8 Powerful Ways High Blood Sugar Fuels Depression – And How to Break Free

The Link Between Depression and High Blood Sugar

I see many patients struggling with both high blood sugar and depression. High blood sugar limits the energy available in the brain, causing fatigue, inactivity, slowness, and a lack of desire to do things – all signs of depression. On the other hand, being depressed causes stress in ways that increase insulin resistance. This puts a patient in a terrible bind that prevents them from solving either problem.

This “Catch-22” means high blood sugar and depression are two prevalent and serious health conditions that not only coexist, but feed upon each other.[1] Individuals with type 2 high blood sugar are at a higher risk of developing depression, and those with depression are more likely to develop type 2 high blood sugar.[2] This relationship can significantly impact the physical and mental well-being of those with high blood sugar, making it crucial to understand the connection between the two conditions.

Type 2 High Blood Sugar:

For our discussion of high blood sugar, insulin is the problem. Here we are talking about type 2 high blood sugar, metabolic syndrome, or insulin resistance. The key to this illness is not elevated blood glucose or obesity, but rather insulin resistance, which can happen many years before glucose levels are elevated.

Depression

is a feeling or sense of inability to reach your goals, or hopelessness. Clinical depression, or major depression, means someone feels that life is not worthwhile, which makes everything hard. Change is especially hard, and that is what is needed to get well. Hopelessness prevents people from making changes that could help them feel better and even reverse their illness.

How High Blood Sugar Increases the Risk of Depression

High blood sugar significantly increases depression in a correlated manner – worse blood sugar is associated with worse depression. An interesting study showed that among people who all had high blood sugar, those with poor blood sugar control had much more depression than those with good control.[3] Moreover, there is a correlation between sugar consumption and major depressive disorders in whole populations.[4] It is not easy to know whether depression caused the high blood glucose levels, or the high glucose caused depression, but we do have some clues.

Low Energy

High blood sugar affects the body’s ability to regulate blood sugar levels, which is the primary energy supply of the brain. Persistent high or low blood glucose levels can lead to biochemical changes in the brain, influencing mood and cognitive function. Insulin resistance affects the available energy, leading to fatigue, and a sense of hopelessness.

Inflammation

Chronic high blood sugar increases oxygen free radicals which cause inflammation in the brain[5]. Inflammation changes the way the cells of the brain communicate, creating insulin resistance, less energy, and signs of depression.[6]

Neurotransmitter Imbalances

Insulin resistance can affect the regulation of serotonin and dopamine, neurotransmitters associated with mood regulation.

Adrenal Dysregulation

High blood sugar can alter the body’s stress-response system, making individuals more prone to depression.

Medication side effects

Those who take medications for high blood sugar generally increase insulin resistance, making the brain function worse and contributing to depression.

Psychological Stress

It is hard to have to think about what your pancreas normally does automatically – maintain blood sugar at normal levels. Living with high blood sugar requires constant monitoring of blood sugar levels, adherence to dietary restrictions, and management of medication or insulin therapy. This long-term stress can contribute to feelings of frustration and helplessness, which may lead to depression.

Poor Nutrition

Since type 2 high blood sugar is related to eating processed foods, carbohydrates, and restaurant meals, it is associated with nutrient depletion. Nutritional deficiencies of any kind contribute to depression because the brain is very sensitive to any lack of nutrients.

Reduced Physical Activity

People get type 2 high blood sugar partly from a lack of physical activity. Exercise is like a shot of insulin to bring glucose into the muscle cells. It also helps the brain to make neurotransmitters like dopamine and enkephalins to feel good.

 

How Depression Increases the Risk of High Blood Sugar

High blood sugar causes depression, but depression also interferes with the control of blood glucose, worsening, or causing high blood sugar.[7]

Food choices

People who are depressed feel hopeless and often seek comfort in temporary pleasures such as “comfort foods” which are often sweet and highly processed. Moreover, sweet, fat, and salty foods release dopamine which makes them feel better so they can’t stop eating, leading to insulin resistance.

