Most people do not realize how emotions and social factors can make managing diabetes very challenging. I am not only referring to the sudden mood swings diabetes can cause. Sometimes, your anxiety over your situation is more overpowering than knowing you have a chronic illness.
When I was diagnosed with type 2 diabetes in 1999, I was going through a very turbulent time. One of the things they asked me was if I was feeling any type of unusual stress. I was 29, married, with three small children to raise and the last person on my list was me. What kind of question was that?
My initial reaction was denial. For two years, I did not do much other than change my eating habits. I joined a gym, then but I never got to go. I believed what I was told: that it was my fault that I had diabetes for not watching what I ate and that I brought it on myself for eating too much sugar. It would not be until this year (2020), six years after my mother's death, and 22 years after I was first diagnosed, that I would learn that my mom developed diabetes much earlier than I originally thought. I first believed she was diagnosed in her sixties but in reality, she developed it about twenty years before that.
Two years later, in 2001, I went through a divorce and fell into depression. On top of everything else that was going on, I felt overwhelmed and frightened about how I would manage to raise three children without my husband's financial support. We had just decided I would stay home to take care of the kids. I was frightened that the depression was feeling would affect my ability to support and care for them, and it did. Well-intentioned family members and friends all had the same general reaction, 'Oh well that's no big deal. Diabetes is manageable. You just need to watch what you eat from now on and stop eating so many sweets,' or some version of that. I even agreed with that. I had no idea then that stress-induced increases in glucose cannot be metabolized properly or that stress produces hyperglycemia in type 2 diabetes.
Several months later, I joined the gym again this time with my sister as my workout buddy. I worked five days a week, and went to the gym seven days a week and trained for two hours a day I hired a trainer; lost 40 lbs. and had never felt better. To-date I have only gained a few of those pounds back and my body was forever changed. When I go back to a gym now, I may be out of shape but it is never as hard as it was that first day. My body remembers. Looking back, I have no idea how I even managed to keep my energy level up that high. I joined to lose weight and avoid taking medicine. I stuck with it for the emotional high I was getting.
In 2004, my father was mowing the yard and had a heart attack. It was so debilitating that he was too weak to have surgery and was told if he suffered another heart attack, that he would not survive it. He had six major arteries blocked and urgently need a quadruple bypass. Those were the longest ten days of my life. He made it and I went back to my gym routine but the pace gradually slowed as the raising kids, day-to-day responsibilities and full-time work to pay for everything took front and center stage. By then I was taking Metformin and Actos to control my blood sugar levels.
In 2005, I met an amazing man and fell in love for a second time. That was a whirlwind romance. He flew me to Germany and there I walked on cobblestone roads older than this country, visited castles, ate freshly baked bread every morning, visited caves with beautiful stones that looked like gems, went on long, scenic hikes filled with hills and winding roads, visited the Netherlands and lived in a town that reminded me of something straight out of Hansel & Gretel. It was one of the happiest times of my life. I was madly in love with him, the town, and that life. Then in 2007, reality set in, and despite our best efforts, family and work responsibilities trumped romantic love and we ended it. I could not bear to move my kids to Germany away from their entire family nor would I have asked him to leave his family home and his kids to move to Texas.
It was around that time, that my medicine was changed from Metformin to Janumet. My blood sugar levels were at an all-time high. I stayed on Janumet from around 2007 until around 2014. At that time, I attributed the change in medication to the years of taking the same medicine, and my body getting used to it, a natural evolution that only made sense since I had had diabetes so many years; never once taking into account the emotional toll of the disease on my body or even my family genetics..
On August 10, 2012, my brother died at the age of 50 from congestive heart failure due to complications of diabetes, but not before both of his legs were amputated and he underwent multiple eye surgeries. Upon my return, the person I was with broke up with me, and I was left alone to deal with the grief of losing my brother and the stress of moving because I could no longer afford to stay there. What did I do? I warrior-ed through it, because it was "just a breakup", because "I had no choice", because "what else could I do", because, because.. the reality was it did not even cross my mind that my body was absorbing all the blows one by one.
On July 14, 2014, my mom died of a heart attack after years of battling with Alzheimer's at the age of 82, It was around this time that I lost my job taking care of her and with it, my medical insurance. My blood sugar levels got completely out of control and stayed that way for the next several years.
In 2015, one of my sons was diagnosed with bipolar depression and was shot to death by law enforcement on March 12, 2016, of the following year, at the peak of the Black Lives Matter movement. It was then that I stopped watching the news completely. I still do not watch the local news or any news programs on television to this day.
I fell into a deep depression this time and honestly, I almost did not make it. I developed a cyst the size of a boiled egg in my back that had to be drained. I had no insurance then so it was done in my doctor's office. That meant they could not remove the sac and there was a risk it could return. Another appeared on my left leg literally overnight. It disappeared on its own almost as quickly as it came. I kept a respiratory infection for months. It was not until I started having debilitating panic attacks that I started to connect my physical wellbeing with my emotional state, and vice versa.
The physical effects of diabetes may lead to nervousness, anxiety, and confusion on its own, add the loss of a child and it becomes this black abyss you cannot even understand or begin to fathom. There were days I hit blood sugar levels so low, that I thought I would have to call 911 because I would not eat and there was no one around to make sure I did. I was not talking to anyone. I would sleep for hours. Everything was a struggle. Just living was a struggle. Who had the energy to think about tracking and meds and food and tests and and and...
