5 Ways People Living with Type 2 Diabetes Manage Their Mental Health

Caring for both your mind and body is crucial for helping you cope with type 2 diabetes holistically — here are some tips on how to do it.

“It hits you like a Mack truck at first.”

That’s how Rebecca Olander, 55, of Virginia describes getting a type 2 diabetes diagnosis. When Olander was first told in the spring of 2022 that her blood sugar numbers made her officially a person with diabetes, she felt depressed, afraid, and overwhelmed.

“The first thing I asked my doctor was, ‘Am I going to need insulin?’” Olander says. “Her response was: “Not if you turn this around.’”

Immediately, Olander began her search for support. As someone already managing chronic illness (she has high blood pressure and thyroid issues), she knew that she was going to need a community to help her get on track.

She found a couple of groups on Facebook, met with her diabetes educator who helped her cut back on high sugar items that were spiking her blood sugar, and began mental health therapy. As a result, Olander has been able to get her blood sugar down from around 350 to 100–130 on average.

“You can reverse type 2. That’s what I’m aiming to do,” she says. But the key, Olander knows, is that you can’t get back to healthy ranged blood sugar levels alone — and you can’t overlook the mental side of it.

“I started therapy because I knew I needed someone to talk to who listens and who I feel like is there for me,” she says.

Following a type 2 diabetes diagnosis, the first thing doctors and diabetes educators will work with you on is your diet and exercise. Behavioral changes in these areas can be as important (if not more so) for managing a type 2 diagnosis as medications.

But what’s often overlooked is how crucial it is to manage your mental health while managing your blood sugar numbers.

“It’s a vicious cycle. Stress can wreak havoc on your blood sugar to begin with,” explains Lesley Koeppel, LCSW, a New York-based therapist who specializes in counseling people with chronic illness. “Then you have the added stress of managing your physical health with diabetes.”

In fact, research suggests a link between diabetes and mental health issues such as depression. This may be due to the way diabetes impacts the brain, the stress of managing the condition day-to-day, or a combination of both.

But many doctors and endocrinologists are only focused on the physical aspects of diabetes, Koeppel says. “Some just don’t understand the mental side of it.”

“I felt very alone with managing my diabetes,” says Tracey Hayes, 44, who’s based in Ireland and was diagnosed with type 2 diabetes in May 2019. “My doctor told me to work only on diet and lifestyle to get it under control. She was well aware I had an eating disorder and had battled bipolar disorder, as well. She was of no help.”

Both Hayes and Olander have learned that managing type 2 is as much a matter of managing your mental health as it is managing what goes on your plate.

So we put together some concrete tips that can help you find your way to caring for your mind and body with type 2 diabetes. No matter where you’re at in your type 2 journey, these tips can go a long way toward helping you cope with the disease holistically.

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Don’t let diabetes control you

Managing type 2 diabetes is a 24/7 job. While other conditions require taking meds and managing symptoms, the nature of type 2 diabetes creates a lot of pressure for patients to control every detail of their diets and routines.

“It’s a good thing that with type 2 you do have some level of control over the disease and how it progresses,” Koeppel says. “But it can be a recipe for disaster if you become overly focused.”

People managing diabetes are more at risk of developing eating disorders, research shows. If you’re feeling anxiety or shame around eating, or overwhelmed with rigid schedules around food and anxiety, this is something to seek support for before it gets worse, Koeppel says.

“When I was first diagnosed, it really took over my life,” Olander says. “I had to really take a step back and find a balance.”

For her, it was a matter of trial and error.

First, she cut out the things she knew were just an absolute no — things like pasta (her weakness, she says) and International Delight Iced Coffee (chock full of sugar). Then, she worked with her diabetes educator to build healthy meals she could enjoy.

Finally, she takes a moderate approach to managing cravings. “I think it’s important to have some things on the ‘no’ list sometimes and in moderation, like once a week,” Olander says.

“For me, I really like Funyuns and Doritos. I’ve found I can have 13 Funyuns or Doritos without spiking my blood sugar if I pour out that portion on a napkin and eat them very slowly, one at a time, over 30 minutes. It satisfies the craving without negating my progress,” she says.

Find a support group

A type 2 diabetes diagnosis can change everything about your life. It can be isolating when it’s no longer OK for you to eat and drink without thinking about it, or when you can’t eat the same meals as your family, for example.

Not only that, type 2 diabetes can be very individual. Every person with diabetes comes to know there are specific things that spike their sugar personally, or they learn little tricks for food prep or monitoring that really help them manage.

Sharing these learnings — and the frustrations along the way — can be massively healing, Koeppel says.

“There is nothing more powerful than being in a room or on a Zoom call with others dealing with the same thing. There’s nothing more powerful than having a shared experience,” Koeppel says.

Whether you join a formal support group or an informal one, finding a tribe of other people with type 2 diabetes who you can lean on for support can go a long way toward helping you navigate the ups and downs of the disease.

Understand the link between mood and blood sugar

As we said earlier, researchers have noted a clear link between mood disorders, like major depression, and type 2 diabetes. It’s also important to note that many of the symptoms of mood disorders are also symptoms of unmanaged blood sugar.

“When my diabetes was unmanaged, I struggled with severe mood swing highs and lows,” Hayes says. “I struggled with both depressive episodes and anxiety. I had no idea my blood sugar affected my moods.”

Only after she was diagnosed did she realize these were actually just symptoms of her diabetes. Today, she knows that “hangry” feeling and works to prevent herself from getting there.

“The way I’ve learned to manage is to make sure to eat every 4 to 5 hours,” Hayes says. “Any longer than that my blood sugar drops, I get sweaty palms, [become] irritable and hangry, and my body gets stressed.”

“The way to break the cycle is by developing a level of awareness of these issues,” Koeppel adds.

When you know that not only will a spike in blood sugar affect your physical health but your mental health, it’s motivating to stay on track with your meals and snacks and medicines so you don’t get to that point.

Try mindfulness or another relaxing activity that works for you

Just because you have diabetes doesn’t mean it’s the only stressor in your life. Most people with diabetes are also living full lives with jobs, families, and other responsibilities.

But stress is a particular concern for people with diabetes. Just as spiking blood sugar can make you feel anxious and stressed, outside stress can spike your blood sugar. “The way to break the cycle is by learning some stress management techniques,” Koeppel says.

This could mean downloading a mindfulness meditation app to your phone and creating a daily practice.

Olander has found success with guided meditations. “You can check YouTube and even your local library’s online resources for free sessions. There’s so many different types. Guided controlled breathing with guided body relaxation works best for me,” she says.

“Emotions definitely mess with your blood sugar,” she adds. “I’ll check mine when I’m upset and see it’s high, and I know I need to go lie down for five minutes and disconnect. Just take five breaths in and five breaths out.” That’s often all you need to tamp down on the stress response.

Don’t beat yourself up

It’s easy to feel like a failure when you’re working really hard to improve your health and yet the number on the scale or the blood sugar monitor doesn’t seem to be moving.

Keep in mind that what works for everyone else may not work exactly the same for you. But learning to be resilient in the face of type 2’s many challenges can help you keep going until you find your own version of health and success.

“My main piece of advice is: be patient with your body,” Hayes says.

“Learning to love myself unconditionally has been the key to finding my way back to wellness. Managing diabetes is for life. So go easy on yourself, but commit to yourself — you’re worth it,” she says.