[Let me preface this post with this: if you use Twitter (or even if you don't - sign up!), there is a weekly discussion about all things Diabetes that you should know about. Our fearless leader, Cherise, hosts organized discussions (via Twitter) on living with diabetes, advocacy, health, meters, support and more. If you would like to participate, look around or just hang out log on to Twitter every Wednesday at 9PM, EST. Follow @DiabetesSocMed, #dsma or log on to http://tweetchat.com/room/dsma.]
Tonight's DSMA discussion centered around the connection between diabetes and mental health. Trying to find a happy balance between diabetes and "life" is a never-ending challenge. As many of my fellow d-bloggers have discussed, it can feel like this connection to mental health is largely ignored by the medical community. We are asked by our doctors and CDE's "how we're doing" with our diabetes, but the question is posed in the context of blood sugar control. We don't often get asked how we're really doing - mentally, emotionally.
Diabetes affects every single part of my life, and and will affect it during every single moment of forever. Eating always involves math (How many carbs are in this? How much insulin should I take for it, based on at least ten different factors that play into this?). Exercise is a risky proposition (Do I have active insulin in my system right now that will make me drop too low? Did I eat enough carbs to cover the amount of exercise I plan to do? Is it going to be aerobic or anaerobic?). Sleeping can be perilous (What if I drop really low while I'm sleeping, and this is the time my body doesn't wake me up? Do I have an unexpired Glucagon kit handy if A needs to revive me Pulp Fiction-style?). It's a major financial burden (Have you ever priced out test strips for someone who tests 15+ times a day?). It can cause immense amounts of frustration (No, I didn't get this because I ate too much sugar/weigh too much/didn't take care of myself. Yes, I can eat this, actually. I know you want me to stop sitting in my parked car and back out so you can have my spot, but my blood sugar is too low to drive right now.) It can also cause immense amounts of guilt (I wish this didn't affect my parents/husband/family/friends/co-workers. Why, if I'm doing everything "right", am I still a "bad diabetic" for not having an A1C of 6.0? Will I be able to have kids safely? Am I selfish for wanting that?) It can be a little mind-numbing and overwhelming. We're trying to do the job of an essential organ of the body, for Pete's sake.
I can say that with time, acceptance and the ability to balance the two has improved for me. It can, and does, get better in some ways. I learn what to expect, but every day is a fight, and some days you're just tired of it. Every day involves intensive attention. Every. Single. Day. And even with that, sometimes things go wrong anyway, for no apparent reason.
I find that with more years of diabetes under my belt, I tend to think more about how diabetes has and will affect my life. The things I've missed out on, or done in spite of. The things I still want to do, but have no idea if I can do (or if I will live long enough to see). I know none of us have that guarantee, but not every child gets told "Hey, you know that thing you have? The thing you didn't ask for, cause, or deserve? That's going to shorten your life by five to seven years."
I'm a pretty optimistic person, but optimism can only take you so far some days. The reality of the disease hits you pretty hard sometimes. The worst doesn't happen to everyone, but you never know which side of the coin you're going to be on.
So, what can we do about it? First, we can know that feeling down about diabetes is normal. Totally, completely normal. We can know that there doesn't have to be any shame in asking for help, in whatever form that comes. Have a support system - family, friends, the DOC, whoever. Talk to your doctors not only about how things are going, but how you're feeling about those things. Make them aware of the impact this chronic condition has on you, and help them realize that it needs to be addressed. It would be great to get that kind of help at diagnosis, though many find that the mental angle of the disease isn't acknowledged. Those people? They should get a pony. (Read the transcript from tonight's #dsma for an explanation. And join us next week!)