In 1977, the emotional aspects of chronic disease were very much under the rug. My doctors encouraged me to “tough it out.” In my teens, I translated that nebulous instruction into a life adrift between blood sugar levels and corresponding emotional extremes. I found my way. Unfortunately, many people with diabetes suffer from denial and shame.
There are over 27 million individuals in the U.S. with diabetes. The disease triggers a lifestyle transformation; it requires 24/7 vigilance and monitoring. On top of that, blood sugar levels impact people’s moods, affecting how they think and learn. Understanding the effect of blood sugar levels the first step in understanding your mental state.
The Vicious Cycle of Diabetes
When you’re stuck in a depressive rut or are just feeling “foggy,” it’s not you—it’s your body’s chemistry. Low blood sugar reduces the glucose in your brain, leading to poor memory and difficulty learning. High blood sugar is no picnic, either; it causes the blood to thicken and oxygen levels to reduce. This mental fog can create a vicious cycle—sickness leads to depression, which leads to apathy and denial. Without proper management, these symptoms only grow worse.
I’ve seen people lift their spirits and gain their energy back, simply by getting a handle on their blood sugar levels. Conversely, I’ve seen people destroy their lives and relationships by letting things go unchecked. The result? Resentment, denial and low self-worth.
Bob: A Tale of a Ravaged Marriage
Let’s take a look at Bob (name changed). Every morning, the type 2 diabetes patient lies in bed, struggling to open his eyes. He’s under the impression that he’s an early riser, choosing to fall back asleep; meanwhile, his wife, who has already showered and dressed, resents his laziness. Neither he nor his wife recognizes that his lethargy as a consequence of disease.
An hour passes. Bob forces himself up. He doesn’t feel well, and discovers that his blood sugar is high at 250 mg/dL, so he administers a corrective dose of insulin. Moments later, his wife shouts that breakfast is ready. Not wanting to cause trouble, Bob eats without waiting for his levels to return to normal.
And so, Bob’s day begins with the dulled, persistent sickness that comes with improper health management. His physical and emotional symptoms start to blur—am I feeling sick? Maybe I’m just depressed, he thinks. Then, in comes the guilt and shame.
Bob’s wife leaves to run errands; Bob has plans, too, but the combined stress and guilt leave him cemented to the couch. Two hours later, listless, he checks his blood sugar, which has spiked to 280 mg/dL.
His wife comes home and asks if he did the grocery shopping. He said that he didn’t feel like going today, which he’ll do it tomorrow. His wife is fed up.
- “What am I supposed to cook for dinner?” she asks pointedly.
- He looks at her, dazed, and says, “I don’t know.”
- She responds,“You don’t care about our marriage. Do you think I spent all day running your errands because I ‘felt like it’?
- “Maybe we should just end it.”
- Bob gives her a bewildered look. “End what?”
- She fires back at Bob,“Our marriage. All you do is lie around the house all day. What happened to you?” she says, incredulous.
- Hurt and confused, Bob shouts, “I do plenty!” and storms to another room.
There are two ways to tell Bob’s story. The first is one of mysterious tragedy: Five years ago, after 20 years of blissful marriage, Bob began to change, losing interest in his wife and his daily routine. His diagnosis was the coup de grace, extinguishing whatever vitality was left.
The second story is the truth, and provides hope for Bob’s future. Bob is sick, and has been for a long time. His illness could have begun up to fifteen years ago. In those years, it took its toll, altering his personality and ravaging his body. At diagnosis, his blood sugar was three times the normal level. Terrifying. Bob’s journey is just beginning, but he’ll need coping tools—and the support of his loved ones.
Next post, I’ll share the means of dealing that I’ve collected in my experience and from others living with diabetes. These techniques will help you break the cycle of suffering, bringing long-term emotional relief and strengthening your relationships.
Eliot LeBow, LCSW, CDE, is a diabetes-focused psychotherapist. His private practice, located in New York City and is also available via Skype. LeBow, who has been living with type 1 diabetes since 1977, treats the many diverse cognitive, behavioral, and emotional needs of people living with type 1 and type 2 diabetes.
All the advice included in this blog is therapeutic in nature and should not be considered medical advice. Before making any changes to your diabetes maintenance program, please consult with your primary physician or endocrinologist.