Although you can’t change a diabetes diagnosis, you can take steps to ease your anxiety.
What Is Anxiety, and How Might It Affect People With Type 2 Diabetes?
Everyone experiences anxiety from time to time, but for someone with an anxiety disorder, feelings of worry and fear are overwhelming or uncontrollable — and they persist and may even worsen over time, notes the Mayo Clinic. People with anxiety may have intrusive thoughts, avoid certain situations that cause distress, and have physical symptoms like high blood pressure. An anxiety disorder is just as much a medical condition as diabetes is. The difference between everyday anxiety and a clinical diagnosis is how much the anxiety affects your life. “A clinical diagnosis really requires that degree of impairment in your life where you’re not able to fulfill major obligations,” says Nicole Bereolos, PhD, MPH, a clinical psychologist and certified diabetes care and education specialist in Dallas. Although people with anxiety can care for their family and perform tasks at their job, anxiety can affect how well someone is able to attend to those obligations, Dr. Bereolos says. RELATED: Should You Add a Therapist to Your Diabetes Care Team? According to another study, published in February 2014 in the journal Medical Science Monitor, 42 percent of people with type 2 diabetes also have anxiety and 28 percent have depression. Women are also more likely than men to experience anxiety. And according to a study published in November 2015 in the American Journal of Public Health, anxiety might be more common in women during the first two years of the disease. Interestingly, research suggests anxiety may be tied to type 2 diabetes risk. According to a September 2016 study published in the journal Psychoneuroendocrinology, which measured levels of blood glucose and IL-6, a protein in the body that stimulates immune response and healing, found that people with with low inhibition — or attention control — were more likely to have type 2 diabetes. RELATED: Is Stress the Source of Your Blood Sugar Swings?
What Causes Anxiety in People With Type 2 Diabetes?
For people with diabetes, the causes of anxiety are multifaceted. For starters, the everyday hassle of testing blood glucose levels, taking medication, and trying to manage diabetes can be stressful. “You can do the same thing every day of the week and have different blood sugar values,” Bereolos says. People with diabetes may also worry about trying new foods; traveling; diabetes complications; the toll the condition takes on their family; and healthcare costs, which are 2.3 times higher than for someone without diabetes, explains the American Diabetes Association (ADA). What’s more, according to an October 2019 survey commissioned by John Hancock (an investment, financial services, and life insurance company), nearly half of the more than 30 million people living with diabetes “worry they won’t qualify for a life insurance policy because they have diabetes, and if they can secure coverage they’re worried that it’s too expensive.” “It’s always on your mind, so you can become preoccupied and then overgeneralize your thoughts,” Bereolos says. RELATED: How to Help Prevent Kidney Disease When You Have Diabetes
What Are the Symptoms of Anxiety When You Have Type 2 Diabetes?
Trying to determine whether anxiety is psychological or due to blood sugar fluctuations can be tough because both hypoglycemia and hyperglycemia symptoms mimic symptoms of anxiety, Bereolos says. But unlike blood sugar fluctuations, signs and symptoms of an anxiety disorder persist. According to a study published in August 2014 in Health Technology Assessment, symptoms of anxiety disorder include:
Restlessness or feeling on edgeDifficulty concentrating or mind going blankIrritabilityMuscle tensionProblems with sleepBeing easily fatigued
RELATED: How to Stabilize Your Blood Sugar The one exception is panic disorder. Panic attacks are intense and short-lived — they usually last between 15 and 20 minutes, according to the NHS. They aren’t triggered by a specific thought or event, but occur seemingly out of the blue. Some people who experience panic attacks never know where they come from, Bereolos says. Past research has linked panic episodes to specific situations like higher A1C levels, increased diabetes complications, and disability. According to the National Institutes of Health (NIH), symptoms of a panic disorder include:
Sensations of shortness of breath, smothering or chokingHeart palpitations, a pounding or racing heartSweatingTrembling or shakingFeeling like you’re having a heart attack or dyingFeeling of impending doom
RELATED: The Top 10 Blogs to Help You Manage Anxiety
How Is Anxiety Diagnosed in People With Type 2 Diabetes?
Because symptoms of blood sugar fluctuations and anxiety can mimic each other, it’s important to speak to your doctor first to rule out a blood sugar issue before turning to a mental health provider for treatment for anxiety, Bereolos advises. If you believe you have an anxiety disorder, your primary care physician or a therapist can make the diagnosis by asking a series of questions or asking you to fill out a questionnaire. RELATED: 5 Surprising Foods That Have Little Impact on Blood Sugar
How to Cope With Anxiety
When it comes to coping with anxiety, it’s important to find effective ways to deal with stress. For some, a regular meditation practice helps with stress management. According to the Mayo Clinic, finding ways to better manage your time, practicing good sleep hygiene, eating balanced meals, and exercising are other ways to find relief, too. “You want to calm the body down so it can better deal with stress day to day,” Bereolos says. Also, a diabetes or anxiety support group can help you cope with anxiety, especially if you think you’re the only one experiencing it. “It can help to rationalize your thinking, which in essence helps to treat the anxiety and depression going on,” Bereolos says.
How to Treat Anxiety
Although anxiety disorders respond well to treatment, only 36 percent of people are treated, according to the Anxiety and Depression Association of America (ADAA). If you have anxiety, there’s no reason to suffer in silence. Not only can it prevent you from living a happy, full life, but a study published in January 2017 in the journal Diabetes Care found that people with both anxiety and depression have a higher risk for premature death. RELATED: The Truth About How Type 2 Diabetes Affects Your Life Expectancy Cognitive behavioral therapy (CBT) combined with medication can also help. CBT works by identifying, understanding, and changing thoughts and behaviors, according to the Anxiety and Depression Association of America. Several telemedicine apps, such as Talk Space and LiveHealth Online, can help you connect with a therapist remotely, if you’re unable to see a specialist in person. As an active participant in your treatment, in CBT you’ll do homework and practice exercises over several weeks or months. “This is a new skill that you’re having to fine-tune and develop over time in order to incorporate it into your day-to-day life,” Bereolos says. There are several different types of medications you can take to manage anxiety, such as antidepressants and anti-anxiety drugs. Although they’re generally compatible with diabetes medications, you should always tell your doctor what you’re taking, to be safe. Like any medication, drugs for anxiety all carry side effects; they may also take up to six weeks to start working, says the Mayo Clinic. Your primary care physician can prescribe medication, but if you have a serious mental health diagnosis, are concerned about drug interactions or can’t find a medication that is effective, it’s best to see a psychiatrist. RELATED: 10 Tips to Help You Take Your Diabetes Medication on Time
How to Help Someone With Anxiety and Diabetes
If you have a family member or a friend with type 2 diabetes and anxiety, be positive, and don’t assign blame, give advice, or try to fix it. People with anxiety, whether they have diabetes or not, simply want to be heard. “The best thing to do is be there as a sounding board,” Bereolos says. For advice on coping with stressful situations, check out Diabetes Daily’s article “Type 1 Therapist’s Tips for Coping and Grieving During Hard Times”!
