Diabetic Macular Edema and Mental Health

Diabetic macular edema is a possible complication of diabetes that can affect your eye health. Prioritizing your mental health is essential as you navigate your care journey.

Diabetic macular edema (DME) is a leading cause of vision loss. It’s a severe complication of diabetes that can affect your mental and emotional health in addition to your eye health.

DME causes swelling in the macula, a part of the retina that is responsible for clear central vision. As a result of DME, your vision can become blurry, colors can fade, and straight lines can look wavy. Without prompt, effective treatment, DME may eventually lead to vision loss in one or both eyes.

As you seek treatment for the physical symptoms of DME, it’s essential to consider your mental health as well. You may experience various emotions, including uncertainty or sadness, as you find treatment and make lifestyle changes. Learning how to care for your mental health with DME can help improve your well-being.

A 2021 study from the Centers for Disease Control and Prevention (CDC) found that about 1 in 4 adults with vision loss reported experiencing depression or anxiety. The risk of severe mood disorders is much higher among younger adults with DME.

This article looks at how DME can affect your mental and emotional health and what you can do to minimize those impacts.

Good vision allows you to travel, take in the visual arts, and enjoy other opportunities without accommodations. You can see loved ones, sunsets, and so much more. So anything that reduces your vision might make you nervous about the future impact on your quality of life.

Vision loss associated with DME or other eye diseases may affect your ability to carry out daily activities and plan life events.

For example, a 2020 review of studies examining DME’s impact on mental health found that DME limits activities such as walking, driving, and reading and that those impacts are greater when the disease severity is greater. The researchers also found that DME has the potential to significantly affect people’s psychological well-being.

A 2019 review suggests that DME and its precursor, diabetic retinopathy, are strongly associated with depression and less favorable psychosocial outcomes. However, the researchers also note that early interventions, especially those that help preserve vision and slow down disease progression, are associated with improved mental health.

When you receive a diagnosis that involves vision changes, you might have many questions about the next steps and the changes you may need to make to your lifestyle. Thoughts about work, finances, and socializing can seem overwhelming.

Remember that a diagnosis is the first step in finding treatment to manage symptoms and possibly reduce disease progression. Your doctor will guide you as you decide what type of treatment works for you.

The initial signs and symptoms of depression can build gradually. Some people don’t notice changes in their mood, outlook, and behavior until those changes begin to significantly interfere with daily functioning.

Common signs and symptoms of depression include:

• low mood
• changes in appetite
• changes in sleep patterns
• hopelessness
• increased irritability and agitation
• thoughts of harming yourself or others
• withdrawal from friends, relatives, and activities you once enjoyed

Vision loss might make you feel cut off from the outside world and from your friends and family members. Even simple interactions with others can seem different.

One of the main reasons DME and other vision problems affect mental health is that they can leave people feeling isolated or even trapped in their homes. Vision loss may change how you create a schedule, run errands, and plan leisure time.

You might feel self-conscious about sharing your DME diagnosis or making plans with others. In that case, you might want to plan ahead to have specific conversations about changes in your lifestyle with certain people. You can also ask a mental health professional to help you take proactive steps for upcoming social gatherings.

Family dynamics can also change, often adding stress to a home already affected by health challenges. Partners can become caregivers unexpectedly. A family member may need to take over driving, shopping, and other responsibilities, or you may need to hire outside help to fulfill certain obligations.

While some family members might treat you just as they always have, others may be less inclined to stay as close. They might feel awkward or not know what to do or say about your vision loss.

While it may be most convenient and efficient to find help within your family, DME-related vision loss may also require outside support for both mental health and logistical reasons. The American Academy of Ophthalmology and other organizations provide local, national, and online support groups and other resources.

Your eye doctor may also be able to recommend support services in your area.

Moving forward with DME can include ongoing care for your physical health, including monitoring and treatment of your eye disease and diabetes as well as your mental health. Integrated care, which involves caring for both your mental and physical health, may be the most helpful and effective means of preserving your overall well-being.

One way to pursue integrated care is to assemble a healthcare team who will address your needs holistically. Your team might include:

• a primary care doctor to coordinate all your care
• a retina specialist to monitor your DME and provide treatment when necessary
• an endocrinologist to manage your diabetes care and treatment
• a mental health professional or social worker to address issues such as isolation, loneliness, depression, anxiety, and difficulties with day-to-day functioning (household finances, cooking, cleaning, etc.)
• other specialists, as needed, if conditions such as kidney disease or neuropathy develop

A 2017 review of DME treatment suggests that a multidisciplinary team of specialists can help ensure that people receive optimal DME care along with treatment for other conditions related and unrelated to DME.

DME and other possible complications of diabetes can have life-changing impacts. But you can take steps to prevent those challenges from severely affecting your quality of life.

Be proactive about your eye health and diabetes management rather than giving in or giving up. Though you may not be able to recover lost vision, medications and other treatments might help you avoid or reduce disease progression.

Don’t hesitate to ask family members and friends you trust for help when you need it. While you may not be able to see the world the way you once did, you’re still seen by those who love and care about you.