Diabetic Nerve Pain and Depression

The relationship between diabetic nerve pain and depression is direct ("What Is Diabetic Nerve Pain? – Symptoms, Causes, Treatments"). Diabetic neuropathy, or nerve damage, because of high amounts of sugar in the blood (hyperglycemia) can cause pain. When it does, this nerve pain can lead to depression. One study found that almost 28 percent of people with diabetic nerve pain developed depression (Gore, et al., 2005).  A 2016 report asserts that people with diabetic nerve pain have a depression rate that is four times that of people with diabetes but without pain (Davenport, 2016).

Diabetic nerve pain and depression go beyond occurring together. These conditions move together, a further indication that they are directly linked. When pain is mild, so, too is depression in those that are experiencing it. When pain is severe, depression symptoms worsen and become more debilitating.

Intense nerve pain and depression affect someone’s ability to function. They’re more likely to experience a decrease in both physical and emotional functioning as well as sleep problems. The overall quality of life is lower for someone living with neuropathy and diabetes than it is for others, even those also living with diabetes alone.

Let’s explore more about the relationship between depression and diabetic nerve pain.

The Relationship Between Diabetic Nerve Pain and Depression

Pain and diabetes are practically synonymous. Physical pain (due to consequences of the disease) and emotional pain (due to limitations, loss, and decreased quality of life) plague people with diabetes nearly every day of their lives. Just some of the difficult or downright painful things they may deal with daily are

• Blood sugar monitoring via self-administered blood tests
• Insulin treatment (everyone with type 1 diabetes and some with type 2 diabetes)
• Damage to any system of the body and resulting pain, problems
• Painful foot problems, including risk of amputation
• Unsteadiness and risk of falls
• Nerve pain

Of all of these, it is nerve pain that is most directly connected to depression ("What Treatment for Diabetic Nerve Pain Is Available?"). When someone experiences nerve damage due to hyperglycemia, the pain can range from mild to nearly debilitating. People describe this type of pain as tingling, numbness, a painful cold sensation, or electric shock-like. Tingling and numbness haven’t been linked to depression. Shocking, shooting, or that sensation of painful coldness, however, are directly linked. The worse this type of pain, the deeper the depression experienced.

Why the relationship between depression and diabetic nerve pain? It appears that the link might reside in the brain. Structures in the brain like the amygdala, hypothalamus, and anterior cingulate gyrus as well as neurotransmitters like serotonin and norepinephrine are, together, at work in pain, depression, and anxiety.

When structures and neurotransmitters regulate pain as well as emotions and mood, there can be an overlap so that when nerve pain is high, depression is also more intense.
 
In addition to the biology and functioning of the brain, other factors contribute to the development of depression when someone has diabetic neuropathy ("Anxiety and Diabetic Neuropathy: What Helps?"). Some risk factors that have been identified include:

• The presence of other long-term complications of diabetes
• Being female
• Feeling a lack of control over diabetes treatment and lifestyle
• The belief that you don’t have the ability to deal positively with this disease

No matter how bad the nerve damage, how intense the pain, and how severe the depression, treatment is available. Nerve damage is irreversible; however, pain can be managed. Depression, too, can be fully overcome or managed so that it is no longer as bothersome.

Treatment of Depression and Diabetic Nerve Pain

Because both pain and depression can become severe and debilitating, it’s important to identify and treat these conditions as early as possible. Regular check-ups with your doctor are helpful in catching pain and depression. The doctor might give you questionnaires to help narrow your symptoms, and together, you’ll both watch carefully for early nerve damage and depression.

Once symptoms begin to appear, it’s important to begin treating the whole person:

• Diabetes
• Neuropathy
• Depression
• Other mental health concerns
• Sleep (problems are common)
• Pain
• Lifestyle and quality of life

Typical treatments include

• Diabetes medication
• Medication for nerve pain, commonly topical analgesics)
• Depression medication (no single type has emerged as the most effective)
• Proper nutrition
• Blood sugar control
• Lifestyle changes such as exercise, stopping smoking, limiting or eliminating alcohol consumption
• Mental health therapy

Diabetic nerve pain and depression can limit lives, and they can be hard to treat. By being alert for your symptoms and changes, though, you can start treatment as early as possible. You can reduce pain and depression symptoms and be ready to engage in your life once again.

Ed. Note: More research is needed to fully understand the connection between these conditions. Study results have been mixed; many show a strong correlation between depression and nerve pain in diabetes, while other outcomes are less certain. For now, it’s cautiously accepted that these two conditions are related. The information here is based on the results of research studies and is therefore reliable. Future research may modify currently accepted information, however.

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