How diabetic retinopathy can affect your mental health

Diabetic retinopathy is an eye disease that develops as a result of having diabetes. It occurs when high blood sugar levels cause damage to the delicate blood vessels in the retina, the layer of light sensitive cells located in the back of the eyeball.

In its early stages, diabetic retinopathy may cause no symptoms or only mild symptoms. As the disease progresses into later stages, vision can become distorted or blurred and a person may have difficulty seeing colors and details. They may also see dark or empty spots in their vision, and in some cases, experience permanent vision loss.

There is no cure for diabetic retinopathy, but there are treatments that can help. In the early stages, treatment may only require careful monitoring and better diabetes management. In more advanced stages, there are treatments like laser eye surgery or anti-VEGF injections, a medication that treats eye disease by helping to prevent the growth of abnormal or leaky blood vessels around the eye.

And at any stage of diabetic retinopathy, mental health should be a focus and a priority.

Diabetic retinopathy and mental health

Any condition that affects vision can negatively impact mental health. According to the Centers for Disease Control and Prevention (CDC), vision loss can be associated with feelings of social isolation, loneliness, fear, anxiety, and worry.

There is a well established connection between diabetes and issues with mental health. Studies have also found an association between mental health disorders and diabetic retinopathy.

Diabetes, mental health, and diabetic retinopathy can also be a repeating cycle:

• The stress and difficulty of living with diabetes can contribute to anxiety, distress, and depressed moods—which can make it more difficult to manage diabetes, leading to inadequate diabetes control.
• Uncontrolled diabetes can lead to more severe diabetic retinopathy, as well as other diabetes complications like kidney disease. More severe complications can further contribute to anxiety, distress, and low moods.
• Low vision can also make it more difficult to perform everyday tasks required to successfully manage diabetes—for example, taking the correct dose of medication, counting carbohydrates while preparing a meal, or exercising can all become more difficult with low vision.
• With inadequate diabetes control, diabetic retinopathy and other complications can become more severe.

Even in the early stages, diabetic retinopathy can negatively affect mental health. While it may only cause mild symptoms, or no symptoms at all, diabetic retinopathy tends to get worse over time. Living with this knowledge can lead to feelings of anxiety or fearfulness about the future.

Recognizing mental health symptoms

Symptoms of depression, anxiety, and distress are not always easy to recognize. Just as you are checking things like your blood sugar levels, it’s important to check in with your thoughts, moods, and habits. Questions like these could help:

• Have your sleep habits changed?
• Have your eating habits changed?
• Are you following your diabetes management plan?
• Are you skipping doses of medication?
• Do you feel burned out by having to manage diabetes?
• How much time do you spend alone?
• Are you worried or anxious about the future?
• Do you regularly feel sad, angry, defeated, or fearful?
• Do you feel like a burden to others?
• How would you describe your quality of life?

This is not a comprehensive list of questions. Everyone’s mental health is different, and everyone responds in different ways when living with the challenges of conditions like diabetes and diabetic retinopathy.

While talking about mental health symptoms can be difficult, it's important to notice your symptoms and do your best to describe what you are experiencing to your healthcare providers.

Healthcare providers can help

If you have diabetic retinopathy, there are treatments available and healthcare providers who can help you. Good diabetes control can help you slow the progression of diabetic retinopathy and lower your risk of other complications related to having diabetes.

Treatments can slow and in some cases repair damage to the eyes caused by diabetes. Low vision devices and low vision rehabilitation can help you adjust to living with impaired vision and remain as independent as possible.

Providers who specialize in mental health can also be a great addition to a healthcare team. Counseling and therapy can help you learn strategies to cope with the emotional, psychological, and social challenges of living with a condition that has impacted your vision.