Life with diabetes is hard work. Diabetes has been likened to a job — not just any job, but one in which you have to work 24 hours a day, 7 days a week, 365 days a year, with no holiday, no praise, and no pay. I don’t know about you, but I wouldn’t stay working in a role like that for very long! However, individuals with diabetes don’t have the option of walking out or giving up; they have to keep ‘working’, day in and day out, for the rest of their lives.
None of us can do anything in life that requires effort over a sustained period without getting support and respite — and diabetes is exactly the same. There are wide ranges of emotional factors that can impact the well-being of someone with diabetes — some of which affect people with type 1 or type 2 only, but many of which affect individuals with any type.
Dealing with Diagnosis
The diagnosis of diabetes is a life event that has been likened to the experience of grief. In the same way as it is natural to grieve for a lost loved one, being given a diagnosis of diabetes can trigger a grieving for one’s lost health. It is common to live life as if we are invincible, rarely considering our health or mortality. This dramatically changes when we are diagnosed with diabetes: we are suddenly acutely aware that life is not without limits. We now have to rely on regular medication, frequent visits to a medical setting, and a team of health professionals to keep ourselves well. By becoming aware of the different stages of grief and recognising the stage of the process that you may be in, you can manage the potential challenges better.
Depression, Low Mood and Distress
Psychological research has demonstrated that low mood and depression are very prevalent among people with diabetes; in fact, studies have demonstrated that depression is approximately twice as common in people with diabetes as in people who are in good physical health. ‘Diabetes Distress’ is a particular type of low mood, describing the emotional burden associated with the self-care demands required. Life has its challenges for all of us, with or without diabetes, and experiencing the whole range of high and low moods is part of the human condition. However, coping with a demanding condition like diabetes is an extra stressor to contend with, and it is very common to struggle with low mood and distress at times.
Guilt, Shame and Self-Blame
Feelings of guilt, shame, and self-blame can be experienced by people diagnosed with either type 1 or type 2 diabetes. For individuals with type 1 or 2 diabetes there can be the shame of being ‘different’ for having this health problem to contend with, not helped by the way the media can stigmatise diabetes. Injecting and blood testing in public can be experienced as embarrassing and something we would rather hide than engage in openly. Some of us may experience these emotions because they we have been aware we needed to make changes to our health and lifestyle, and they feel regret we didn’t act on this awareness in time to prevent diagnosis.
Fear and Anxiety
Fear and anxiety affect many people with diabetes. They can be divided into two categories: fear about factors in the here and now, and fear of the future. Fear in the here and now may be anxiety over hypoglycaemia, fear of needles, or simply the daily anxiety about the changes that diabetes causes in life. In terms of fear of the future, many people worry about the long-term complications and how they may have an impact in the years to come.
Using Food to Cope with Emotions
For many people, both with and without diabetes, food can offer more than just fuel for the body. From birth, food is intimately linked to feeling safe and secure in the world, and in adulthood food can become a shortcut to dealing with difficult emotions, rewarding ourselves and simply just getting through the demands of life. Many people go their whole lifetime using food in this way to a greater or lesser extent, and often without causing much harm. However, individuals with diabetes need to be more mindful of the role food plays in their lives, and that using food to cope can cause problems.
Communicating with Health Professionals
Developing a good working relationship with your healthcare team can go a long way towards making you feeling supported in your journey of managing diabetes. However, it’s common for people to avoid going to their health appointments completely, or to feel a range of difficult emotions when they do go. Exploring the various ways you may be relating (or not) to your healthcare team can help you see these relationships in a more helpful light. You may also want to equip yourself with some conversational tools that help you feel more able to assert yourself and have yourself heard.
Diabetes doesn’t only affect the person with the condition. It has the potential to affect the whole family. Just as the person with diabetes can struggle emotionally, those around them can too. Family members can express their concern and worry in a multitude of different ways. Some loved ones may have a tendency to be over-involved with the management of diabetes, which can feel suffocating to the person with diabetes. The opposite can also happen, when family members withdraw and seemingly ignore what is going on, leaving the person with diabetes feeling lonely and isolated.
Difficulties with sexual response are a very common experience for people with diabetes and can affect men and women in differing ways. For individuals with diabetes this can be a further setback: not only do they need to deal with all the other challenges of managing diabetes, now the part of their identity that could be expressed through their sexual relationship is hindered. It can feel like there isn’t any part of life that isn’t affected by diabetes.
How Does Psychology Help?
So we can see that there are a variety of challenges that can affect the emotional wellbeing of the person with diabetes. If you’d like support with any of the issues mentioned here, please do check out my ‘Diabetes Mind & Body Programme’, an online toolkit of psychological strategies that you can implement right away to feel better about your diabetes AND your life. Membership starts at just £7, learn more by clicking here!