Emotional effects of diabetes

One aspect of diabetes, which is often overlooked or not acknowledged by the patient and his family and friends is the effect it has on emotional well being. It can lead to depression and other complications, which don't manifest in psychical symptoms like neuropathy etc.

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DR. SANJAY GUPTA

The Emotional Effects of Diabetes

By Dr. Sanjay Gupta

For people with type 2 diabetes, managing their emotional health can be as important as keeping their blood sugar under control. The condition requires constant attention, and that can trigger feelings of stress and anxiety. Studies have shown that diabetics are much more likely to have an anxiety disorder or depression. They may neglect their diet, stop monitoring glucose levels, or revert to unhealthy habits.

Steve Sternlof, PhD, a psychologist with the Harold Hamm Diabetes Center at the University of Oklahoma, talks about the psychological impact type 2 diabetes can have and ways to help patients cope.

How do you know if a diabetes patient is suffering from stress or anxiety?

There are different situations. It might be someone who is not compliant with their self-care and isn’t checking their blood sugar regularly or taking their medications as prescribed. Their doctor notices this and sees their A1C [hemoglobin test] levels are up and there are problems. In that case we might get communication from their physician, and we’ll help them work through their issues and come up with a game plan.

It might be a patient who is severely depressed and openly talking about their level of sadness and that they’ve given up hope. Their diabetes is affecting them socially and putting a strain on their relationships or marriage.

Sometimes patients are good at hiding these feelings. It’s important that doctors ask questions and probe beyond how their medical care is going. A lot of patients are reluctant to talk about their feelings unless asked. When a doctor is willing to ask questions above and beyond whether or not they’re checking their blood sugar, the patient is more willing to talk.

What are some of the major mental health issues that affect diabetics?

There’s a high correlation between diabetes and depression. It can come in different forms and different levels of severity. Some people just get down a few days out of the week or month, others have chronic depression. It can be difficult for them just to get out of bed and function in their daily lives.

It can also create anxiety in that people worry about how they’re going to talk about their disease to other people, and whether or not they’ll understand what they have to go through.

They also worry about how diabetes will affect how long they live, they worry about complications, whether or not they’ll go blind, if they’ll need a limb amputated. It creates a lot of stress and worry. Even if their diabetes is under control, it’s that “what if” factor.

Diabetes also has a big effect on interpersonal relationships. People who have these depression or anxiety problems and have a chronic illness tend to withdraw from others and isolate themselves. The problem is a lot of depressed patients put loved ones off. I tell family members to not give up—the patient may not respond after the first or fifth time, but maybe after the twentieth time. They at least have to leave the door open.

How do you help someone diagnosed with diabetes cope with the pressures of constant self-care?

It’s a big struggle. People live their lives and have a certain way of living it and have certain habits and routines. Those things are very hard to break. When you get diagnosed with diabetes, you don’t have to totally break them. But now you have to fit in something else throughout the day every day for the rest of your life. This involves checking your blood sugar, taking your medication, watching what you eat, doing some kind of physical activity, following up with your doctor.

Some people decide their diabetes care either doesn’t fit into their routine or it falls short on their priority list. Most people will list their job and their family and other things way above diabetes care on their priority list.

I usually have new patients reflect on why diabetes care is such a low priority when it involves taking care of their health and quality of life and how long they’ll live well with the disease. It’s helpful when they can make that connection on their own that if they don’t take care of themselves and don’t manage the disease properly, then they’re not going to be around to have a job or spend time with their family.

Does there need to be more of a focus on mental health in caring for people with diabetes?

When the emphasis is just on the physical – that my body isn’t performing the way that it should – that’s difficult for some people. It’s helping to change their thinking and have them realize that while they may not have control over the way their body uses insulin, they can at least control how they feel about it. Everyday life, even without diabetes, is tough enough. When you add diabetes that requires so much of someone every single day, it creates an extra burden of stress. Sometimes people don’t feel like they have an avenue of escape. It’s important they have something they can find joy or comfort in.

Please keep warm, my friends in South Africa, and cool in the Northern hemisphere.

I greet you all,

Barbara

Extra tip out of my favorite remedy box:

Please also give Lavender or Valerian tea their chance to relieve anxiety.