Diabetes Distress occurs when someone who lives with diabetes experiences frustration, exhaustion, and anxiety due to the stress of managing diabetes, day in and day out. Living with and managing any chronic health condition can be physically, mentally, and emotionally challenging. With diabetes, the day-to-day management of things like testing blood sugar, meal planning, adjusting insulin, exercising, and dealing with high and low blood sugar, among other things, can be overwhelming at times.
Some other stressors when living with diabetes are social stigma, financial stressors, insurance costs, and co-payments. Those without health insurance are fighting an uphill battle trying to manage the costs of their care, medications, and insulin.
People can feel stressed if they are not meeting their treatment goals for whatever reason, or if they feel that meeting their treatment goals requires too much time, work, or money, especially if their treatment goals are perhaps unrealistic or overzealous.
Psychologically, living with diabetes can be a challenge, and an individual’s baseline mental health and coping abilities will affect their risk of experiencing diabetes distress. Frequent anxiety and worry about developing complications can get in the way of daily functioning, making it harder to do the things necessary to manage their care.
The number of barriers to being able to self-manage one’s diabetes can lead to a greater likelihood of distress – the more barriers, the greater the risk. Some examples of common barriers are other health conditions a person may have, financial issues, insurance issues, lack of health insurance, having uncontrolled blood sugar or frequent highs or lows, lack of resources, and lack of support. About in 1 in 5 people living with type 2 diabetes, and 1 in 4 people living with type 1 diabetes, will experience diabetes distress or burnout. A person is at higher risk if they are going through a major life transition such as divorce, loss of a job, injury, a move, or loss of a loved one. Distress is more common at the time of initial diagnosis, when treatment is changed, when a complication is diagnosed, or when a complication worsens.
Some of the signs of diabetes distress and burnout are:
- Feelings of frustration, overwhelm, or even anger about having diabetes and over the demands of managing it
- Having anxiety and chronic worry about one’s diabetes and the implications of uncontrolled blood sugar, and about complications that can occur
- Lack of motivation to do all of the things you need to do to take care of your diabetes –These can include not checking blood sugars, missing doctor appointments, or making unhealthy food choices that will adversely affect blood sugar and overall health.
- Feelings of isolation, feeling they are alone in their struggle and that nobody really understands what they are going through. Feelings of helplessness, hopelessness, and indifference regarding their condition are also signs.
It is important to know that these feelings can happen, they can come and go, and that they can be normal reactions to a challenging situation. There is nothing ‘wrong’ with these feelings from time to time, and most people do not manage their diabetes perfectly. Trying to do so is not reasonable, realistic, or attainable. If you or someone you know is experiencing the feelings of anxiety, worry, frustration, anger, overwhelm, or indifference for more than a week or two, reach out to a loved one or a member of your health care team for help.
Some helpful things to remember if you or a loved one is living with diabetes:
- Self-compassion – try to go easier on yourself. Try to set SMART goals – small, manageable, attainable, realistic, time-specific goals instead of setting very high expectations. Remember that the goal is progress, not perfection. Spend time on self-care whenever possible, whatever that may look like to you (talking with a friend or loved one, taking a walk in nature, having a massage, reading a good book, spending time on a hobby you enjoy – anything that can bring you some peace and joy).
- Take breaks – make it okay to take a small break from your routine from time to time, with input and recommendations from your healthcare team – this can look like being a bit more flexible with your blood sugar targets for a day, checking a little less often for a short time if it is safe to do so, etc.
- Talk about it: talk to others about how you feel. Sharing how you’re feeling with your family, friend, or caring individual can help others become aware of what is going on with you, and enable them to support and help you. Seeking out support groups, in-person or online, can be very helpful – talking to other people living with diabetes and facing many of the same or similar challenges as you are can make you feel less alone, and you can share and learn tips for handling common issues or challenges.
- Involve your healthcare team: it is important to share how you’re feeling with your team so that they can help. Make a plan with your team that can help alleviate your distress in a safe way. Talking to a therapist or counselor may also help – you can ask for referrals from your healthcare provider for additional support.
- Discuss with your team if you are experiencing financial distress, or if lack of finances is a barrier to affording the medication/insulin that you need. Check with your pharmacist, healthcare provider, or community health center for information about programs which supply medication or insulin for reduced or no cost.
References:
10 Tips for Coping with Diabetes Distress | Diabetes | CDC
All Blogs are written by Professionals in the fields of Nutrition, Human Development and Diabetes.