Can Hypoglycemia Cause Depression?

By Brandon Kamins  |   Submitted On October 29, 2014

When your blood sugar (glucose) falls below a certain level, it may be harmful to your health. The medical name for this increasingly common condition is hypoglycemia. There are several reasons why blood sugar may drop into the danger zone; most of which are associated with drugs that used to treat diabetes. Although these medications are needed to keep glucose levels within a healthy range, they may increase the risk of depression in some patients.

Hypoglycemia vs. Hyperglycemia

To understand why people with diabetes are more susceptible to hypoglycemia and thusly to depression, it is important to discuss insulin resistance syndrome - one of the most common conditions in the Western world. Generally caused by an steady diet of sugary foods, the disorder occurs when cells that would normally take sugar out of the blood become resistant to the action of insulin. As a result, the hormone can no longer lower blood sugar to healthy levels, which causes hyperglycemia, a potentially deadly condition.

In order to restore balance to their blood, those with insulin resistance syndrome and/or diabetes must take drugs that mimic the effects of insulin. But taking these drugs is far from an exact science. Because they are injected rather released as needed by the body, it is often very easy to take more synthetic insulin than needed, which may cause glucose levels to fall into the unhealthy, hypoglycemic range. But how can fluctuations in blood sugar affect your mood and state of mind?

Biochemistry 101

If we start with the simple, indisputable fact that all biochemical reactions are driven by energy, it's easy to see why the brain reacts the way it does when glucose (the sugar our body's use as energy) falls below acceptable levels. Here's how it works. Threatened with energy starvation, the brain prepares the body for deprivation by sending messages to the adrenal glands to release powerful stress hormones like adrenaline and cortisol. These stress hormones help convert stored glucose molecules (glycogen) back into glucose to give the brain the energy it needs to complete essential operations. However, this emergency action comes with a price.

Stress Hormones and Depression

Scientists have known for years that stress hormones set off a chemical chain reaction in the brain. In particular, the potent cortisol has a suppressive effect on dopamine and serotonin, two neurotransmitters that help combat stress by producing feelings of satisfaction and well being. It is not surprising then that most antidepressants help stimulate the production of these neurotransmitters in patients with deficiencies. It is also not surprising that elevated cortisol levels are common in people that suffer from episodic and clinical depression. The symptoms of these illnesses may be harder to control if they are caused by an underlying illness such as hypoglycemia.

The Solution

Whether it is caused by insulin resistance syndrome or poor diet, low blood sugar precipitates the release of stress hormones that can wreak havoc on our mental state. Because they cannot control their own insulin levels, the former group is at a much higher risk of depression than the latter. But if the patient has yet to develop Type 2 diabetes, blood sugar levels may be normalized in time. The adoption of a hypoglycemic diet, for instance, may help restore healthy glucose, insulin, and stress hormone levels in a manner of months.

Can Drugs Help?

The number of biochemical reactions that are involved in the descent from healthy blood sugar to hypoglycemia and finally to depression make it highly unlikely that pills could ever address them all. Furthermore, most of the antidepressants on the market today are extremely powerful, addictive, highly toxic medications that carry with them a whole host of serious side effects. So while the temptation to try to cure all that ails you with a pill may be hard to resist, we implore you to do just that!

Triggers

Because they can be converted to glucose far faster than fat or protein, carbohydrates are the food of choice for fast energy. And the organ that makes the most frequent and insistent requests for fuel is the brain. Did you know, for instance, that your brain consumes one-third of your total glucose intake? But when it does not get what it needs, our smartest organ panics and floods our system with stress hormones.

For a hypoglycemic person, these hormones are both a blessing and a curse. Stress hormones save them from suffering the most serious symptoms of low blood sugar, but at the same time force them to operate in emergency mode until the crisis has been resolved. The only problem for those with the disorder is that the next crisis is just around the corner. It is therefore not at all uncommon for a person with persistently low blood sugar to suffer from chronic stress, anxiety, and depression.

Prevention

When blood sugar levels are consistently low, the problem can often be corrected by diet. For people who suffer from diabetes, injecting too much insulin will cause glucose levels to fall, sometimes precipitously. The same is true when diabetics do not eat enough before a period of extreme exercise or physical activity. Symptoms such as blurry vision, rapid heart rate, anxiety, and sudden mood changes may occur soon after blood sugar levels enter the danger zone. Signs of depression, however, are not likely to manifest themselves as expeditiously. In most cases, those that have chronically low blood sugar will fall into a funk for which they have no explanation or clear cause. It is only later when they learn that they are hypoglycemic that the symptoms of their disorder start to make sense.

For those who have experienced bouts of hypoglycemia in the past, whether diabetic or not, eating high-carbohydrate snacks are often the best medicine. A cup of sugary soda or juice or a handful of hard candy should increase blood sugar levels enough to alleviate the symptoms of mild hypoglycemia. Those with depression, however, should talk to their doctor as soon as possible. Why?

Although the two are undeniably linked, it is not true that everyone who experiences spells of low blood sugar will also experience depression. The etiology of the mental disorder is far too complicated to ascribe to a single risk factor or even to a precipitating condition. What we do know, however, is that people with diabetes who are depressed have a 40 percent higher risk of a hypoglycemic episode than those who are not depressed. Once again, researchers believe the stress hormones that are released when blood sugar levels fall too low increase the risk of depression for some patients.

Because they are more susceptible to hypoglycemic episodes, most of the research that links depression to low blood sugar has involved diabetics. Numerous studies have not only found that depressed patients with diabetes had a significantly shorter time to their first major hypoglycemic episode, but also that they were more likely to experience additional episodes in the future. Although more testing is needed, researchers have established a clear association between depression and hypoglycemia.

Conclusion

While not definitive, there seems ample evidence to suggest that low blood sugar may be a risk factor for depression. That it strikes some patients with hypoglycemia and not others is not at all surprisingly, since the biochemistry of well-being is well beyond our ken. We can, however, encourage those that are at high risk of hypoglycemia, i.e., diabetics, to monitor their blood sugar levels on a regular basis. This simple step should help them reduce their risk of depression in the long run.

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