Emotions and Diabetes – How to tame the fear
Many people diagnosed with diabetes can find themselves gripped by anxiety and fear of the future. This can lead to nervous illness and depression. Studies have shown that people with diabetes are 20% more likely to experience anxiety and up to three times more likely to be become depressed.
Anxiety is a physical and mental reaction to a perceived threat, which triggers at the more basic level, the flight or fight response. The term ‘anxious’ comes from the Latin ‘anxius’, which means to be upset about some possible future happening. It can lead to, amongst other things:
Nausea/lack of appetite
The unpleasant symptoms, caused by the release of adrenalin, can cause people to avoid the original cause of the fear. This has been called the ‘fear-adrenalin- fear cycle’ by Dr. Claire Weekes. People begin to ‘fear the fear’ itself and so get trapped in a cycle, which unless tackled can lead to nervous illness and depression.
How does this play out in diabetes? Upon diagnosis, people are hit with a huge amount of information about the disease; a disease which up until that moment, they might have had no knowledge of. They hear about the need to take medication, to test their blood sugar regularly and the possibility of very unpleasant outcomes such as – heart disease, amputations, blindness and strokes. There is also the need to adjust lifestyle and eating habits. The list goes on. They also might worry about the cost of the disease, the financial burden, and how this might impact their careers.
For some the fear of the future and even death becomes very real and traumatizing.Some people enter ‘denial’. They avoid the subject completely and with diabetes, this can be something that is very easy to do. In many cases, the impact of not treating your diabetes may not have any impact to your health for many years. It’s possible to convince yourself that this is a minor issue for you.
Other people become very anxious and the more and more they read about the disease, the worse this becomes. In the end, they start to avoid the issues and for example will not look at an article in the paper about diabetes as it makes the anxiety and fear worse.This is the classic ‘avoidance’ of a fear, that in the end can lead to anxiety disorders and maybe even depression. It’s the vicious anxiety cycle that Dr. Clair Weekes explains so well in ‘Self help for you nerves’. “Surely it can be understood how, by adding extra stress of fear to his original stress, the sufferer stimulates the release of more and more adrenalin and so intensifies the symptoms he dreads, which are themselves symptoms of stress”. http://astore.amazon.com/wwwsingapored-20/detail/0722531559
Dr. Weekes believes that anxiety over the longer terms can lead to nervous exhaustion and ultimately depression. It will also undoubtedly lead to worse outcomes in terms of diabetes management. “Finally there is fatigue of the spirit. When a nervously fatigues person is so depleted that every action, perhaps every thought is an effort, he begins to wonder if the struggle is worth it”.
Depression then can be seen as depletion of the mind and body’s resources and energy, which leads to the following symptoms (for two weeks or more):
An overriding feeling of hopelessness and negativity.
Loss of interest in activities or pleasures.
Insomnia, oversleeping, awakening early in the morning
Dwelling on death or suicide
Weight change and decreased or increased appetite
Concentration problems, memory problems and indecisiveness
Lower energy and increased fatigue
Feeling helpless and powerless to change your situation
Persistent sadness or anxiety, a feeling of hollowness
It’s understandable that the diagnosis can lead to mental health issues, and in my view a lot of this begins with the original ‘diabetes anxiety’ and the advice and help that people are given at the start. The absence of clear and consistent information is needlessly putting people at risk from these issues.
I believe that with the right support and advice and importantly the right information people can get back on their feet very quickly, as I did. Too many people are sent down the wrong path, fail to get quick control of their blood sugar and enter diabetes anxiety, and some end up with depression. The first part of gaining control of your diabetes emotionally is acceptance. Acceptance is a hugely important concept and goes beyond the usually meaning of the word in everyday use. We usually mean ‘acceptance’ to refer to acknowledgement of something, for instance: ‘I accept that it was my fault’. With diabetes and diabetes anxiety, the meaning is far broader; far less of a passive state. It also implies action – and moving forwards. Before acceptance, of course, the patient needs to face their fear and must understand that the first step is to no longer shy away from the source of the fear – diabetes.
They must not run away and begin to realize that the very first thing that will in effect make you ‘better’ lies within yourself. It is in the moment you realise that the doctor, or the endocrinologist can only do so much for you. I’ve said this before, but it bears repeating, diabetes is unlike nearly all other diseases in that it requires the patient to take over a lot of their own care and their own decisions. I’ve lost count of the number of times I’ve been asked by people on my website how ‘qualified’ I am to give out the advice that I do. This misses the very point. Of course, I reply, I am not giving you medical advice – in fact I have a disclaimer on my website and Facebook page about that – I am not a qualified doctor, endocrinologist or anything else similar (although I do have a degree in psychology).
What qualifies me to give advice is that I have lived with Type 1 diabetes for 10 years and have lifestyle methodology which works! I have faced the disease and learnt about it; it now holds no fear for me.
I regularly hear from people who are looking for an easy answer. People have contacted me recommending all sorts of supplements, and fruits which can magically lower blood sugar, and all manner of other types of ‘cures’. Many of these people, when I ask them, admit to not knowing their HbA1c. I am not demeaning these people for their efforts in looking for solutions. But, the essential truth is that diabetics have a problem with processing glucose. Either your pancreas has stopped working, or you have insulin resistance.
There is a medical reason underpinning your problem that needs medical advice first, and then lifestyle changes next – there is no getting away from that. By all means research supplements and alternative cures, but first get control of your blood sugar. Test your blood sugar regularly – and set a target for your HbA1c as your first priority.
That is what I mean by acceptance. Acceptance is not avoiding, not running away, not looking for a miracle cure. It’s about working with the doctor, and not expecting him to ‘cure’ you. It’s about reading about the foods you should avoid and testing yourself after eating food to understand the impact on your blood sugar. It’s also about questioning what people tell you. Not all advice you will receive will be right. If you blood sugar tests show you one thing and a doctor or nutrionist, or someone else tells you differently, then you should be asking questions – do not be passive. Your blood sugar does not lie! The bestsource of information is your blood sugar.
With facing diabetes and acceptance, and learning genuine ways to manage the disease, the anxiety and fear will dissipate. How good does it feel to go the specialist and get a great set of results? You know that you have lessened the chances of complications and you know what you are doing is working. This way you have started to remove the source of your diabetes anxiety. Acceptance is going towards the source of your fear and not away from it. You may not be able to completely get rid of that negative internal chatter about the disease, or completely rid yourself from anxiety, but by taking control of your own treatment, you will slowly but surely lessen its control over you.
So, to summarize the right approach to diabetes in relation to managing the psychological aspects of the disease, I would encourage you to:
- Walk towards the disease and not away
- Accept completely that you have diabetes
- Listen to your doctor first
- Research and understand the lifestyle changes
- Trust your blood sugar readings and question advice that leads to the wrong results
- Be highly skeptical of easy answers
Some people do find it harder than others to deal with diabetes, and if you do struggle, please get help from a professional – there are many ways you can be helped, but do not struggle alone and in silence.