I am still not a medical provider.  If you think you or someone you love is clinically depressed or needs professional help, seek out that help immediately.  Do it now.

I think depression in people and in kids living with diabetes is more situational than chemical.  If there is a link between diabetes and depression, how can we avoid negative consequences of depression while we take care of our diabetes, or support someone living with the disease?

Diabetes and Depression—The Double Edged Sword of Managing your Disease

Diabetes is a double-edged sword: telling someone they have the power to keep their diabetes under control can often result in that person feeling like a failure when it doesn’t stay there.

One of the worst parts of living with diabetes, for me, is that I am always reflecting on what I did and second guessing my actions.  If I go high or low, I feel like there was something I could (and should) have done to prevent it.  I want the reason behind nearly every glucose reading my meter displays.

As you have probably read this week, I understand there are certainly a lot of factors outside of my control that affect my blood glucose levels.  For me, I still want to know what those factors are so that I can adjust what I do the next time.

I need to keep reminding myself that while it is important to understand what factors play into each glucose reading, I am only gathering data and not creating value judgments about myself.  Diabetes is a data-driven disease and when I can remove emotions from the mix, I can better manage my disease. 

The only real way to “fail” when it comes to living with type one diabetes is to ignore it or make it bigger than it is.  Once you put your disease in its proper place in your life, you are already succeeding.  You know that your management is sometimes beyond factors you can control, and after you can accept that and learn to manage the information in a way to keep you healthy and happy, you are already there. 

You rock.

I am not a medical provider.  If you think you or someone you love is clinically depressed or needs professional help, seek out that help immediately.  Go.  Now.

I think depression in people and in kids living with diabetes is more situational than chemical.  If there is a link between diabetes and depression, how can we avoid negative consequences of depression while we take care of our diabetes, or support someone living with the disease?

Diabetes and Depression—Who Has the Power Here

When you are first diagnosed with type one or type two diabetes your medical team probably had you attend at least one educational class.  If not, they probably had you see a certified diabetes educator (CDE) who told you what your blood glucose parameters are.  You may have even heard magic numbers in an ad, or seen it on a lab result.   

What you probably didn’t learn at that time was just how DIFFICULT it was going to be to keep your blood glucose levels steady or in range.

There are just so many variables in your life and in your body that when you have to function for your pancreas AND live your life simultaneously you will always face a tradeoff.  Do you want to keep your levels in range 100% of the time?  Likely that will take 100% of your brainpower and 100% of your focus and oh yeah 100% luck in there too because outside forces like the weather, hormones, stress, exercise, even the way a restaurant prepares your food all need to be factored into the mix.

Because so many things are literally outside your control 100% of the time, you will max out if you try to “control” your diabetes.  You very plainly do not have the power to control your diabetes.  There are simply too many things that your body is doing and so many things you encounter in the world that don’t have anything to do with your diabetes that you would need to control in order to control your disease all day every day and at night too.

Just like your family pet or your teenage brother, your disease has things it will do that you cannot control. 

It is probably better to try to “manage” your disease than to “control” it. 

So, what you CAN do is try and strike a balance.  Shoot for keeping your blood glucose levels in range a majority of the time.  Try to minimize the effects of those outside forces.  Above all, keep your diabetes in perspective: your diagnosis was never meant to fundamentally change who you are.  You are YOU and you have an additional job to do.

Yes, there will be times that you need to focus 100% on your diabetes.  For me, that includes times I need to stop and eat something to combat a low blood glucose.  It has included times I needed to leave work because my pump was malfunctioning.  I have postponed or cancelled countless workouts because of my blood glucose. 

Do not give your disease the power to consume you and never let diabetes define you.  YOU CHOOSE HOW YOU LIVE YOUR LIFE.  Your diabetes doesn’t have that power on its own.

I am not a medical provider.  If you think you or someone you love is clinically depressed or needs professional help, seek out that help immediately.  Now.  This is what matters.

I think depression in people and in kids living with diabetes is more situational than chemical.  If there is a link between diabetes and depression, how can we avoid negative consequences of depression while we take care of our diabetes, or support someone living with the disease?

Diabetes and Depression—Anxiety

Living with anxiety is a part of living with diabetes.  Most of the time this is just an underlying constant check of my body that I run throughout every day.  Sometimes, though, it affects how I treat myself and my disease; I wish I did a better job for myself on that.

The other day I was leading bootcamp and for some reason I went low with about 10 minutes left of class.  I’m not always good at knowing when I am low versus when I’m just hungry (especially at bootcamp, when I eat a little something before but have breakfast after class) so I thought maybe I was just hungry.  My meter was in my car, about 10 yards away from where I was leading class, but they would not have been able to see or hear me if I went to my car.  I don’t have a problem checking in front of others, nor do I have a problem eating in front of them.  (Although I could deal with less “are you eating CANDY?!” teasing from those who don’t yet know I have type one diabetes.)  I was just trying to make it through the stretches at the end of class and go to my car to check and drink juice.  So, I made the decision to just keep going and then end class two minutes early.

I understand that no one would have asked or expected me to keep leading class if I needed to go check and drink some juice.  Sometimes, though, especially when I’m low, going through the “type 1 versus type 2” conversation and questions from others feels overwhelming.  It can also be too much for me when I say I’m low and seven people nervously ask me what they can do.  I’m just low; it isn’t a big event for me.  For others who don’t live with diabetes I guess it’s a bigger thing.

When I got to my meter, I was 49. 

