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Mental Health vs. Diabetes

Mental health is a hot topic these days, and rightfully so. More than ever people all over the world are opening up about their mental health and the importance of taking care of it, although it still isn’t taken as seriously as it should.

 Being in the middle of a seemingly never-ending pandemic full of quarantines and lockdowns has certainly shined a light on how serious the effects of poor mental health can be. It got me thinking about how being diabetic could not only affect my physical health but my mental health as well.

Even though I’ve been diabetic my entire life, mental health isn’t something that I’ve ever considered concerning my diabetes. Obviously, there are rough days, one too many finger pokes or a wrong dose of insulin can really be a buzzkill, but I’ve never thought of it as depression, or anything other than a rough day.

Oh, how wrong I was.

For the last few weeks I’ve been reading up on mental health and diabetes, and though I’m barely scratching the surface I feel like I’m getting a whole new perspective on how my diabetes affects my mood, stress levels, and relationships.

Mental health and diabetes are so much more intertwined than I would ever have guessed. It made sense to me that changes in my blood sugar levels are a contributing factor to the state of my mental health at that moment, but I had no clue there were long term effects. 

Having diabetes can double my chances of developing depression, and if my diabetes is poorly managed the risk is higher still. Roughly 30% of diabetics show some form of depressive symptom at some point in their life, and there are many different causes. 

  • Family history of either disease
  • Obesity
  • High blood pressure
  • Inactivity 
  • Coronary artery disease

A scary number of mental illnesses other than depression are much more common in diabetics than non-diabetics such as eating, sleeping, mood, stress, and anxiety disorders. Having a serious mental illness such as schizophrenia, major depressive disorder, or bipolar disorder significantly raises the chance of developing type 2 diabetes, much more than that of non-diabetics.

It’s been pretty surreal for me, realizing how much more susceptible I am to mental health issues than the general public. It’s been almost more surreal wondering how I never knew any of this until now!

But the more I read into it the more it made sense, and the more things started to click in my head. I’ve been dealing with two types of diabetes-related depressive symptoms for the past few years, and I didn’t even realize it.

Diabetes distress, and fear of hypoglycemia.

Diabetes distress is essentially a total burnout due to the demanding day to day self-care regime needed for a healthy life with diabetes. Diabetes is extremely demanding. It never stops, gives you a break, or cares about how you feel; Hell it’s usually what makes you feel like crap in the first place. 

Over the last few years, I guess since I’ve become an “adult” (ugh) I’ve noticed an increase in difficulty managing my diabetes. All the Dr. appointments, pharmacy runs, remembering to change my insulin pump site every two days, carb counting, more Dr. appointments, high blood sugar, low blood sugar, and everything in between; started wearing on me.

I always told myself that it’s just a part of growing up, I’m on my own now (in the sense that I’m not under my parents’ constant care) and it’ll get easier as time goes on. I’ll get used to dealing with everything on my own as time goes by. Right?

Well, as time went on things just kept getting more and more difficult. I started getting stressed all the time over the smallest things, just having to run to the pharmacy for my insulin or test strips started becoming a very daunting task, and my blood sugars started going high much more often.

I stopped staying in touch with my endocrinologist and diabetes education team for the most part, because I felt embarrassed about how I was managing my diabetes. I could take great care of my diabetes when I was 16, but suddenly it felt like a thousand-pound weight vest.

I learned very quickly that most of the reason I managed to stay so healthy even with diabetes was the fact that I had such good parents that took most of the stress on their own shoulders for me. Once I moved out, I didn’t have that extra watchful eye covering my back. The responsibility was on me now.

I have more experience and knowledge than ever before, and suddenly for some reason, I feel like I can’t do it. Something I’ve done my whole life, something I have to do to stay healthy and alive, and I can’t. At least not without a struggle.

I’m stressed out, and I’m tired.

I’m tired of needing a vile of medicine to survive and having to live with a tube inside me 24/7. I’m tired of 2 AM low blood sugars that wake me up in a nightmare state, not sure of where I am, why I’m soaked in sweat or why I feel like I’m dying. I’m tired of needles, infections caused by those same needles, and all the pain that comes in-between.

