Diabetes Burnout :
How to stop the daily grind from bringing you down
Dr Linda Beeney trained in psychology
at the Joslin Diabetes Centre in Boston, USA, and now works with children,
teens and their families at The Children's Hospital, Westmead, and as a
diabetes coach working with individuals with diabetes and family members in
private practice. She uses her psychology training to assist families living
with diabetes to cope well and manage their health.
DO YOU SOMETIMES FEEL discouraged with
your diabetes regimen? Feel angry when you think about having and living
with diabetes? Have feelings of guilt or anxiety when you get off track with
you diabetes management? If you answered YES to one or more of these
questions you are certainly not alone. Studies have shown that a majority of
people living with diabetes experience worries, fears and negative feelings
like these at some stage.
Anyone diagnosed with diabetes can
experience a range of different emotions, such as sadness, grief, loss or
anger. These are normal reactions to living with a chronic illness of any
type AND it does not mean that you are going mad. It could be diabetes
burnout.
Joan is 58 years young and has had type 2
diabetes for 5 years. Joan had been trying her best to keep on track with
her diabetes but her BGLs always seemed to be high and she wasn't sure what
to do about them. On top of that, she didn't seem to be getting anywhere
with her weight despite her efforts and felt guilty about eating the ?wrong?
goods. Joan recently told her educator that she'd stopped checking her BGLs
months ago and felt fed up with the whole thing. Joan is suffering from
diabetes burnout.
Diabetes burnout is one of the major
psychological complications of diabetes. Most of us get tired of doing
everyday tasks and diabetes sure adds to those! Few, if any, people can
maintain all the tasks of diabetes care week-in, week-out AND keep blood
glucose and HbA1c?s in the narrow ?normal? range all the time. Without
realistic expectations and practical strategies for managing the emotional
side of diabetes, the risk of burnout is high.
The way we think and talk about diabetes
has a major impact on how we feel and manage diabetes. You might have
already noticed we use the word CHECK instead of the word TEST when talking
about blood glucose. This is deliberate. Almost everyone uses the test when
referring to a blood glucose, but we know many people who feel that having
their blood glucose tested by the doctor or educator really is more like
taking an exam to be passed or failed! And many parents of children with
diabetes feel that having their child's HbA1c done is like taking an exam
for them.
Let's say you checked you BGL right now
and it's 15.2 ? how do you feel? What if it was 7.5 ? how would you feel?
Did you feel bad or negative at 15.2 and much happier when it was 7.5? Do
you think of a BGL of 15.2 as ?bad? and 7.5 as ?good??
Out-of-range blood glucose may make you
feel inadequate and out of control emotionally. Don't be tough on yourself
because of an out-of-range blood glucose reading. Many times they can't be
explained. Sometimes you'll do exactly the same things two days running,
same food, same medication, same exercise, same everything, and get totally
different blood glucose readings. Like so many other people you may feel
angry and frustrated but don't waste energy getting made or upset.
One way to handle this is to change the
way you think about your BGLs. Rather than getting made or upset, look at
your BGL results as information to help you decide what to do next. Don't
waste time punishing yourself over a high number. Use what you know to plan
ahead and make positive adjustments. Of course, this is easier said than
done, so if you don't know how to do this or lack confidence, ask your
diabetes health professional for help.
Diabetes is called a chronic condition and
this chronic aspect is one of the reasons diabetes can be so hard for people
to live with. Sometimes we can gloss over the reality of the day-to-day
grind of looking after a condition that doesn't take a holiday. Eating well
and getting regular physical activity is hard enough for people without
diabetes, but combined with the multiple other diabetes-related tasks is
especially challenging.
Even diabetes health professionals find it
hard to implement what they recommend for their patients. Some years ago a
group of student dietitians tried to live for a week following meal plans
recommended for someone with diabetes. How many would you guess managed to
last the week? All of them? 80% of them? Half the students could not manage
to follow the meal plan for even one day.
Feeling tired, having crying spells or
having trouble sleeping may be signs of depression or part of the illness.
If can be difficult to tell, especially if you are feeling run down. When
these feelings start to interfere in a major way with taking care of
yourself, it could be time to act and talk to someone about it. If your
doctor, educator or dietitian suggests that you might benefit from talking
to a psychologist or counsellor about these feelings, if does not mean they
think you're weak or that you have signs of mental illness. Often just being
able to tell someone who understands how diabetes is affecting you will help
a lot to reduce your distress.
Diabetes is not a do-it-yourself disease!
A discussion of the psychological aspects of diabetes would be incomplete if
we didn't consider the other important members of the team: spouses,
partners, parents, children and friends of those with diabetes. Working with
these important people has shown Linda that there are specific struggles for
them, in particular, negotiating the line between helpful involvement and
nagging. Studies show that telling others about your diabetes and knowing
how to respond to questions such as ?should you be eating that piece of
cake?? are some of the most stressful things about diabetes. A degree of
assertiveness goes a long way to help with these interactions.
We have covered only a small part of the
psychological side of diabetes. It is a vast subject ? we could also discuss
the effects of stress on blood glucose and behaviour, fear of changing from
tablets to insulin, fear of hypoglycaemia and other issues. Below are some
strategies and tips for you to change the way you think about diabetes and
avoid diabetes burnout: -
- Remember, it's normal to feel sad,
distressed and angry at diabetes;
- Think adjustment, not acceptance;
- Think ?high? and ?low? not ?good? and
?bad? blood glucose;
- Think ?checks? not ?tests?;
- Use BGL results as information to help
you decide what to do next;
- Set realistic expectations for BGL
targets with your diabetes health professionals;
- Diabetes is not a do-it-yourself
condition. Speak up and ask for help!
