One in three people with diabetes are likely to develop depression, according to research. Feelings of depression, anxiety, and distress are not unusual when it comes to diabetes.
Since it is primarily seen as a physical condition, many may experience that the psychological side of diabetes is not always addressed. Yes, there are physical ways to deal with high blood sugar, but what about the mental state that comes with that?
There are certainly ways to deal with such emotions; a doctor will often be the first point of contact. However, speaking to a doctor – or anyone else who might be able to help – is a step in itself.
Talking about problems can be easier said than done. Or, in this case, it may be harder to say something than it is to do something.
Whether you’re the kind of person who opens up about everything, or whether you prefer to keep things to yourself – talking about problems can definitely be helpful.
So, let’s talk about the first step in addressing the psychological side of diabetes: let’s talk about talking about diabetes.
A Common Experience
If you’re uncertain about opening up, it can be useful to know that you’re not alone in what you’re going through. Here, we can take a look at what some experiences with diabetes might look like.
But, while many may experience similar issues, it’s also worth remembering that there are ways of overcoming those issues.
Both the initial diagnosis, and subsequent life with diabetes is a form of loss. It’s a kind of loss that people may interpret in different ways: loss of freedom, loss of certainty, loss of control, loss of independence.
Loss in general is often characterised as a process with different stages: denial, anger, bargaining, depression, acceptance.
You may not experience the stages in this particular order, and you may not experience some of the steps at all. Nonetheless, experiencing these stages is natural; never feel ashamed for having a natural response to loss.
This process is something we’ve noticed in our interviews with people with diabetes. We recognise that there is an initial denial of how serious a person’s diagnosis is, and a denial of the impact it will have on their life.
From this, there is a journey to an attitude of “let’s kick diabetes’s ass” by thoroughly researching it.
But later, that same person might revert to the same thinking of denial, resulting in poorer diabetes self-management.
Again, this might change when an important event happens in their life, such as having a child – this can bring back that energy to make a positive change.
So, while there is a process, it is not necessarily linear: it goes in cycles. This is especially true because diabetes is a long-term condition.
Indeed, the day-to-day of diabetes management can be exhausting in itself: Diabetes Fatigue is an identifiable problem for many with diabetes.
Fatigability means you feel exhausted – either physically or mentally, or both – in a way that occurs often enough to negatively impact your life.
Fatigue is also the physical symptom of hypoglycemia (having blood sugar that is too low). But, in the words of Dr Kalra and Dr Sahay, fatigue “may even persist after glycemic control is achieved”.
Similarly, Diabetes Distress is not uncommon. According to Diabetes UK, 1 in 4 people with type 1 diabetes experience Diabetes Distress, as do 1 in 5 with insulin-dependent type 2 diabetes, and 1 in 6 with non-insulin-dependent type 2 diabetes.
There’s no denying that there is a great deal to think about when you’re managing diabetes. That aspect can sometimes feel like an overload of responsibilities, resulting in long-term distress.
We’ve touched upon Diabetes Distress in our blog post Stress and Diabetes, where we included a link to an example of the Diabetes Distress Scale: a tool for measuring how severely a person is affected by distress.
What can we make of all this? Well, if you have diabetes, and you’re experiencing similar issues, then you know that there are others like you.
These facts do not show a rose-tinted view of diabetes – but this knowledge is there to help, and hopefully improve the health of others in a similar situation.
Why Should I be Talking about Diabetes?
The decision to talk about your diabetes is your decision alone. It’s an extremely individual matter.
At Hedia, we’ve interviewed many people with diabetes, all of whom have varying perspectives on talking about diabetes.
Some people feel that talking about diabetes is irrelevant because it won’t make a difference – at the end of the day, they will still have diabetes.
Others feel that talking about it helps to take a weight off their shoulders, and helps lessen their worries.
There is no right moment or right way to open up. It is your diabetes, and you should be able to decide how to talk to others about it.
But if you are with someone professional or with someone you trust, there is nothing to lose from speaking your mind.
Someone you trust may be able to help you see a situation in a different light, think of solutions that might not have occurred to you before, or – probably most importantly – they can simply listen to you. This will allow the release of tension.
Even if talking doesn’t resolve problems immediately, it can still show someone else that you might need help. This can lead to a more professional or in-depth way to address your problems.
Everybody needs help with something, and asking for it is a sign of strength.
So, talk about diabetes in whatever way feels most comfortable to you – and you don’t need to be fearful of any help that may come your way.
How do I open up?
Maybe you’d really like to talk about diabetes but you just don’t know how to start.
Dr Barnard – the same Dr Barnard who studied the prevalence of depression in those with diabetes that we mentioned at the beginning of the post, and the same Dr Barnard whose study about sleep we cited in our blog post about Diabetes and Sleep – has some ideas.
For inspiration, Accu-Chek has examples of questions that Dr Barnard thinks can be used for a person with diabetes. These questions help a person with diabetes begin to address and identify how their environment makes them feel.
Thus, it can begin by questioning whether people understand what having diabetes is like. This can be followed up by questions that look into other people’s perspective on diabetes, such as what way do people treat you because of diabetes and what frustrates you about that.
Questions can also look at how you receive support: do people close to you support you in your management of diabetes? Have you asked them? Why or why not?
Finally, you might ask yourself how you would prefer things to be. How would you prefer to be helped? Or how would you prefer not to be helped?
Finding the answer to these questions will help to arrange your feelings, ready for communication; to give you an idea of the kind of thing you think might be worth talking about.
Maybe you still don’t feel ready? That’s fine too. Just communicate in the way that makes most sense to you. Even writing a letter might feel easier!
How will I feel better?
Since diabetes concerns both the physical and psychological, the two sides influence each other. It’s worth considering how a better overall diabetes self-management can help with the psychological side.
There are many resources for this, including the various topics of our blog. At Hedia, it’s our job to make diabetes feel easier. You can download our app from Google Play or the App Store – perhaps a diabetes assistant is a step on the path to reducing the problems that come with diabetes. There will be no single “fix-all” solution, but the small steps will all add up.
However, the absolute first step in getting better is to tell someone. So, begin to try thinking about how you might talk to someone. You are not alone.