Why are depression and diabetes linked, and what can you do to prevent and treat them?

Two of the most common health problems in the United States are depression and diabetes. Nearly 15 million American adults are diagnosed with depression in any given year, and more than 23 million people have diabetes. But depression and diabetes have more in common than just their prevalence—each can increase your risk of having the other.

This link has been demonstrated in several studies. Depression may increase your risk of type 2 diabetes, although the link is not as strong as it is for diabetes increasing the risk of depression. Twenty to 25 percent of people with diabetes are estimated to have clinically significant depression—twice the rate of those without diabetes.

Managing either depression or diabetes can be difficult. Having both can be even more challenging. People with both tend to have more severe symptoms of each disease and require more medical services. Fortunately, treatment is available for both depression and diabetes.

Why depression increases your diabetes risk

Experts still don't fully understand why depression and diabetes are so strongly linked, but a mix of biological and behavioral factors seems to be at work. Factors that may make those with depression more susceptible to type 2 diabetes include:

  • Cortisol. Also known as the stress hormone, cortisol is involved in blood glucose metabolism and insulin sensitivity. People with depression have high cortisol levels, which are also associated with increased fat deposits in the abdomen—a risk factor for type 2 diabetes.
  • Unhealthy lifestyle choices. If you are depressed, you may not have the energy or motivation to exercise or eat a healthy diet. You may turn to smoking or other unhealthy behaviors that can increase your risk of diabetes.

Why diabetes can bring on depression

Factors that may cause those with diabetes to experience depression include:

  • Illness burden. This phrase refers to the psychological impact of a chronic illness—in other words, simply knowing you have diabetes can lead to depression.
  • Diabetes-related stress. Managing a chronic condition—especially one such as diabetes, which can require significant lifestyle changes—is stressful, and that stress can lead to depression. If you are diagnosed with diabetes, you may feel that you're missing out on things and that spending time with friends and relatives is too complicated because of your dietary restrictions. As a result, you may withdraw from the people and activities that you love, which can put you at risk for depression.

Publication Review By: Karen L. Swartz, M.D.

Published: 21 Aug 2013

Last Modified: 21 Aug 2013