Relationship Between Diabetes and Mental Health

Discover why many people with mental illness, especially schizophrenia and bipolar disorder, are susceptible to diabetes. Plus why many diabetics develop depression.

"I see a lot of diabetes in my clients." exclaims Dr. William H. Wilson, Professor of Psychiatry and Director of Inpatient Psychiatric Services at Oregon Health & Science University.

A simple statement that means so much. Considering that Dr. Wilson is a psychiatrist who works in psychiatric wards, you would not think that diabetes would be such a concern. In the past, the treatment goal was often to minimize psychiatric symptoms first and if the person was lucky and had access to more general care, the physical body second. This has all changed in the past few years.

Mental health professionals and organizations now know that there can't be a separation between a brain and body when it comes to effective psychiatric treatment. This connection has been ignored for too many years and the result is a higher death rate for those with psychiatric disorders from the illnesses associated with metabolic syndrome- including diabetes. Luckily, times have changed. New research has opened the way to more awareness as to what must be done, as well as more education for those with mental illnesses and the people who care about them.

Blood Sugar and Moods

There are varying opinions in the mental health profession regarding blood sugar and its effect on mood. Most agree that blood sugar can affect depression, as improving blood glucose levels seems to make a person feel better. And yet, when it comes to bipolar disorder and schizophrenia, there is little research that blood sugar affects the mania, depression and psychosis found in the illnesses.

Dr. Wilson notes, "I do see a difference in blood sugar levels and depression, but I have not seen a case that controlling blood sugar helps bipolar disorder or schizophrenia."

On the other side, those who approach mental health from a holistic perspective believe that dietary imbalances are an integral part of mental health diagnosis and management; no matter what the psychiatric disorder. Julie Foster, a nurse practitioner in Portland, Oregon notes, "Everything a person eats affects all aspects of physical and mental health and thus a dietary and supplement plan that stabilizes the mood plays a large role in psychiatric disorder treatment."

Another complication is that the fatigue that often comes from blood sugar fluctuations can be seen as depression. For now, the role that blood sugar plays in psychiatric disorders is not conclusive. Dr. Andrew Ahmann, Director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University, provides this explanation: "I don't think there has ever been evidence that if you improve blood glucose levels, you reduce mental illness symptoms, but if you go the other way and improve the depression that can come with diabetes, you do improve blood glucose. When people are faced with a diabetes diagnosis, this can lead to depression as they feel a lack of control. I don't think it's the glucose levels. I think it's overstated when people talk about the role of blood sugar and moods from a mental health perspective."

The debate about the role of blood sugar and moods continues, as there are so many differing views among researchers and other healthcare professionals. However, there is one thing that all mental health professionals can agree on: reducing fat and sugar in order to maintain a healthy weight and balance blood sugar levels is always a good idea. There's also agreement that having a healthy body certainly helps improve mood. People who are healthy always feel better than those who eat too much and lead a sedentary lifestyle. The challenge is helping those with psychiatric disorders make needed changes.

The Relationship Between Diabetes and Mental Health, Part I

ED. NOTE: This section on Diabetes and Mental Health includes information from interviews with:

• Dr. William Wilson, M.D. Professor of Psychiatry and Director, Inpatient Psychiatric Services Oregon Health and Science University
• Dr. Andrew Ahmann, Director of the Harold Schnitzer Diabetes Health Center at Oregon Health and Science University

and the research of Dr. John Newcomer, Department of Psychiatry, Washington University and Dr. Peter Weiden, Department of Psychiatry, the University of Illinois at Chicago.