The Bit Nobody Sees: Diabetes and Your Mental Health

On Day 31 of my challenge, the scales said something I hadn't seen in a long time: under 85kg.

That should have been the headline. It wasn't.

That morning, a friend I've known for years posted about mental health and suicide. They'd been diagnosed with Type 1 a few years earlier. It stopped me in my tracks. And it made me think about how little we talk about diabetes and mental health together.

What this condition asks of you

From the outside, diabetes looks like a numbers condition. Carbs, units, readings.

What people don't see is that every one of those numbers runs through your head, all day, every day, with no day off. What to eat. How much to dose. The unexplained high. The alarm at 3am. Is this my blood sugar or my mood?

There's no version of that without a mental health cost.

The numbers

• People with diabetes are 2 to 3 times more likely to have depression than people without it.
• In a 2024 International Diabetes Federation survey, 77% of people with diabetes had experienced anxiety, depression or another mental health condition because of it.
• 79% had experienced diabetes burnout. Of those, 3 in 4 had stopped or interrupted their treatment.

Three different things

Diabetes distress. The frustration, exhaustion and guilt when the numbers aren't perfect. The feeling that nobody around you gets it.

Diabetes burnout. When it all gets too much and you stop looking after yourself, stop checking. This isn't laziness. It's what happens when a person runs out of capacity. It gets met with lectures. What it needs is support.

Clinical depression. A diagnosable condition, and more common in people with Type 1. Depression makes your diabetes harder to manage. Struggling with your diabetes deepens depression. They feed each other.

My experience

I've been to the dark places.

As a teenager I asked "why me?" until I was hollow with it. In my twenties I used alcohol and worse to quieten the noise. There were stretches of burnout when I stopped caring what my blood sugar was, because caring felt too hard. I grieved for my sight. There were times I didn't want to be diabetic, or alive.

I'm telling you because silence helps no one.

If you've felt any of that, the exhaustion, the hopelessness, the I can't do this forever, you are not alone and you are not weak. You're a person managing something hard, with no days off, for as long as you live.

What helps

• Talk to someone who works with long-term conditions. Ask your GP for a referral to a counsellor.
• Small goals. Work with your diabetes team on a few things, not everything at once.
• Structured education. In a UK trial, the DAFNE course for Type 1 improved quality of life and general wellbeing.
• Move. NICE lists group exercise as one of the first treatment options for less severe depression. That's one of the reasons my challenge exists. Moving every day isn't just training your body. It's managing your mind.
• People who get it. One person who understands can change everything.

Two check-ins for today

Check in with yourself. Honestly, not for show. Are you sleeping? Do you still care about the things you used to? Write the honest answer down.

Check in with someone else. One person you haven't heard from properly in a while. Not "you OK?" with a thumbs up. Something real: I was thinking about you. How are you actually doing?

If you're struggling right now

Please tell someone. A friend, your GP, your diabetes team.

• Samaritans: 116 123, free, any time, day or night (UK and Ireland).
• Diabetes UK helpline: 0345 123 2399, Monday to Friday, 9am to 6pm.
• If you or someone else is in immediate danger, call 999.

You don't have to be at rock bottom to call.

The mind comes first. Look after it as seriously as you look after your CGM.