Living with diabetes can be challenging, leading to worry and stress about your health. Doctors have coined the term “diabetes distress” to describe this very common type of emotional reaction. But if you feel sad or hopeless for weeks on end, you could have a more serious condition: depression. People with diabetes are about twice as likely to have depression as those without diabetes—a harmful combination. One study found that, in people older than 65 with diabetes, those who also had depression were 78% more likely to die early than those who were depression-free. A Vicious Cycle Doctors still aren’t sure exactly why diabetes and depression so often go hand in hand. But they know that diabetes can give rise to difficult emotions. For example, you might feel stress over worsening complications or tension with your doctor. Or you might feel a sense of isolation from family and friends as you cope with your disease. In some people, those emotions may set off a bout of full-blown depression. What is clear is that depression can make your diabetes worse. Depression can cause tiredness, feelings of helplessness, and problems with concentration and memory. In that frame of mind, it’s hard to take good care of yourself. You might ignore your eating plan, forget your medicine, or neglect to check your blood glucose. And poor self-care can lead to more severe diabetes problems. Breaking the Chains Recognizing depression is the first step toward healing. Watch for these warning signs: Constant tiredness or lack of energy Feelings of helplessness or worthlessness Irritability or restlessness Lack of appetite or overeating Long-lasting feelings of sadness or hopelessness Loss of interest in things you once enjoyed Sleeping too little or too much Thoughts of suicide Trouble concentrating and remembering details Talk with your doctor if you experience these symptoms for two weeks or more. If you have thoughts of suicide, call 800-273-TALK (8255) to speak with a trained counselor right away. Depression can be treated. Antidepressant medication, psychotherapy, or a combination of the two can help. By taking charge of your depression, you’ll not only lift your mood, you’ll also give your overall health a boost. Key Takeaways: People with diabetes are about twice as likely to have depression as those without diabetes. Diabetes can cause difficult emotions, which can set off depression. Depression, in turn, can cause tiredness, feelings of helplessness, and problems with concentration, which make it hard to take good care of yourself. It’s important to know the symptoms of depression. Call your doctor if you experience them for two weeks or more.