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Post-Traumatic Stress Disorder and Diabetes

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PTSD

Donald Antich describes the challenges of living with PTSD and type 1 diabetes and how the right treatment gave him the skills he needed to manage both conditions.

Donald Antich, 44, thought he escaped his childhood relatively unscathed. It wasn’t until he was diagnosed with type 1 diabetes at 35 that years of physical, emotional, and sexual abuse caught up to him. 

“It felt like the stress of managing diabetes meant my brain lost the resources that were holding my PTSD at bay,” Antich, an HR analyst in Portland Oregon, said. “I’ve had to work really hard in therapy to learn new skills and accept pieces of myself.” 

Post-traumatic stress disorder (PTSD) can be caused by exposure to terrifying or life-threatening events. That can include natural disasters, sexual assault, physical abuse, or a bad accident. However, experiencing trauma doesn’t guarantee someone will develop PTSD. 

“Most people will show symptoms after a traumatic event, but they will resolve with time and support,”  said Eileen Anderson, assistant professor of psychiatry at the Case Western Reserve University School of Medicine. “When the symptoms remain or worsen over time, then a PTSD diagnosis becomes relevant.”

Not everyone’s experience of PTSD looks the same, and the symptoms can vary widely. 

“Intrusive memories, flashbacks, and nightmares are common,” Anderson said. “Many people become hypervigilant and avoid situations that might trigger recollection of the trauma. Negative thinking can onset including hopelessness, irritability, and trouble concentrating. People with PTSD may have trouble with emotional regulation and become irritated or angry faster than they used to – or feel numb.”

PTSD symptoms can start immediately after witnessing or experiencing a traumatic event. Or like they did for Antich, these symptoms can appear months or even years after the events occurred.

For Antich, both diagnoses of PTSD and diabetes happened around the same time, during a period of his life when he was under enormous stress. He and his husband at the time had just adopted three children when his mother was diagnosed with lung cancer that would ultimately claim her life. 

“I became her primary caregiver and had just become a parent. I was taking on so much in all areas of my life already, that to have this disease thrown in my lap was so challenging,” Antich said. 

In fact, research has found multiple links between diabetes and PTSD, including similar risk factors and ways they may exacerbate each other. Ahead we’ll untangle what people with diabetes should know about PTSD. 

Does PTSD cause diabetes?

People with PTSD may have a higher risk of developing type 2 diabetes, according to multiple studies. 

Some research has also found links between the incidence of childhood trauma and type 1 diabetes, especially if the trauma is severe and repeated. But whether trauma exposure directly causes diabetes onset is still unsettled. 

“What we know is that people with PTSD have a higher risk of developing type 2 diabetes, as well as cardiovascular disorder,” said Dr. Betul Hatipoglu, director of the Center for Diabetes, Obesity and Metabolism at Case Western Reserve University. 

Partly this is related to the fact that the symptoms of PTSD – especially depressive symptoms – can lead to a sedentary lifestyle, weight gain, and poor nutrition, all of which are also risk factors for diabetes. But an underlying biological link is also likely playing at least some role. 

“Our body is not separated from our mind, so our mental health directly affects our body and our body, our mental health. Treating only one won't fully achieve what is needed: a healthy, joyful life, that everyone deserves,” Hatipoglu said.

PTSD can make it harder to manage diabetes

People with dual diagnoses of PTSD and diabetes may have a harder time managing their diabetes, research suggests. In a 2020 study, researchers surveyed a group of people with diabetes about their trauma history and found that those with a PTSD diagnosis had higher A1C levels

“People suffering from PTSD are less likely to make positive behavioral choices such as exercise, healthy eating, and taking medications as prescribed,” Anderson said. “In fact, they may go the other way into substance abuse or other risky behaviors. They might also pull away from close relationships that can be supportive to health-seeking behaviors.” 

For Antich, diabetes seemed to fuel his PTSD and vice versa, especially in those early days when he was first learning how to live with diabetes.

“I found that it was consuming so much of my life trying to understand this disease. I lost the ability to engage in my life the way that I used to. My brain couldn't focus on things. I was dissociating a lot,” Antich explained. 

“And there's something about the moments when you do go low and you're shaking and sweating and you can't form words – it’s so scary that it can trigger your PTSD,” he said.

Getting help

While it can feel overwhelming to manage PTSD and diabetes at the same time, the most important thing to know is that you are not alone and there is help out there.  

“Working to manage one of them can actually help with the management of the other,” Anderson said. ”For example, healthy eating and regular exercise are shown to help both. Therapy and behavioral coaching can also help both. Finding social and professional support can really help.

Treatment for PTSD can include psychotherapy (cognitive behavioral therapy or exposure therapy), and medications, especially selective serotonin reuptake inhibitors, a type of antidepressant. While medications can help reduce the severity of symptoms, a combination of medication and talk therapy is the most effective treatment. 

For Antich, his struggle with PTSD came to a head in early 2023. 

“I became suicidal. I was really struggling, and I just realized I couldn’t keep going on like that,” he said. 

He took a leave of absence from work and enrolled in an intensive outpatient program. Today, he’s doing much better owing to the coping skills he’s worked to build. Now being open about his experiences is its own type of therapy. 

“We don’t talk about the darkness or the struggles enough,” he said. “People struggle so silently all the time. I just feel now that if we’re going to struggle, we shouldn’t have to feel isolated simply because we don’t know that others are going through this experience.” 

If you are currently having suicidal thoughts and need immediate help, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255) or access the Crisis Text Line by texting “TALK” to 741741. Find additional helpful suicide prevention resources here.

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