NEW Guest post from Doctor Jen Nash - Diabetes: "What Do Emotions Have to do With It?"

Diabetes: What Do Emotions Have to do With It?

Life with diabetes can be 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 either 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 you are diagnosed with diabetes: you are suddenly acutely aware your life is not without limits. You now have to rely on regular medication, frequent visits to a medical setting, and a team of doctors and nurses to keep yourself 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 and Low Mood

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. 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 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' by virtue of having this health problem to contend with. For those with type 1, injecting and blood testing in public can be experienced as embarrassing and something they would rather hide than engage in openly. People with type 2 diabetes may experience these emotions because they may have been aware they needed to make changes to their health and lifestyle, and they feel regret they 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. 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 with their emotions 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.

Family Relationships

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 the condition. 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.

Sexual Difficulties

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. Next time I'll be explaining exactly how therapy can help. Look forward to connecting with you then!

Dr. Jen Nash is a Clinical Psychologist chartered with the British Psychological Society. Dr. Jen helps her clients find solutions with simple and highly-effective psychological strategies to gain freedom from the frustration and stress of living with diabetes. To sign up for her free Diabetes Diary, visit www.PositiveDiabetes.com.

Diabetes Art

I LOVE art! I wish I could paint or create everyday. I wish I had a room to do just that. I get lost when I paint. I don't think about anything. Not the growing To-Do list, the carb counting, the finger sticking, the grocery store. I have zero thought. For those of you that know me you are probably laughing because I think a mile a minute and multi-task like no other. However, when I paint I'm transported to a world of quiet. I feel content and peaceful. I normally don't re-post my previous posts but today has been crazy. Our family had a fundraising event for our Hemophiliac son and then a basketball tournament game for my daughter, dinner, down pour (we were eating outside) and a mouth bleed with the Hemo son. It's been a busy day! So I'll re-post a picture I did from Lee Ann Thill's Diabetes Art Day last year and pray you give me some forgiveness and grace for re-posting and I promise myself to paint something soon and post for your enjoyment! Have a great night all!

Freaky Friday

Today our challenge is if we could swap diabetes for another chronic illness which would it be AND has being in the DOC (Diabetes Online Community) changed the way you treat others with different medical conditions.

As many of you know, we deal with another chronic illness in our family. Our son, Jackson, was born with Severe Hemophilia A. This means his blood does not clot. He receives his blood clotting medicine through an IV infusion that we administer twice weekly; sometimes more if he has a bleed. Every fall, bump, scratch, skinned knee is a potential need for his medicine. Oh and the best part of hemophilia (insert sarcasm here) is he can have spontaneous bleeds and internal bleeding. That knot on his head from where he hit it on the table as he was hiding from someone can be a potential risk for him. The fall he took when he was 18 months old and fell on a toy car ending with a hip bleed (internal) that resulted in him not walking required extra infusions. While it's not as everyday hands on as diabetes it certainly can be just as life threatening.

So would I switch diabetes for hemophilia? NO.

Would I switch diabetes for another chronic illness? NO.

Each chronic illness has its own set of rules and different life threatening issues.

I'm sure if you asked a  person with MS, Fibromyalgia, Juvenile Arthritis or any other chronic illness they wouldn't say their illness is a walk in the park.  Nor do I think they would say, "Sure! I'll take T1D instead!"

Part 2: Does being in the DOC change the way I treat others with different medical conditions?

Right around the time Nora was diagnosed my friends son was diagnosed with Autism. She showed me that maybe the kid acting out at the grocery store wasn't ill behaved but maybe he was on sensory overload. She showed me that maybe the kid that doesn't respond when spoken too isn't rude but rather focusing on something else to block out all the other distractions. So I tend to look at people differently. I try to not be quick to judge, to listen and to learn. The answer to the question is yes, if having three kids with chronic illness has taught me nothing else but compassion then so be it. Lesson learned.

Accomplishing Diabetes Big and Small

Today I will share with you one of my smallest accomplishments that will hopefully have a BIG impact.

Empowering my girls.

In our house, we have the motto, "You CAN do ANYTHING."

We don't let D stop us.

Well we try to not let it stop us. High blood sugars and ketones sometimes win out but not too often. Chasing low blood sugars sometimes come in delaying fun (or sleep for this D Momma) but we keep moving forward. I don't want my kids to feel like victims...I want them to feel like kids; that can do anything; and just happen to have diabetes.

Since Nora was little I've taught her to speak up if she is feeling bad. To get up out of her seat and head to the Nurses office REGARDLESS of telling the teacher or not. To ask for help if she needs it. To stand her ground and educate people who question her about diabetes. I'd like to think that this has rubbed off on Evelyn too as she can be very outspoken if she is passionate about something.

I know I won't be around forever to fight their battles.

I want them to be able to do that for themselves.

Memorable Day

Today for the Bitter~Sweet Diabetes Blog Week we are asked to share a memorable diabetes day.

I have several but I'll pick when Nora was diagnosed back in June of 2005; she was 4 years old.

