Mental Health and Diabetes — a Surprising Connection on World Health Day

The World Health Organization (WHO) was founded on April 7, 1948, and every year that date is commemorated as World Health Day, putting a global focus on one specific aspect of health around the world. This year the topic is “Beat Diabetes,” and you might think diabetes has little connection to mental health — but you would be wrong.

As the authoritative medical journal The Lancet notes, “Patients with diabetes are at higher risk of mental health disorders — including depression and psychotic disorders — than the general population. Likewise, patients with mental health disorders are at higher risk of developing diabetes.”

There’s no clear reason why this causality exists, although the American Diabetes Association (ADA) reports that avoiding dealing with emotions like stress, sadness, anger and denial about a diabetes diagnosis can lead to depression. The prevalence of diabetes among individuals with serious mental illness (SMI), according to the ADA, is estimated to be 16% to 25%, or two to three times the rate of the average population. Interestingly, a recent Swedish study of kids with type 1 diabetes found they were more prone than their healthy siblings to develop psychiatric disorders or attempt suicide, which the authors conclude is a result of the disease rather than hereditary issues.

The Substance Abuse and Mental Health Services Association (SAMHSA) notes that, “Rates of severe psychological distress are twice as high in people with diabetes compared with the rates among those without the disease. In addition, severe psychological distress is negatively associated with processes of diabetes care (e.g., access to prevention services) and outcomes.”

WHO estimates that worldwide 350 million people have diabetes, and they expect that number to double in the next 20 years. In the US, 29 million Americans, or 9.3% of the population, had diabetes in 2012, according to the ADA. Diabetes cuts across all races and ethnic backgrounds, although low-income individuals are more likely to develop the disease.

More than 90% of Green Door’s clients live at or below the DC poverty line, and in addition to persistent mental illness many of them have co-occurring substance use issues. Approximately 20% of our clients are managing their diabetes in addition to their other health issues. We also know that significant weight gain is a common side effect of many psychotropic medications. Among people with serious mental illness, a sedentary lifestyle, “food insecurity,” and a lack of access to fresh fruits and vegetables substantially increase the risk of diabetes.

A healthy diet and an active lifestyle can slow or even prevent the onset of diabetes. Health professionals have long known of the connection between physical and mental health, which is one of the factors behind the Our Door Community Wellness Center. A program of Green Door Behavioral Health, Our Door provides activities, resources and referrals that promote the mind and body linkage and encourages participants to actively engage in their wellness.

Ensuring our clients have a holistic view of their health and care, Green Door Behavioral Health encourages health promotion, provides primary care, and oversees medication therapy management. Neither a mental illness nor diabetes are hurdles that cannot be overcome.