Checking your sugar, watching your food, taking tablets every day, and worrying about complications: living with diabetes or high blood pressure is a lot. Here’s how these conditions connect with mood, and what helps.
Diabetes and high blood pressure are both linked with depression and anxiety, and the links run both ways. Low mood can make daily self-care harder, and the constant demands of diabetes can cause “diabetes distress”. Both are common, and both can be helped.
How common these conditions are in Nigeria
About three million Nigerian adults live with diabetes, according to the International Diabetes Federation’s 2024 estimate. High blood pressure is far more common: WHO estimates it affects about one in three adults aged 30 to 79, and only about one in nine of them has it under control.
How mood and these conditions connect
In Nigerian hospital clinics, studies have found depression in about one in five to one in two people with diabetes, and in about one in eight to one in four people with high blood pressure, depending on the clinic and the questionnaire.
The links run both ways. In long-term studies, people with depression were more likely to develop type 2 diabetes later, and people with diabetes were somewhat more likely to develop depression. These are links, not proof of cause.
For blood pressure, the picture is mixed. Some studies link depression and anxiety with later high blood pressure, while a large Norwegian study found the opposite. So it’s too simple to say stress causes high blood pressure. Stress still matters for how you feel, sleep and look after yourself.
Diabetes distress isn’t depression
Diabetes distress is the worry and weariness of managing diabetes day after day: the numbers, the food, the costs, the fear of complications. The American Diabetes Association treats it as separate from depression, and it’s linked with harder self-care and higher blood sugar.
In two Nigerian clinic studies, about three in ten people had moderate or high diabetes distress. In one of them, nearly half said they had skipped or cut down medicines because of the cost.
The American Diabetes Association recommends checking people with diabetes for both depression and diabetes distress at least once a year.
When anxiety might be low blood sugar
The early signs of low blood sugar (a “hypo”) include shaking, sweating, a racing heart, feeling anxious or irritable, hunger and dizziness. They come from adrenaline, so they can feel just like anxiety or panic.
Suggested read: Binge Eating Disorder: Signs and Help
If you take insulin or some diabetes tablets and feel this way, check your blood sugar if you can. It’s the only way to tell the difference. Ask your doctor what to do if it’s low.
Why mood matters for your numbers
Depression is linked with missed medicines and appointments, and with poorer blood-sugar control. In trials in the US and India, care that treated depression alongside diabetes or heart disease improved both mood and physical measures such as blood sugar and blood pressure.
What helps
- Tell your diabetes or blood pressure team how you’ve been feeling. Ask to be checked for depression and diabetes distress.
- Talking therapy. Cognitive behavioural therapy (CBT) helps with depression and diabetes distress, including by phone or video.
- Diabetes education and support. Learning to manage the condition with support reduces distress.
- Talk about costs. If cost is making you skip medicines, tell your doctor. There may be cheaper options.
- Medicines, if needed. A doctor may suggest treatment for depression and will choose it to fit with your other medicines. Don’t stop your diabetes or blood pressure medicines without talking to your doctor.
You can find a therapist who works with stress and burnout, by video, voice or chat. Read our overview of chronic illness and depression, our guide to anxiety’s physical signs, or more about depression and stress.
If you’re having thoughts of ending your life, call Safe Place Nigeria on 0800 800 2000, free and open 24 hours. If you’re in immediate danger, call 112, or 767 in Lagos.
Frequently asked questions
Can diabetes cause depression?
Diabetes and depression are linked both ways: people with diabetes are somewhat more likely to develop depression, and people with depression are more likely to develop type 2 diabetes. It isn’t clear that one directly causes the other.
What is diabetes distress?
The emotional weight of managing diabetes every day: worry about numbers, food, costs and complications. It’s different from depression, it’s common, and it can be helped with support, education and talking therapy.
Can stress cause high blood pressure?
The research is mixed, so it’s too simple to say stress causes it. Managing stress still helps your sleep, mood and self-care, which all matter for your health.
Is it anxiety or low blood sugar?
They can feel alike. If you take insulin or some diabetes tablets, check your blood sugar when you feel shaky, sweaty or anxious. That’s the only way to tell.
Can therapy help people with diabetes?
Yes. Talking therapies such as CBT help with depression and diabetes distress, and they can be done by phone or video.
This article is awaiting clinical review. It’s based on published research and health guidelines, and we’ll update it once a clinician has reviewed it.
Suggested read: Cyclothymia: The Milder Mood Swing
