Before diabetes, I would occasionally work a long shift - maybe 12 or 18 hours. It would often involve driving long distances and by the time I got home, I either wanted to jump straight into bed or grab a beer, sometimes both at the same time.
That was the full extent of my exhaustion.
Don‘t get me wrong, I was working hard and my self-pity was justified, or at least relative.
In hindsight, I was obviously having a great time. Not much to worry about other than getting my job done and getting home in one piece.
I don‘t want to be ’that’ person, who looks back and says “I was SO lucky. I should have cherished every moment“ given what I now have to manage (type 1 diabetes). That frame of mind will only help me grow old and bitter (faster than I already am).
But there are other things at play here. I have not had diabetes for decades, nor do I have any complications (touch wood). I have not experienced DKA (diabetic ketoacidosis), or a hypo so severe I’ve passed out. A lot have, and I can only imagine what toll that can take on your mental health.
I get glimpses when I have a bad day with my blood sugars, and find myself struggling to not lose my temper with my wife when she asks me harmless, innocuous questions.
I also overthink and scrutinise every random pain or ache now, believing any undesirable twinge to be diabetes related. It’s hard to admit, but surely over time this will have a negative impact on my mental health. Unless, of course, I can identify these feelings early on, and put strategies in place to not allow them to escalate - but how do we do this?
Today (12th Sept) is “RuOK” day. A day dedicated to suicide prevention. It’s not a pleasant subject but it’s an extremely important one. One that we all need to be aware of and particularly if you’re a diabetic.
Diabetics are at a higher risk of suicide than the general population. This is probably obvious to you given the insidious nature of the disease. The day-to-day management nags at our patience and is fiercely unrelenting.
We’re also two to three times more likely to suffer depression. Again, no big shocks here.
But depression and suicide are not chained to us like some kind of sick animal in a Russian zoo. We are just as likely (if not more) to become stronger and more resilient because of our disease. We hold down important jobs, look after our families and are an integral part of our community, whilst managing diabetes. Where are the studies to show this?
We are though, completely understandably, at increased risk of reaching a point where we simply lose hope.
Diabetes.co.uk says it well;
Diabetes burnout is the term given to the state of disillusion, frustration and somewhat submission to the condition of diabetes. Burnout can be characterised by a person's complete disregard for their blood sugar levels.
Burnout is a common term to describe when a person reaches a point whereby their ability to cope with something runs out. It happens with jobs, diets, friends, even family.
Due to the nature of diabetes and it’s management, it’s not surprising that many of us will reach this point. Unfortunately, the consequences of essentially ignoring aspects or all of your disease can be devastating.
You could attribute diabetes burnout to self harm. Why? Because the lack of self-attention and care results in physical harm to your body. Inconsistent and very high blood sugars start to toxify the blood, damage to the blood vessels in your eyes and extremities can start to happen quickly.
Amazingly, we have the capacity to reverse a lot of complications from diabetes with strict glycemic control, but there are still some that we cannot change, and for this reason alone, it is vital we identify diabetes burnout as soon as we can.
My personal experience has been that the more strict I am with my diet and exercise routine, but the less strict I am with my insulin regimen (I.e. no two days are the same, so why does my basal need to be?) - this has benefited my mental health enormously because I am less stressed about going too high or low after meals or overnight. I’m also less stressed about my blood sugars in general and the fear of complications.
Creating a new normal life with diabetes is essential as It sets you up for success. By starting afresh and implementing healthy, daily practices, you’re less likely to miss things that aren’t good for you, that may trigger relapse into unhealthy ‘normal’ lifestyle choices.
What are we talking about here?
Bad food choices, excessive alcohol, being sedentary, and not attending doctors appointments to name just a few.
Many people describe feeling burnt-out as ‘trying to seek freedom from the disease. Self-destructive behaviour that may accompany this can be disregard of their blood sugars, or eating and drinking whatever they want and simply estimating the insulin amounts‘.
Let’s be honest here, at best we’re always estimating how much insulin is required but when you don’t know your blood sugars before and after food, you‘re on a dangerous path.
There are other psychological factors that often coincide with burnout, which include:
Can we prevent diabetes burnout?
As mentioned above, coming to terms with the fact that your life may not look like it did before is imperative. But that isn’t a bad thing. It’s actually an amazing thing.
Being proactive and motivated to experiment with new foods that don’t spike your blood sugars, and learning new recipes empowers you to stay focussed on a healthier way of life.
Adopting consistent exercise routines and blending your social life and your daily exercise together can help keep you on track.
Having other diabetics to talk to is profound as we are the only people who know what it’s like to live with this disease. Reach out online or meet with people through fundraisers etc to grow your social circle and get invaluable support at the same time.
Many people find meditation and mindfulness helpful as it helps drown out the stresses of life and stay focussed on you. There are plenty of apps and groups dedicated to this.
Professional help, either through your doctor, endocrinologist, psychologist or therapist is a great resource if you have the means. You can even get mental health professionals who specialise in diabetes.
The point here is that there is a plethora of support out there. We are all only human and needing support is completely natural.
Don’t, for one second think you’re a burden or ever feel guilty. Diabetes is tough but you have the capacity to control it, and be healthier than any non-diabetic.
I call myself a peaceful warrior, because the battles we fight are on the inside. Socrates
Believe the hypo