Now, please keep in mind:  I eat the exact same thing every morning at the exact same time and take the exact same amount of insulin.  When I lead bootcamp, I generally demonstrate a few moves and then watch and correct the bootcampers’ form on the exercises rather than exercise myself.  I still can’t explain why I went low that day.

I know one low isn’t a big deal.  I’ve had diabetes for 22 years and so there have been a lot of lows, and a load of experiences exactly like the one I just described.  But for someone new to diabetes, and for someone not as comfortable with their disease or who wants to hide it from others, this situation creates a lot of anxiety.  

I think a good approach is to lay everything out there, for a few key people in your life.  You can’t explain everything to everyone all the time, and that’s okay.  I know at my law office I am always open to questions about my diabetes.  I don’t have a problem explaining something to someone, and would always rather answer than perpetuate misinformation (“so you can’t eat sugar?” etc).  But sometimes I just say “diabetes” if someone I don’t know looks quizzically at me and what I’m doing.  That one word shuts them up pretty quickly, believe it or not.

Living with diabetes means I need to plan and prepare for a complete range of glucose readings, and I know that even if I plan and prepare for it all I still won’t get it 100%.  The more I can make my diabetes simply a part of who I am and not something foreign and scary that requires seven anxious people to run and get me a juice box, the better. 

Although, maybe I should appreciate anything that gets those bootcampers to run even faster…

Important reminder worth repeating: I am not a medical provider.  If you think you or someone you love is clinically depressed or needs professional help, seek out that help immediately.    Don’t keep reading—ask for help instead.  Now.   You have everything to lose.

People often ask me if I think there is a link between depression and diabetes.  If you caught yesterday’s post you know that I believe there is a link and I believe there are some pretty good common sense reasons to support a connection between diabetes and depression. 

Given that depression can be debilitating, I think it’s safe to say we all hope to avoid it in our lives and in the lives of the people we love.  But if there is a link between diabetes and depression, how can we avoid negative consequences of depression?

Taking the first point from yesterday’s post, what can one do to prevent depression in ourselves or our loved ones?

Know that you are not alone with your diabetes. 

Sure, maybe you’re the only person in your family with insulin dependent diabetes.  Maybe you are the only person you know who takes shots, or wears a pump.  But that doesn’t mean we aren’t out here!  Reach out and find a camp, or a program, or ask your medical team for some recommendations. 

Just because you live with diabetes doesn’t mean you are going to like or enjoy everyone else who has diabetes.  That’s okay; diabetes affects all kinds of people throughout the world.  If the camp or group or program doesn’t feel right to you, it’s okay to find another one. 

If living with diabetes is feeling like a lot, ask your mom or your dad or siblings to spend a day or a week being diabetic—quiz them instead of the other way around!!  Have them check their blood glucose before eating, ask them how many carbohydrates are on their plates, and tell them what you think about their (pretend) insulin calculations.  Ask your doctor if they will let your family have a vial of sterile saline to practice injecting themselves.  You are the resident expert when it comes to diabetes in your family—but a word of warning: if you are obnoxious in how you treat your family members on their “Day of Diabetes” they probably won’t want to repeat it next time!

What is important, and worth finding for yourself, are others who know some of your struggles with diabetes and others who understand what you feel like when you say “I am 52” or “I am 317”–make those friends and you will go a long way.

Important reminder at all times: I am not a medical provider.  If you think you or someone you love is clinically depressed or needs professional help, seek out that help immediately.  Don’t even keep reading—ask for help instead.  Now.  You have everything to lose.

People often ask me if I think there is a link between depression and diabetes.  I typically try to sound sophisticated in my reply, but for the sake of brevity here: you betcha I think there is a link!

However, I do not think there is necessarily a genetic link between depression and diabetes.  I think depression in people and in kids living with diabetes is more situational than chemical, at least at the outset.

Think about it from the perspective of a kid living with diabetes, equally applicable to adults:

1. Welcome to feeling alone.  Your thoughts are necessarily different than those of your friends.  You are likely the only one in your family who has to bleed before you eat.  You’re also probably the only one who, when you look tired, causes family, friends, and teachers to look at you and worriedly start asking you when you last checked your blood glucose.  You are the one who, at the birthday party, has to look at the size of cake with a whole set of questions beyond “is it the corner piece?!” and you know that if you do score that corner piece, more frosting means more carbs and more insulin.
2. Welcome to worry.  You know how it feels to be different numbers.  You know that numbers carry value judgments, no matter how hard you try to avoid it.  You know you are looking to get those numbers to be in a range that often seems impossible.
3. Welcome to anxiety.  What you don’t always know is what will happen to your body when your numbers aren’t in that range.  Sometimes you’ll feel sick for a few hours with a high, or sometimes you’ll feel incredibly weak, shaky, and unable to function when your blood glucose is low.  You do know that your diabetes will get in your way sometimes, you won’t always predict it, and you will want to do something but your blood glucose levels won’t permit it right when you want to do it.  Add that to feeling alone and different, and it’s enough to make any kid anxious.
4. Welcome to feeling powerless.  You probably learned right off the bat how difficult it really is to achieve the blood glucose goals your medical team set out for you.  Diabetes does require recognizing there are times your diabetes has to take center stage or you risk uncomfortable, embarrassing, even dangerous outcomes. 
5. Welcome to feeling like there was always something you should have done differently.   One of the worst parts of living with diabetes, for me, is that I am always reflecting on what I did and second guessing my actions.  If I go high or low, I feel like there was something I could and should have done to prevent it.  I’m not even sure how realistic it is, but I know that I still search out the reasons behind almost every glucose reading my meter gives me.

I’m kind of amazed at how great kids living with diabetes do with all of it!!  What a testament to their strength.