At that time, I was living with my youngest child in this rinky-dink little place. I didn't care about much of anything. I couldn't work. I was numb. Ironically, it was becoming my dad's primary caregiver that helped me, as I focused my energy toward taking care of him,
Taking care of him meant many sleepless nights as he was very weak by then and could not move unless he called for me to help him but it kept my mind off of me. Eventually, I found work. I found my bearings and for the next few months, I would just go through the motions. Toward the end, we were in and out of the hospital every weekend due to infections. On July 10,2017, my father died at the age of 84 of a heart attack. To be honest, he lasted longer than I expected. My parents had together 61 years and married for 56 of those.
After dad died, I started working over 60 hours a week between two jobs to make ends meet. One job was fulltime in a corporate setting, the other was as a waitress at a diner. The waitress job was supposed to only be part-time but I would end up working through the morning and going into my "real job" with only a few hours of sleep. I was suffering from shoulder pain, hip pain, leg pain, sore feet but I attributed all of that to the work schedule I kept, the lack of sleep even rheumatoid arthritis because it also runs in my family. I was reluctant to use diabetes as a crutch or an excuse, after all, millions of people live with diabetes every day. It was manageable. Surely it was not that. But the reality is that diabetes was attacking my nervous system I lasted a few more months before my body simply crashed.
In April 2018, I landed in the hospital with acute, unidentifiable abdomen pain. On a scale of one to ten, this was a fifteen. I did not know then, that diabetes could affect your gut. Concerned it may be related to something in my reproductive system or worse, they rushed me to the hospital by ambulance. On the way to the emergency room, they tried to take my blood glucose reading and it was so high it would not register on the machine. When they were finally able to get reading, it was 800.
Although my blood glucose level was so high, the ER doctor attributed the pain to a small cyst that I had and I was sent to an Ob-Gyn for follow-up. The Ob-Gyn completely threw that idea out the window and referred me to an Endocrinologist. That is when I began to get real help.
Eighteen years after being diagnosed, I finally found a doctor who helped me and did not just give me medicine. She began to explain how diabetes could affect my stomach. Suddenly I could recall other times my stomach had been in pain (2001 after my divorce I went to a gastroenterologist because of stomach pain and I was told it was gastritis), (2004 when dad was hospitalized), (2014 when mom died). She had a strategy. She asked me questions. She listened. I could not afford her fully yet but I could not afford not to see her either.
I returned to work after the trip to the hospital and about a week of rest. I knew I would have to make some drastic changes, and I immediately quit my part-time job.
In 2019, I downsized from a four-and-a-half bedroom house to living with friends in a tiny two-bedroom apartment for a few months, until I could get my own apartment. I left the stressful job I was in during that time and found a better full-time job,
But by then, by blood sugar levels had been uncontrolled for over 7 years and I was diagnosed with Diabetic Macular Edema. I had no idea what it really was at the time. It was my first micro complication. That is how they described it. Micro. I saw nothing micro or moderate about my vision getting worse. I was scared and no one I knew understood what it was or knew anything about it. My first experience with a retina specialist was a nightmare. You can read more about that
here. Thankfully, I have a job now which affords me the proper treatment and I am grateful for that,
While it is true that to succeed in living with diabetes, you need knowledge and good medical care. the stress of living with diabetes can contribute to both changes in mood and concerns about potential complications. Unfortunately, people with diabetes as well as doctors often neglect these real-life aspects of the disease.
People with depression and anxiety have a higher risk of developing type 2 diabetes. Stressful life events or traumatic experiences. general emotional stress can all cause the body to produce especially high levels of stress hormones, which drive blood sugar levels up.
So the question for me becomes, "Am I emotional because of my levels, or is there really something else going on that could affect my levels negatively in either direction that may require me to recalibrate my meds?" (loss of a love one, a life change like losing a job, moving, etc.) That becomes easier to identify if you keep a journal of some kind.
If there is one thing all this has taught me is that staying strong emotionally is the key to keeping stress under control and your blood glucose, blood pressure, and cholesterol levels where they belong. You build your emotional strength by acknowledging and learning how to cope with life's misfortunes.
Express your emotions through journaling or blogging. Writing is therapeutic. Feel free to share as much or as little as you feel comfortable. Look for patterns in your behavior with the help of continuous glucose monitoring systems, smartphone apps, or by keeping a
diary. I believe in options.
Plan for your diabetes. Track it.
Keep to a routine. Whether you swear by smartphone apps, love paper, or thoroughly enjoy both like I do.
Don't punish yourself for how you feel. I am a firm believer that feelings are feelings and do not require logic to be real or valid. It is natural to feel down, angry, or even jealous. When you are experiencing any negative emotions, you have the right and the power to examine them and figure what you want your next step to be.
Experiment and evaluate what you are doing. If it is not working, change it up! Take the time to find a doctor that empowers you, listens to you, and treats all of you. Create a support network, whether it is family friends or both. Focus on the ones who understand or want to learn and ignore the rest.
You can do this. You are not alone.
