Type 2 Diabetes and Depression: Is Age a Driving Factor?
Depression can lead to type 2 diabetes, and if you have type 2 diabetes, research shows you’re more likely to develop depression. This is a dangerous cycle, but there are resources available that can help.
Many studies have shown an association between developing depression and having a diabetes diagnosis, especially type 2. In fact, depression is twice as prevalent in people with type 2 than in people without diabetes. This makes sense: maintaining good mental health can be difficult if you live with diabetes.
But does age play a factor as well? Do levels of depression skyrocket even more if you’re experiencing all of the stress, burnout, and general malaise of a life lived with type 2 diabetes from a young age, as compared to being diagnosed later on in life?
How are diabetes and depression linked?
If you live with any form of diabetes, research has shown that you’re more likely to struggle with depression and anxiety. An estimated 40% of people with type 1 diabetes and 35% of people with type 2 experience significant levels of diabetes distress, which can lead to depression, anxiety, and burnout.
Dr. Mark Heyman, founder and director of the Center for Diabetes and Mental Health (CDMH), explains in How Diabetes Impacts Your Mental Health:, “Diabetes is a self-managed condition. This means that it is the person with diabetes, not their doctor, who is responsible for taking care of him or herself on a daily basis. Diabetes involves making frequent, sometimes life or death decisions under sometimes stressful and physically uncomfortable circumstances.”
Heyman continues, “In addition, diabetes management is constant and can feel overwhelming. If you or someone close to you has diabetes; take a minute and think about all of the steps you take in your diabetes management everyday. What to eat, how much insulin to take, when (or whether) to exercise, how to interpret a glucose reading, how many carbs to take to treat a low; the list goes on. Decisions, and resulting behaviors (and their consequences) are critical aspects of diabetes management. However, doing everything necessary to manage diabetes can become overwhelming – and feeling overwhelmed is usually no fun.”
Having to manage depression and type 2 diabetes is associated with less adherence to medical treatment, like regularly testing your blood sugar and taking insulin, which can result in lower quality of life and increased risk of diabetes complications, as well as increased risk of premature death.
Does age matter?
In short, yes. In a study published in September 2022, researchers analyzed electronic medical records from people diagnosed with type 2 diabetes between 2006-2017 from the US and the UK, totalling over 1.4 million people.
The researchers were looking for trends in the prevalence of depression and the risk of developing depression, especially by comparing those with “usual-onset” type 2 diabetes (diagnosed after age 40) versus “young-onset” type 2 diabetes (diagnosed before age 40).
In results that echoed other studies, people with diabetes in the study had higher rates of depression, on average, than the general population. What was more surprising was that the “young-onset” type 2 diabetes group had significantly higher rates of depression than their “usual-onset” counterparts.
In the UK, compared with people 50 years and older, the youngest men had a 23-57% higher risk of developing depression, and the youngest women had between a 20-55% higher risk than the older cohort with type 2 diabetes.
In the US, younger men with type 2 diabetes faced an increased risk of developing depression by between 5-17% and the women faced an increased risk of between 8-37%, compared to the older cohort.
This research is coming to light at a time when mental health is at an all-time low. In our current COVID-19 world, substance abuse and suicidal ideation are increasing, and access to mental health resources and health insurance coverage is growing ever more evasive. Fewer than 1 in 3 youth with severe clinical depression receive consistent mental health care, and over 60% of do not receive any mental health treatment at all. Add to that a type 2 diabetes diagnosis, and you have a recipe for a healthcare disaster.
Why might younger people with T2D be more depressed?
This is just one study, and more research is definitely needed, but it hints at a larger trend: the longer one lives with diabetes, the more likely they are to suffer from physical, mental, and emotional complications from diabetes.
When focusing on type 2 diabetes in particular, being diagnosed at a younger age may simply be more difficult to bear, when many of one’s peers may not be facing the same physical and emotional struggles so early in life.
As mentioned above, people with diabetes suffer from depression much more often than the general population, and new research shows that the younger you’re diagnosed with type 2 diabetes, the higher the likelihood of having depression.
People who are diagnosed with type 2 diabetes under the age of 40 have a significantly higher risk of developing depression even compared to those with “usual-onset” type 2 diabetes (which is a diagnosis after the age of 40), with similar risks in people both with and without other comorbidities at the times of their type 2 diabetes diagnosis.
The causes of this are unclear, but contributing factors may include living with the stigma of type 2 diabetes, the high costs of the disease, the mental toll of living with a chronic disease for a larger portion of your life, and the general hardship of living in society with a chronic illness.
It would be ideal to have doctors and other providers regularly screen for depression in people with all types of diabetes, and especially in those with type 2 diabetes who were diagnosed before the age of 40.
If you or someone you know lives with type 2 diabetes, all is not lost! There are resources available that can help.
The American Diabetes Association has a great tool for finding a mental health provider near you, or you can always talk with your doctor for their thoughts and recommendations.
Additionally, the National Alliance on Mental Illness (NAMI) organizes the work of different local affiliates, to offer support for and raise awareness about mental illness. You can call their helplines to be connected with resources near you. NAMI also helps family members and loved ones of people who are struggling with mental illness, including depression.
Finally, finding and cultivating a community of people who are having similar life experiences can be extremely affirming, and those positive interactions can have lasting effects on mental health.