Exercise

Depression also brings with it a lack of motivation to do physical activity. Some may call it laziness, but there is a lack of motivation to do many things. For some it’s a struggle to just get out of bed in the morning.

Stress

Depression is directly related to stress,[8] leading to increased production of cortisol, the stress hormone. Elevated cortisol levels contribute to insulin resistance, higher blood glucose, and abdominal fat accumulation, all of which are risk factors for high blood sugar.

Sleep Disturbances

Lack of sleep also increases the stress hormone cortisol which causes insulin resistance. Those who don’t sleep early and get up early are much more likely to get T2D.[9] The sleep problems associated with high blood sugar, are also risk factors for depression.[10] People with depression commonly suffer from sleep disorders, such as insomnia or excessive sleepiness, which are linked to impaired glucose metabolism and an increased risk of T2D.

Medications

While most doctors will give medication to help people feel better, it doesn’t lower their risk of high blood sugar. There is evidence that controlling depression with medications does not improve blood glucose levels. However, controlling blood glucose does improve depression.[11]

 

Managing Both Conditions Simultaneously

Since high blood sugar and depression are closely linked, managing both conditions is essential for overall health. Some effective strategies include:

Regular Physical Activity

Exercise improves insulin sensitivity and boosts mood by increasing endorphin levels. The ideal forms of exercise push the limits of what you can do. High-intensity interval training (HIIT exercises) is a great way to take care of both problems. This is where you push your exercise as hard as you can for ten seconds, and then do light, easy exercise for thirty seconds. Only 15 minutes a day of HIIT can make a big difference in both depression and blood glucose.[12]

Ketogenic Diet

There has been a lot of research recently about mental illness and the ketogenic diet. Christopher Palmer, MD, a psychiatrist at Harvard Medical School wrote a book called Brain Energy.[13] There has also been recent research at Stanford University about using the ketogenic diet for depression and bipolar disorder.[14]

The ketogenic diet is simple: Eat less than 20 grams of net carbohydrates in a day. “Net carbs” means you take the total carbs and subtract the fiber. You don’t digest fiber and make it into sugar, so it doesn’t count in your carb content. This means that you can eat all the lettuce, broccoli, spinach, and other non-starchy vegetables you want. A simple plan is found in the Diabetes Solution Kit which has a complete outline and explanation of how to get started. It reverses both high blood sugar and depression.

Stress

Joining support groups can reduce feelings of isolation and stress. You may also consider psychotherapy, such as cognitive-behavioral therapy, to help you to deal with stress and manage depression. The best way to manage stress is by connecting with others

Sleep

Sleep is an important way to manage stress. Sometimes people stress about not sleeping and make their problem worse. Start with a regular sleep schedule, where you go to sleep and wake up at the same time every day. It seems like the best sleep schedule is 10 PM to 6 AM. This gives you good restorative sleep. Even if you are awake at night, just relax and lie there, meditating on happy things.

As you lie there, your body will start to get the idea that it’s time to rest, and you will get restorative sleep. This does not mean you need to be unconscious for eight hours, because restorative sleep comes in ten- to thirty-minute intervals. During the time you are awake and resting, you will periodically have REM sleep for ten or twenty minutes. That’s restorative.

Conclusion

The relationship between high blood sugar and depression is complex and multidirectional. Understanding this connection is essential for effective management and prevention. By addressing both physical and mental health through lifestyle changes, and psychological support, individuals can improve their overall quality of life and reduce the risk of complications associated with both conditions.

