From what I understand, depression, stress, burnout, and anxiety are extremely common for those with type 1 diabetes, but I never seem to come across much information on how to cope with these issues without jeopardizing insulin’s effect on the body. Most antidepressants, when taken by a person with type 1 diabetes, cause a lot of problems with low blood glucose levels (even after making adjustments by an endocrinologist). What do people do for treatment of mild to moderate depression and anxiety if medications cause even more problems with blood glucose? Are there any alternatives that can be just as effective? What do other people with type 1 diabetes take? Is there a safer/more popular medication or alternative treatment to deal with the daily stressors of a chronic illness such as type 1 diabetes?

I do not know if I would characterize all medications taken for depression as causing low blood sugars. Some of the medications can induce appetite, and they result in higher sugars. There is an ongoing discussion as to whether the biology of diabetes causes more depression or whether it is the chronic stress of dealing with a chronic disease that causes more depression. Either way, it is very important to be able to provide patients support for this condition that clearly occurs more often in people with diabetes than in those without diabetes.

Most specialists who deal in this area look at a multidisciplinary approach using exercise, medication, group counseling or support, as well as methods to maintain good glucose control. In addition, there are a variety of medications from a variety of drug classes that might be used to treat depression in a person with diabetes. If you find yourself battling this problem, you may want to talk with a mental health professional that has special interest in patients with diabetes.

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