Navigating the dual burden of type 1 diabetes and mental illness: A phenomenological study

Despite high burdens of mental illness among people with type 1 diabetes (T1D), little is known about how affected individuals experience this dual disease burden. This qualitative study aimed to address this gap.

Five online focus groups were conducted with 21 adults with T1D and a history of mental illness. We analysed data using a six-step descriptive phenomenological approach: (1) collecting data, (2) gaining an overall sense of participants' perspectives, (3) segmenting narratives into units of meaning, (4) synthesizing units into themes, (5) determining the structure of the phenomenon, and (6) integrating features into an essential description of living with T1D and mental illness.

Two overarching themes were identified. The first, The Weight of Unseen Struggles, encompasses pervasive stressors, including the mental load of diabetes management, experiences of medical trauma, hypervigilance, burnout and the cyclical interplay between diabetes and mental health. These stressors manifest as a range of psychological and somatic symptoms, including depression, anxiety, obsessive thoughts and behaviours, sleep disturbances and trauma responses that affect daily functioning. The second, The Burden of Being 'Othered', highlights how interpersonal, institutional and societal factors contribute to experiences of judgement, stigma and ostracism.

Adults with T1D endure a complex interplay of psychological, interpersonal and environmental stressors that exacerbate mental health symptoms and hinder treatment-seeking. Integrating tailored clinical psychological support within diabetes care settings and developing mental health intake policies for people with T1D may enhance access to mental health treatment and improve health outcomes.