Читать книгу Diabetes For Dummies - Рубин Алан Л. - Страница 6

Do you remember what you were doing when you found out that you had diabetes? Unless you were too young to understand, the news was quite a shock. Suddenly you had a condition from which people can die. In fact, many of the feelings that you went through were exactly those of a person learning that he or she is dying. The following sections describe the normal stages of reacting to a diagnosis of a major medical condition such as diabetes.

Experiencing denial

Your first response was probably to deny that you had diabetes, despite all of the evidence. Your denial mindset may have begun when your doctor tried to sugarcoat (forgive the pun) the news of your condition by telling you that you had just “a touch of diabetes,” (an impossibility equivalent to “a touch of pregnancy”). You probably looked for any evidence that the whole thing was a mistake. Perhaps you even neglected to take your medication, follow your diet, or perform the exercise that is so important to maintaining your body. But ultimately, you had to accept the diagnosis and begin to gather the information you needed to help yourself.

When you accepted the diabetes diagnosis, I hope you also shared the news with your family, friends, and people close to you. Having diabetes isn’t something to be ashamed of, and you shouldn’t hide it from anyone. You need the help of everyone in your community: your co-workers who need to know not to tempt you with treats that you can’t eat, your friends who need to know how to give you glucagon (a treatment for low blood glucose) if you become unconscious from a severe insulin reaction (see Chapter 4), and your family who needs to know how to support and encourage you to keep going.

Your diabetes isn’t your fault – nor is it a form of leprosy or some other disease that carries a social stigma. Diabetes also isn’t contagious; no one can catch it from you.

Feeling anger

When you pass the stage of denying that you have diabetes, you may become angry that you’re saddled with this “terrible” diagnosis. But you’ll quickly find that diabetes isn’t so terrible and that you can do something to rid yourself of the disease. Anger only worsens your situation, and being angry about your diagnosis is detrimental in the following ways:

✔ If your anger becomes targeted at a person, he or she is hurt.

✔ You may feel guilty that your anger is harming you and those close to you.

✔ Anger can prevent you from successfully managing your diabetes.

As long as you’re angry, you are not in a problem-solving mode. Diabetes requires your focus and attention. Use your energy positively to find creative ways to manage your diabetes. (For help managing your diabetes, see Part III.)

Bargaining for more time and feeling depressed

The stage of anger often transitions into a stage when you become increasingly aware of your mortality and bargain for more time. Even though you probably realize that you have plenty of life ahead of you, you may feel overwhelmed by the talk of complications, blood tests, and pills or insulin. When you realize that bargaining doesn’t work, you may even experience depression, which makes good diabetic care all the more difficult.

Studies have shown that people with diabetes suffer from depression at a rate that is two to four times higher than the rate for the general population. People with diabetes also experience anxiety at a rate three to five times higher than people without diabetes.

If you suffer from depression, you may feel that your diabetic situation creates problems for you that justify being depressed. You may rationalize your depression in the following ways:

✔ You can’t make friends as easily because diabetes hinders you.

✔ You don’t have the freedom to choose your leisure activities.

✔ You’re too tired to overcome difficulties.

✔ You dread the future and possible diabetic complications.

✔ You don’t have the freedom to eat what you want.

✔ You’re constantly annoyed by all of the minor inconveniences of dealing with diabetes.

All of the preceding concerns are legitimate, but they also are all surmountable. How do you handle your many concerns and fend off depression? Following are a few important methods:

✔ Try to achieve excellent blood glucose control (see Part III).

✔ Begin a regular exercise program (Chapter 10).

✔ Tell a friend or relative how you are feeling; get it off your chest (Chapter 20).

✔ Recognize that every abnormal blip in your blood glucose is not your fault (Chapter 7).

If you can’t overcome the depression brought on by your diabetic concerns, you may need to consider therapy or antidepressant drugs. But you probably won’t reach that point.

Moving on

You may experience the various stages of reacting to your diabetes in a different order than I describe in the previous sections. Some stages may be more prominent for you, and others may be hardly noticeable.

Don’t think that any anger, denial, and depression are wrong. These feelings are natural coping mechanisms that serve a psychological purpose for a brief time. Allow yourself to have these feelings – and then drop them. Move on and discover how to live normally with your diabetes.

These phases of coping may not occur in the order given, may not occur at all, and/or may last a long time. If one phase inhibits your ability to cope with your diabetes for more than a few months, you may need outside help.

Here are some key steps you can take to manage the emotional side of diabetes:

✔ Focus on your successes. Some things may go wrong as you find out how to manage diabetes, but most things will go right. As you concentrate on your successes, you will realize that you can cope with diabetes and not let it overwhelm you.

✔ Involve the whole family in your diabetes. A diabetic lifestyle is a healthy lifestyle for everyone. For instance, the exercise you do is good for the whole family. By doing it together, you strengthen the family ties while everyone gets the health benefits. Also, should you need your family to help you, for instance, during a particularly severe case of low blood glucose, their early involvement in learning about diabetes will give them the peace of mind to know they are helping you, not hurting you. (See Chapter 20 for ways to enlist help from people around you.)

✔ Develop a positive attitude. A positive attitude gives you a can-do mindset, whereas a negative attitude leads to low motivation preventing you from doing all that is necessary to manage your diabetes.

✔ Find a great team, pinpoint problems, and set goals. Determine the most difficult problems that you have with your diabetes and then consider how you can solve them by yourself or with a great team of supporting players like a primary care physician, a diabetes specialist, a diabetes educator, a dietitian, an eye doctor, a foot doctor, and so forth. Set realistic goals to get past your problems. (Chapter 12 tells you everything you need to know about getting help from the supporting players.)

✔ Don’t expect perfection. Although you may feel that you’re doing everything right, you may experience blood glucose levels that are too high or too low. This uncontrollable situation happens to every person with diabetes, and it’s one of the biggest frustrations of the disease. Don’t beat yourself up over something you can’t control. Keep doing the things I suggest in the treatment section, and you will be very gratified at the end.