I’ve become terrified of growing any older than I am due to the endless number of long term side effects of a life long battle with type one diabetes. Knowing that I will likely have some type of kidney, heart, or eye disease numbs me to my core. 

Almost all diabetics die of diabetes-related complications. No matter how good of a job they did taking care of themselves, and I like to think I’m a fairly healthy person.

I could never figure out why I’ve been so exhausted lately, and why everything was seeming so difficult. It was really getting to me until I started researching this topic. Knowing there’s a name for the stress I’ve been going through and that I’m not alone has given me some level of comfort and motivation. It’s also made everything very real, and somewhat terrifies me at the same time. 

It means that I have some work to do, and I’m okay with that. It’s kinda scary, but so is most of living with diabetes, and that hasn’t stopped me. It will take time, it doesn’t just happen overnight as great as that would be. 

Fear of Hypoglycemia is exactly what its name suggests, fear of low blood sugar. Low blood sugar episodes can be a mildly annoying inconvenience, but they can also be life-threatening and traumatizing. They happen fast and make you feel horrible.

When my blood sugar drops, I know instantly. I become very irritable, lights become oddly bright, I almost feel drunk at times, I’m weak. Everything becomes difficult, physically and mentally. 

My strength is non-existent anymore, my attention span and focus disappear, sometimes I can’t even remember my own name, and panic sets in when it gets low enough. Beating my heart out of my chest.

Low blood sugar is so much scarier than high blood sugar. High blood sugar has much more damaging long term effects, but low blood sugar can have very sudden and fatal consequences. Many people lose consciousness, or worse yet, fall into diabetic seizures and if it drops low enough, die.

I have had multiple diabetic seizures in my life. I’m not sure of the exact number, but It’s somewhere in the 3-5 range I believe. They all happened when I was young, my last being well before I was 7 or 8 years old.

They are complete and utter HELL.

Although it has been a very very long time since I’ve had to endure one, and I don’t remember anything that happened during the seizures, I’m pretty sure no one does. The moments before a seizure happens are burned into my head forever. At least a few of them stuck around up there. 

The worst one I remember actually happened while I was asleep. It started off as a nightmare, which is a common occurrence when a diabetics blood sugar drops during sleep. 

By the time I came out of the seizure, the paramedics were already at my house. I remember asking why there were strangers in my house and wanted them to leave so I could sleep (In hindsight I should’ve thanked them!

All of these events can eventually, sometimes quite quickly lead people to fear the very thought of having a low. Myself included. I’ve been guilty for a while now of purposely keeping my blood sugar just a tad higher than it should be to ensure it’s nowhere near those scary lows. 

Doing this long term is extremely dangerous and unhealthy. I don’t keep it dangerously high; the 8-12 range, but even a slightly high blood sugar level over time will do damage. After all, it isn’t ever supposed to be high. 

I know I’ve been subconsciously doing this for years now, and again I didn’t know it was an actual condition, not me just being paranoid. Some of the things I tend to do to avoid lows preemptively are:

  • Only giving myself insulin for about 90% of what I eat, even when my blood sugar is in target or a little higher(it is okay to do this when being active or having consistent lows all day).
  • Overcorrecting lows with too much sugar and carbs.
  • Adjusting my basal rates so that I get less insulin throughout the day
  • Not giving myself correction insulin or being active when my blood sugar is starting to rise

It’s going to take some work to break these habits, but I know now that I need help managing my stress caused by diabetes. From the day to day demands to the monthly financial cost, I need to find a way to better organize the way I manage my diabetes. 

It’s been quite the wake-up call realizing how much diabetes can affect my mental health, and vice versa. I definitely needed it, and I plan on continuing the research I’ve been doing on the topic.

I’m excited (and scared) to see what I can do to better myself and better manage my diabetes in the future, and if any other diabetics are reading this, you aren’t alone and you’re a badass just for surviving. Never forget that.

Like I said above, I’m hardly scratching the surface here, and I’m no expert by any means. I plan on learning as much as I can and would like to make more posts about mental health in the future. If anyone can relate or find comfort in knowing someone else shares similar experiences then I’ve done at least one thing right.

Mathew Vigar

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