T1D and Mood Stabilizers/Antidepressants?

Hey guys

So, I’m going to be going to a psychiatrist for the first time after going to therapy for over a year two separate times. I’m still in high school, and my blood sugars tend to be horrible. (Go figure, right?) It’s caused major depression and anxiety for me over the years, and it seems to only get worse on the daily. I’ve been clinically diagnosed with Major Depressive Disorder and Severe Generalized Anxiety. It’s quite likely (according to a recent talk with a previous therapist) that I also have Bipolar II.

Well anyway, I’m going to a psychiatrist and a former therapist of mine said it would be likely I would be prescribed a mood stabilizer and/or an antidepressant. Do any of you guys have any tips or things to keep an eye out for as I proceed to start taking medications for my mental health?

@_Despondent Welcome Whitney to the JDRF TypeOneNation Forum! I hope you find a warm welcoming community here and people who will offer you you some helpful information and tips.

I feel for you and have experienced many “low times” and been despondent during my seven decades living with diabetes but have not had to use medications. The one tip that I can give you [based on the many meds I use for other conditions] is that almost ALL medications affect body glucose levels [BGL] in one way or another. Some meds, including insulin, cause BGL to drop while others can cause BGL to increase - sometimes significantly. My tip is to thoroughly read all the fine-print of meds and to keep a diary; be ready to adjust your insulin to compensate for any changes.

Please keep us posted and don’t hesitate to ask and seek support.

Hi Whitney, I have been T1D since I was 17. I was always depressed even as a child. At age 28 I began taking anti-depressants and was diagnosed with Clinical Depression. The medication helped me to feel much better about my self and I developed a positive self esteem. In turn this allowed me to be less despondent about my diabetes and that is when I took proactive steps to better manage my disease. It was then that I began using an insulin pump. That was 1993. I’ve always had anxiety also due to some early childhood issues. In 2010 I began to take a mood stabilizer. I must say that I first thought, why have I not been prescribed this before now? I was so much less reactive to anxiety producing situations. Some mood stabilizers can cause cognitive dulling. If you are in school this may not be the best medication for you. With these medications I have been more successful living with T1D. There is no magic pill. I read the following quote from somewhere, “Which came first, the Diabetes or the Depression?” This can be overwhelming. The T1D is overwhelming enough without adding more meds and diagnosis’s to our life. You are certainly not alone and this group always supports and shares. You are safe here.

Try to not be so hard on yourself too…depression and anxiety affects your blood sugar as well. All Stress affects your BG. It’s so overwhelming sometimes to act as an innate function. We’re responsible for making our own hearts beat. You are not in this alone xoxo

Should I get my baby some counseling now she is 8 diagnosed 18 months ago and we are going through!!! I know she is depressed and has anxiety issues she started sucking a Binky again…

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@ncavitte Nikki, I’m really saddened and concerned about what you and your baby [how old] are experiencing.
My non-professional response is that no one here can responsibly advise you on that matter other than to strongly urge you to bring this matter to your daughter’s attention. discuss your concerns and follow that professional advice.

Hi, Whitney @_Despondent .

Your questions are not easy to answer. As @Dennis indicated, medications used to treat emotional/mental disorders have the potential to make T1D more difficult to manage.

Here are some simple things to consider and to discuss with your psychiatrist. Some of the medications used to treat the “major” psychiatric disorders frequently cause hyperglycemia (high blood glucose). The medication Zyprexa (olanzapine) was one of the earliest “atypical” antipsychotics that was identified as having this potential side effect. Some patients who took olanzapine were said to develop Type 2 Diabetes; their diabetes did not disappear after they stopped taking the drug. The point is, you may want to avoid taking medications that are known to have hyperglycemia as a potential side effect.

Antidepressant medications can affect appetite. Some can cause an increase in appetite, while others can cause a decrease in appetite. A geropsychiatrist friend of mine was very hesitant to prescribe Prozac to older people who exhibited symptoms of depression. Why? Loss of appetite is often a symptom of depression in people who are older, and Prozac can sometimes make loss-of-appetite more profound. The point here is, you will likely want to avoid medications that affect appetite unless you are prepared to adjust your diabetes treatment regimen to account for the change of appetite.

This may seem unrelated, but it really is important - exercise! You’ve heard time-and-time-again that exercise is an important part of managing T1D. It is also very, very helpful in treating and managing mood disorders, like depression, and anxiety. You might discuss this with your psychiatrist and, if the two of you agree, slowly but surely increase your level of exercise. Here’s a hint about exercise - it’s easier to do, and continue, if you have an exercise “partner.” It’s really tough to stay committed to an exercise program if you try to do it on your own. Many people find they can lower doses of psychiatric medications if they are involved in a consistent exercise program.

Treatment of depression and anxiety are often most effective when that treatment includes work with a therapist. The preferred therapy methods for treating mood and anxiety disorders include cognitive-behavioral techniques. Those techniques help people identify “triggers” of their depressive symptoms/anxiety. They then learn techniques they can use to deal with the triggers, and to “quiet” depressive symptoms/anxiety as it begins. Cognitive-behavioral therapy techniques give people “tools” they can use to manage their thoughts and help themselves feel better. And, like exercise, it can reduce the amount of medication that is required to manage mood/anxiety difficulties.

A final thought - there is a “real” emotional consequence when T1D is not managed well. Very briefly, persistent hyperglycemia causes an obvious pattern of “dysphoria” and anxiety. For many people finding a way to lower their A1C even as little as a single number (say from 9.5 to 8.5) can lead to improved mood. It is not due just to the “satisfaction” of having learned to manage diabetes better - it is also due to feeling better physically. It’s pretty simple, when you feel better physically your mood improves and you become less anxious. If you do work with a therapist, discuss cognitive-behavioral techniques you can use to help yourself commit and stay committed to managing your diabetes as well as you can. Your mood will likely improve.

Like @Dennis, I’ve had T1D for over 60 years, and I know it isn’t easy to tolerate. And, it has the potential to cause a person to begin to feel really, really anxious and “down.” But, to me, it has been a question of choosing “who” is going to “win” - me or diabetes? Many, many years ago I “chose” to win. My routine is now so well-practiced that I spend less than 15 minutes a day on managing my diabetes - the rest of the time I’m doing what I want to do.

I hope this helps a bit. I wish you the best of luck.



I’ve had T1D since I was 18 in the early 80s and after about 10 years of managing the disease I recognised that I needed help with my mental health, I’m not sure if it was linked but I’ve been taking an Antidepressant and a Mood stabiliser plus an anxiety medication which I can take when necessary but it’s very strong and can make me very sleepy.
I know that these medications have made it hard for me to maintain a good weight level and have led to me putting on weight and struggling to lose it so make sure you’re aware of any side effects but on the whole these drugs have helped me keep ‘an even keel’. I’m that the right combination will help you too.

Therapy is just good brain stimulation for anyone, gets the juices flowing. However before you decide to start any new medications. I would suggest you get your blood sugar under control. There are many studies linking uncontrolled blood sugars and depression. I personally started to actually care this past year about my blood sugars started on a pump again with CGM. My average A1C was around 7.5-8 and after 3 months of being within range with a1c 6.4 I could already tell the difference in the way I feel every day.

Im so happy you’re aware of your issues and are seeking help!! Kudos to you!!! I’m on an antidepressant daily and anxiety meds as needed.

I find the meds don’t directly effect my meds but when my mood is better and Im feeling better overall, my diabetes management is better as well which leads to better bg’s!!

Good luck and keep up posted on how you do!!! HUGS!!! & imho, U ROCK for taking care of you!! U should be very proud!!!