carry your normal amount of enthusiasm for your day-to-day life. And keep in mind that “burnout” doesn’t have to mean you’ve stopped checking your blood sugar or counting your carbs. Instead, it can simply mean you are really sick and tired of managing diabetes, even while you continue to do all those daily tasks.
• Depression is more general, affecting how you think about many broader aspects of your life and your enthusiasm for your life. And diabetes may certainly be a major contributor to that depression, but it’s impacting your entire life rather than just your A1c. Most likely, depression is going to affect things like your relationships, education, career, social life, family, and overall health. 

Symptoms of burnout

• Eating more of the foods you know make blood sugar management difficult.
• Lying to friends, family, or doctors about your blood sugar levels.
• Going a few days without taking oral medications.
• Going a few days or weeks without checking your blood sugar.
• Purposefully letting your blood sugars run high for hours or days.
• Ignoring carb-counts completely, and winging-it with insulin doses.
• Feeling exhausted by uncooperative and unpredictable blood sugars.
• Feeling scared or depressed by worsening diabetes complications.
• Taking only enough insulin to keep yourself (hopefully) out of the hospital.
• Feeling filled with anger for having to live with diabetes every single day.

Symptoms of depression

• Feeling sad, anxious, and hopeless on a regular basis.
• Feeling worthless or shameful about different aspects of your life.
• Feeling very pessimistic about your life and your future.
• Feeling cranky, irritable, and angry, even towards things or people who bring you joy.
• Less interested in activities you normally enjoy: eating, sex, exercise, hobbies, etc.
• Less energy in general, wanting to stay in bed or sleep an unreasonable amount.
• Difficulty concentrating at work, school, or home.
• Difficulty sleeping at normal hours despite possibly wanting to sleep during the day, too.
• Developing physical symptoms like achy muscles, headaches, and digestive problems.
• Having thoughts of suicide or self-harm. (Call the National Suicide Prevention Hotline, available 24 hours a day: Call 1-800-273-8255.)

Tips for treating depression as a person with diabetes

If you think you are struggling with depression, the American Diabetes Association and the National Institute of Mental Health recommend the following steps:

Talk to your healthcare team! It can be hard to acknowledge depression and ask for help but these people exist in your life for this very reason. Speak up (or write it down on paper if you can’t say the words). You are not the first nor the last person to struggle with depression or burnout. For burnout, simply letting your healthcare team know that you’re struggling and that you need a purposeful break to step back and lighten up on the pressure to achieve a certain A1c, for example, can be all it takes. They are your team! Let them help you.

Talk to at least one closes friend or family member. You might be surprised at just how many people around you have struggled with some version of depression. Opening up to a friend or family can also simply get it out of your head and into real life with someone who cares about you. There’s no way to measure the value of having someone to talk to who knows who you are and what you’ve been through.

Address persistently high blood sugars. Persistently high blood sugar levels will absolutely take a toll on your brain and your body and your enthusiasm for life! If you’ve been enduring high blood sugars for weeks or months, speak up and ask for help. Sometimes a simple increase in your insulin doses or other diabetes medications can make all the difference. 

Definitely, consider seeing a therapist. Whether it’s depression or burnout, therapy is a worthwhile resource, and while it can be daunting if you’ve never been, it can be lifechanging. Even just one or two sessions might be plenty to help get your feelings and thoughts out of your head and onto someone who can help you sort through them. 

Consider an antidepressant for depression, burnout or anxiety. There’s definitely a stigma that comes with needing or taking an antidepressant, but like therapy, it can be lifechanging for some. In many cases, it can simply take a Level 10 anxiety or depression down to a Level 6. Finding the right medication for you can take time, but when you do, it can simply take the edge off those stronger feelings to help you get through your day more easily. Even if you’re dealing with diabetes burnout, an antidepressant to help take the anxiety and stress out of diabetes management could be helpful.

If you are thinking about suicide…reach out for help now. There is more to life than what you’re feeling right that minute or moment. When life is down, it doesn’t stay down forever, just like when life is up, it doesn’t stay up forever either. Call the National Suicide Prevention Hotline, available 24 hours a day at 1-800-273-8255.

Resources for managing diabetes burnout 

• Dealing with Diabetes Burnout: How to Recharge & Get Back on Track by Ginger Vieira
• Diabetes Burnout: What To Do When You Can’t Take It Anymore by Dr. Polonsky