Love don’t judge. Kei whakawā. Me aroha.
It’s estimated that people with diabetes face up to 180 diabetes-related decisions every day. That’s more than 65,000 extra decisions a year.
Diabetes distress is a natural emotional response to living with diabetes. Over time, coping with life’s challenges can get tough. You may put in a constant effort to manage your blood glucose every day, but your ability to cope can be quickly worn down.
What is diabetes distress?
Diabetes distress is the emotional burden of living with and managing diabetes. Diabetes is a relentless, 24/7 condition that can have a real impact on mental and emotional wellbeing.
Every minute of every day, a person with diabetes faces decisions and thoughts, which can create worries and fears about their diabetes.
It’s estimated that people with diabetes face up to 180 diabetes-related decisions every day. That’s more than 65,000 extra decisions a year.
The Diabetes NZ Emotional Wellbeing Survey 2020 found 81% of people living with diabetes have experienced diabetes distress.
What does diabetes distress look like?
If you are experiencing diabetes distress, you may feel:
Overwhelmed by the demands of living with diabetes and feeling like it’s ‘too much’
Concerned or afraid that you are ‘failing’ with your diabetes management
Sad about living with diabetes
Worried about your risk of long-term complications
Frustrated and angry that you can’t predict or ‘control’ diabetes from one day to the next
Guilty and ashamed when your diabetes management gets ‘off track’.
Diabetes distress becomes a serious problem when these emotions start to affect daily life, including work, school, relationships and diabetes management.
If severe diabetes distress is not managed, it can get worse over time. It may lead to diabetes burnout. This is when a person feels emotionally exhausted and overwhelmed by the demands of their condition, to the point where they can no longer take care of their diabetes.
The ‘fight or flight’ response
In times of stress, such as when you are experiencing diabetes distress, the ‘fight or flight’ response is activated. This is where your body is flooded with stress hormones such as adrenaline, creating an increase in blood pressure, heart rate and breathing rate. Your brain is communicating to your body that there is danger in your environment and, as in ancient times, it is preparing you to ‘fight or flight‘ to keep you safe. In modern times, we don’t have the same dangers around us we once did, but the same stress hormones are still activated under the stress of modern life, including managing diabetes.
Stress causes an increase in blood glucose levels, which can create even more stress!
To decrease the ‘fight or flight’ response try taking slow, deep breaths. Breathing this way sends a message back to your body that everything is okay, even in a stressful situation.
The impossible goal of perfection
There is no such thing as perfection when it comes to diabetes management.
Even if you are doing everything “right”, it can be very difficult to be satisfied with your diabetes management if you are trying to be perfect.
Do the best you can with your diabetes management, and don’t let “perfect” be the enemy of the effort you are putting in. Simply focussing on what you can control or can do, can help you rebalance and set new and different expectations.
What can you do to help?
Whether you are experiencing diabetes distress or not, it is important to look after your emotional wellbeing. There are some simple steps you can take to look after yourself and manage diabetes distress if you have it.
Notice your thoughts and feelings and how they relate to your diabetes.
Recognise how you are feeling and label the emotion – are you worried, overwhelmed, angry? Could you be experiencing diabetes distress?
Understand these feelings are normal
Know that most people managing the emotional burden of diabetes will struggle at some point in their journey, and this is completely normal.
Be kind to yourself
Once you have recognised that your feelings are natural, be kind to yourself. Think about how you would react if someone in your whanau or a friend was feeling the way you are. You would most likely give them a hug, tell them not to be so hard on themselves and offer them your support. Treat yourself the same way you would treat a friend in the same position – with care, kindness and compassion.
Stop the cycle
Knowing which activities help you feel calm and support your mental and emotional health can give you a way to interrupt the cycle of diabetes distress before it builds up.
Everyone has different ways of practicing self-care. Some activities that promote self-care might be going for a walk, talking about your experience with a loved one, or taking a moment to enjoy a hot cup of tea or a warm bath.
Once you have identified your feelings and know that you are experiencing diabetes distress, remind yourself that it is natural and understandable that you feel this way. Take a moment for a self-care activity to interrupt your thoughts, lower stress and take care of yourself.
Make a plan
When you know what you are feeling and when you are more likely to feel anxious, worried, sad or overwhelmed, you can plan for having these feelings in the future. For example, if you know you get worried you will have a high number when checking your blood glucose level, what can you do or tell yourself to reduce or manage the worrying feelings?
Get help if you need it
The strategies above are a starting point for preventing or reducing diabetes distress, but they don’t replace professional support.
Your diabetes health care team is there to help you with all aspects of your diabetes, including how you feel about it. You may wish to speak with your GP, specialist, or diabetes specialist nurse who can refer you to a counsellor or psychologist to support you with additional coping tools.
· Call or text 1737 Depression helpline: 0800 111 757 Both are available 24/7 Did you know that practicing self-compassion can help you better manage diabetes, improve your overall health and wellbeing and your mental health?
Physical self-care
Go for a walk
Take a warm bath
Have a massage
Enjoy a hot cup of tea
Spiritual and mental self-care
Spend time in nature – at the beach or in the bush
Watch a funny movie
Read an inspiring book
Write down your feelings
Social self-care
Call/message a friend to chat
Spend time with loved ones
Pet the dog or cat
Meet a friend for a coffee or a walk
New Zealand research has found that those who practice self-compassion have lower HbA1c levels than those who don’t.
That’s because kindness matters. Being kind to yourself and not self-critical when managing your diabetes is not only good for your mental health but good for your diabetes too.
Feeling overwhelmed, frustrated, or worried about your diabetes is a natural response to the emotional burden of living with diabetes. Remembering this can also help ease stress and make it easier to manage your diabetes each day.
Mindfulness
Mindfulness is a strategy that can help with stress, mental wellbeing and diabetes distress. Mindfulness is the practice of being aware of each moment of your day as it happens.
There are a number of online mindfulness courses to help you step away from your thoughts and feelings and alleviate the feeling of being overwhelmed.
We recommend
Mindfulness Education Group https://mindfulnesseducation.nz/
Mindfulness Works https://mindfulnessworks.co.nz/
Mindfulness for Māori https://mindfulnessaotearoa.com/about-us/
How to be more mindful by the Mental Health Foundation, NZ https://www.mentalhealth.org.nz/home/our-work/page/21/2/how-to-be-more-mindful
Need help?
1737 Call or text: (available 24/7)
Rural Support Trust: 0800 787 254
Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youthline: 0800 376 633
Kidsline: 0800 543 754 (available 24/7)
0800 Whatsup: 0800 942 8787 (1pm to 11pm)
Depression helpline: 0800 111 757 (available 24/7)
If it is an emergency and you feel like you or someone else is at risk, call 111.