That spring she ended up with walking pneumonia. She didn't sound bad...she was just lying around; not her typical monkey running around self. She was laid up for a couple of days when I took her into the Dr's office when they told me she had walking pneumonia. After about a week or two she seemed to bounce back to her normal self. But then I noticed that her hands would start shaking and she would whine that she was hungry. I didn't think too much of this as I have that exact same issue. It was always in the morning so it made sense that she was hungry. I would feed her breakfast and she would be fine. Then the excessive water drinking started. She would down 20oz bottles of Dasani in 30 seconds flat and ask for more. It was then that it hit me. 1. She would do well in college for beer bong contests or 2. Something is wrong.

So fast forward to the second week of June 2005. I called the Dr's office and asked for an appointment for Nora. I told them all her symptoms and then said I need her tested for Juvenile Diabetes. Here's the thing. I didn't know what Juvenile Diabetes was. Had no clue. The words just came out of my mouth. We have no family history. We had no friends with it. I've never seen it. I didn't know the symptoms. I didn't know squat about diabetes...let alone T1D. Call it divine intervention, a fluke thing...call it I don't know. But as I said those words it was almost an out of body experience. Weird...

That got me an appointment the next day. Urine analysis confirmed sugar in the urine. What did that mean?  Sent us to get a blood draw. Now remember, Nora is 4 years old. She hated to pee in a cup and then she had to give blood. She was NOT a happy camper. I believe in bribery. By the time we stopped off at the mall for said bribery gift and got home a recording was left saying yes, Nora has diabetes and to go down to Children's Hospital where we would be staying for a week.

I remember that day like it was yesterday and Nora will be celebrating her LIVE-a-versary June 13th with 8 years of T1D.

We the Undersigned and I'm NOT your honey!

So what's up with all these petitions going around the Internet? 

That's my challenge today...write my own. Who would it be to or about and why.

Today I'm writing my petition to the Food Industry. 

Calorie King is great. Restaurant websites are okay. But for D-sake...if you make it, cook it, plate it, serve it...give us a carb count. I don't ask for much. I just ask for ALL menu items to be listed. And nice waitress at Max & Erma's who runs to get the manager when I asked about how many carbs are in their warm, delicious cookies and then come back with a "we can't find the nutritional info and don't worry about it honey...you'll just have to walk it off"... um...I'm NOT your honey and yes I will worry about it...I NEED to give my daughter insulin so that she can eat those cookies because she is a T1D. Look, I can SWAG with the best of 'em. Sometimes I do pretty well others well...not so well. I know that even with the exact carb count stuff happens blood sugars rise and/or fall. But I really would like to know...at least have a fighting chance for good blood sugars. 

So that's my blog challenge petition. What would yours be?

Dear Endo:

Hello all!! Thanks for the little blog rest after participating in the WEGO month long blog last month...whew! It was fun but I needed a break. So thank you for sticking with us!

This week is:

Today we are challenged to come up with what we really could tell our Endo or Diabetes Health Team. This is fitting as I've had both the girls in for their 3 month check ups in the past few days. I'm almost afraid to tell you this...but I LOVE my girls Endo. We didn't have her right at first diagnosis with Nora almost 8 years ago. We've had our share of icky, beat my head against a brick wall CNP's but found their Endo by a fluke and have kept her ever since! 

What I like the most about her is that she actually talks to my kids. She asks them what and how they are doing. She praises them when a job is well done and encourages them when needed. NEVER has she made us feel bad about a non-stellar A1C or harped on us for doing something or not doing something. The girls adore her. I also like that she is aware of how long we've been doing this. So she is courteous with our time. She is aggressive in her treatment but also listens to how I help "manage" the girl's diabetes and takes that into consideration. She is relevant and keeps up to date on new technology. She goes to diabetes camp as one of the Doc's and LOVES it!! She also cares about diabetes globally. She brought the film makers into our city and had a private screening of Life for a Child. She is just awesome...she is how other Endo's should model themselves after! If you ever happen to be in the Cincinnati, Ohio area and need a great Endo at Cincinnati Children's give Dr. Nancy Crimmins a try...I promise you'll love her!! 

HOWEVER, if you don't have the most awesome Endo ever and you DREAD going into yours this is what they should know.

1. Don't harp on the A1C. It's a freaking number...there is enough guilt us D-rents's live with that you don't need to add this on top of it. We consider it our Report Card. Is it not enough we are busting our ass trying to keep the D kid alive? We need encouragement NOT brow beating.

2. Talk to our kids. Ask them how they are doing. Get to know them. I'm not saying go on a family camping trip with them but LEARN something about them. They are kids first. Who just happen to have diabetes. 

3. Encourage, encourage, encourage. In everything.

4. Don't act like you know it all. Yes, you are the one with a MD behind your name but guess what...we do too (not really but we have an honorary MD). We know our kids D better than you do. So give us some credit. 

5. Praise. Even if it's a little victory. Praise it. There are lots of crappy days in dealing with D...we, D-rents try to find the joy in just one little victory. Acknowledge it. 

In closing, I would like you to think about YOUR health care provider. Are they working for you, against you or with you?