 

 

 

 

 

 

 

References

[1] Diabetes Care 2008;31(12):2368–2373; Depression: An Important Comorbidity With Metabolic Syndrome in a General Population  James A. Dunbar, MD, et al.

https://doi.org/10.2337/dc08-0175

[2] Psychology Today; Kristen Fuller, M.D.; The Relationship Between Diabetes and Depression

Why you may be at risk of developing depression if you have diabetes; Posted December 23, 2021; https://www.psychologytoday.com/us/blog/happiness-is-state-mind/202112/the-relationship-between-diabetes-and-depression

[3] Anderson, R. J., Freedland, K. E., Clouse, R. E., & Lustman, P. J. (2001). “The Prevalence of Comorbid Depression in Adults With Diabetes.” Diabetes Care, 24(6), 1069-1078. https://profiles.wustl.edu/en/publications/the-prevalence-of-comorbid-depression-in-adults-with-diabetes-a-m

[4] Depress Anxiety. 2002;16(3):118-20. doi: 10.1002/da.10054.

A cross-national relationship between sugar consumption and major depression?

Arthur N Westover 1, Lauren B Marangell

https://pubmed.ncbi.nlm.nih.gov/12415536/

[5] Cardiovasc Diabetol. 2016 Jun 1;15:82. doi: 10.1186/s12933-016-0397-2

Inflammation, glucose, and vascular cell damage: the role of the pentose phosphate pathway

Concepción Peiró 1, Tania Romacho 1,4, Verónica Azcutia 1,5, Laura Villalobos 1, Emilio Fernández 2, Juan P Bolaños 2, Salvador Moncada 3,6,,#, Carlos F Sánchez-Ferrer 1,,#

https://pmc.ncbi.nlm.nih.gov/articles/PMC4888494/

[6] Cureus. 2021 Oct 30;13(10):e19142. doi: 10.7759/cureus.19142; A Comprehensive Review of Neuronal Changes in Diabetics; Rudy Luna, et al.

https://pmc.ncbi.nlm.nih.gov/articles/PMC8628358/

[7] Lustman, P. J., & Clouse, R. E. (2005). “Depression in Diabetic Patients: The Relationship Between Mood and Glycemic Control.” Journal of Diabetes and Its Complications, 19(2), 113-122.

https://www.semanticscholar.org/paper/Depression-in-diabetic-patients%3A-the-relationship-Lustman-Clouse/589ff663ecf46a434bedceffc356f4761cda87ab

[8] Psychology Today; Philip Gold M.D.; The Relationship Between Depression and Stress; February 7, 2024

https://www.psychologytoday.com/us/blog/next-generation-research/202402/the-relationship-between-depression-and-stress

[9] Cureus. 2023 Nov 3;15(11):e48228. The Link Between Sleeping and Type 2 Diabetes: A Systematic Review

Ali Darraj

https://pmc.ncbi.nlm.nih.gov/articles/PMC10693913/

[10] Neuropsychopharmacology. 2019 May 9;45(1):74–89. doi: 10.1038/s41386-019-0411-y

Sleep, insomnia, and depression; Dieter Riemann, Lukas B Krone, Katharina Wulff, Christoph Nissen

https://pmc.ncbi.nlm.nih.gov/articles/PMC6879516/

[11] Holt, R. I. G., de Groot, M., & Golden, S. H. (2014). “Diabetes and Depression.” Current Diabetes Reports, 14(6), 491.

https://scholarworks.indianapolis.iu.edu/items/08fbce78-947f-4a47-bd77-afbcc3fe219c

[12] https://thefitnessphantom.com/hiit-exercises-list

[13] https://www.chrispalmermd.com/

[14] https://med.stanford.edu/news/all-news/2024/04/keto-diet-mental-illness.html

https://www.bigstockphoto.com/es/image-77363828/stock-photo-portrait-of-lonely-depressed-man

https://www.bigstockphoto.com/es/image-56363234/stock-photo-black-and-white-closeup-portrait-of-a-nervous-woman

https://www.bigstockphoto.com/es/image-93842831/stock-photo-young-woman-suffering-from-a-severe-depression-anxiety-%28color-toned-image%3B-double-exposure-technique