By Chris Woolston, M.S.
Living with diabetes takes a lot of work: regular doctor visits, checking your blood sugar at home, taking your medications as prescribed, exercising regularly, and watching what you eat every day. If you've recently been diagnosed with the disease, you've probably discovered another challenge that few people ever talk about. Without some preparation, diabetes can drain you emotionally as well as physically. If you're going to fight this disease, you'll need to get in the right mindset, and that's easier said than done.
The triple threat: denial, anger and depression
Self-care for diabetes is a lifelong challenge, and getting things under control can take some time. It's okay; in fact, it may take several months after your diagnosis for you to learn what you need to know and feel comfortable managing your diabetes.
Denial, anger, and sadness are normal responses to any difficult diagnosis, but to regain your emotional balance, the key is acceptance of your situation and taking personal responsibility for your health. Since 99 percent of your time is spent outside a doctor's office, you are in the driver's seat. Most people take some time to settle in, but the sooner you do, the better off you will be.
In fact, there may even be a silver lining for some people: Having diabetes can be a wake-up call to discard unhealthy behaviors such as smoking, a sedentary lifestyle, and overeating -- behaviors that can endanger anyone's health, whether or not diabetes is involved. Many people with diabetes take control of their disease and are healthier as a result -- some, like swimmer Gary Hall Jr., have even gone on to become Olympic athletes. "I've definitely seen diabetes prompt some people to take their health seriously for the first time in their lives," says Michael Potter, MD, an attending physician at the UCSF Medical Center.
But moving from diagnosis to acceptance may take some time. According to the American Diabetes Association (ADA), it's not unusual for people diagnosed with diabetes to respond with denial, anger, and depression. You might tell yourself that the doctor made a mistake or that your condition is too mild to worry about. Some people attempt to exercise and change their eating habits, but refuse to take needed medications even when lifestyle modification is not enough. Still other patients feel so frustrated and angry at themselves and their diabetes that they don't want to even think about the disease. These initial reactions to the diagnosis are so common that you shouldn't feel ashamed if you have them. Your job is to make sure these attitudes don't stand in the way of your health.
If you do not get past these feelings, they can keep you from taking care of yourself and preventing the short- and long-term complications of your diabetes. The ADA says denial makes it easy to ignore your meal plan or stop testing your blood sugar. People in denial may also neglect crucial aspects of self-care, such as getting their feet or eyes checked, or quitting smoking. Likewise, people angry about having a disease that requires constant monitoring may not want to do anything to acknowledge it.
Overcoming the obstacles
Whatever you're feeling about your disease, it's a good idea to share it. Being in touch with your feelings and talking openly about them with your doctor, diabetes educator, family, and friends can be very helpful. Simply finding a group of people with whom to share your thoughts may provide the inspiration and support you need.
Many community hospitals sponsor diabetes support groups, where you share tips and can talk with other people who are coping with the disease. The American Diabetes Association lists names and contacts of support groups in your area on its Web site (http://www.diabetes.org/communityprograms-and-localevents/whatslocal.jsp).
If anger is getting in the way of your health, the American Diabetes Association suggests taking a good look at the roots of this emotion. Think about what makes you angry and consider keeping an anger diary. You may discover that you haven't fully accepted certain aspects of your disease. If anger persists, consider visiting a counselor, therapist, or other mental health professional.
Depression, when it occurs, should be treated aggressively. According to the National Institute of Mental Health, several studies suggest that diabetes doubles the risk of this debilitating mental illness. The American Diabetes Association says there is a definite link between the two diseases with some 10 to 30 percent of diabetics also suffering from depression. Feeling disconsolate, flat, empty, and unable to sleep well or get any pleasure out of life for more than a few weeks are among the signs of depression, which definitely isn't something to tackle on your own.
Some people feel depressed immediately after learning they have diabetes, while others face the problem down the road after years of trying to control it. Whenever it appears, depression can sap your will and strength to fight your diabetes. If you feel depressed, seek professional help right away. Modern treatments -- including counseling, antidepressant medications, or a combination of the two -- are usually extremely effective.
Meanwhile, you can help yourself by taking control of your blood sugar and exercising regularly, ideally for at least 30 minutes a day on all or most days of the week. (Talk with your diabetes educator or doctor about the special precautions you should take while working out.) The healthier you are, the better you'll feel -- emotionally as well as physically.
Coping with diabetes can be a daunting task. But first things first. You can't control diabetes until you're emotionally ready to commit to the fight. Eventually, the normal reactions to your diagnosis -- anger, denial, and depression -- should give way to acceptance. Once you accept the fact that you have diabetes, you can do whatever it takes to manage the disease.
American Diabetes Association. Coping with bad feelings.
National Institute of Mental Health. Depression and diabetes. June 2002.
American Academy of Family Physicians. Diabetes: What the diagnosis means. September 2002.
American Diabetes Association. Depression and Heart Disease in Diabetes. http://www.diabetes.org/diabetes-research/summaries/egede-depression.jsp
American Diabetes Association. Executive Summary: Standards of Medical Care in Diabetes -- 2009. Volume 32, Supplement 1. January 2009. http://care.diabetesjournals.org/content/32/Supplement_1/S13.full.pdf+html
Last Updated: March 11, 2013