June 6 2016

Coping with the emotional challenges of diabetes

By Australian Psychological Society

Psychological support can help people with diabetes overcome the fears and challenges often associated with this chronic health condition.

“Strong emotional reactions to being diagnosed with diabetes are not unusual and even if you’ve been living with diabetes for some time, the ongoing challenges of a chronic condition mean that levels of distress may fluctuate and don’t necessarily completely recede,” says psychologist Dr Linda Beeney MAPS*.

Living with a chronic condition

Dr Beeney says it’s normal for many of the 1.17 million Australians living with the serious condition, which has no cure, to experience diabetes-related distress.

“Research shows that approximately 44 per cent of people world-wide will experience severe diabetes-related distress at any one time,” she says.

Dr Beeny says people living with diabetes often face a range of difficulties, from their daily and even hourly diabetes management to judgemental attitudes, a financial burden and a fear of complications.

“When I give talks and ask people with type 1 or type 2 diabetes what they find difficult, they identify a vast range of issues, from some of the daily pressures they feel to uncertainty about their future,” she says.

While optimal diabetes care includes regular exercise, healthy eating, checking blood glucose levels and taking prescribed medication, research shows diabetes distress can be a barrier to people being able to successfully manage their diabetes.

“Even if you do everything ‘right’, there’s still no guarantee that things will go perfectly.”

People living with the condition can also struggle to cope with the fact that other factors outside of their own health behaviours, such as genetics, can influence the course of their diabetes, she adds.

Changing your thinking can help you to cope

Dr Beeney uses diabetes-specific cognitive behaviour therapy (CBT) to help people identify and change the way they think about diabetes, and how they manage the condition.

“Diabetes management is in your head all of the time, there’s never really an hour that goes past when you’re not trying to make some sort of decision or being vigilant about your physical symptoms.”

Dr Beeny says one patient avoided taking her insulin or checking her blood glucose levels in public because of people’s negative reactions, until she received psychological support.

“One of the things that helped her was understanding all her thoughts about her social diabetes anxiety and then challenging those and shifting those thoughts around,” she says.

“It helped her to find a different way to approach the situation which meant she could take insulin and was aiming at a goal that she wanted long term – to be healthy and to have a family.”

Depression vs diabetes-specific distress

Dr Beeney, who has worked as a lecturer, senior clinical hospital psychologist and research consultant before launching her own private practice, says diabetes-related distress can often be mistaken for depression.

“There is a difference – a lot of people will experience what they or their health professional or family members might think of as depression and it may look like depression but it may well be diabetes-specific distress,” she says.

“People with type 1 or type 2 diabetes themselves are usually quite capable of discerning the difference if a pragmatic approach is taken.

“A useful question is – if you didn’t have diabetes, would you would still feel like this?

“Most people experiencing diabetes distress will quickly say no.”

Some psychological support tips for dealing with diabetes:

  • Ditch the blame game. Dr Beeney says it’s important to let go of the idea that diabetes is your fault. “It’s just not helpful – feeling guilt is not a positive motivation,” she says. “I would leave that kind of language and attitude behind. Instead, take responsibility for what you can do now.”
  • Forget the ‘shoulds’. “Work out what YOU want as opposed to what other people think you should do,” Dr Beeney says. “Find that concept of – I want to take better care of myself, I want better long-term health, so what decision will I make about this treatment change that will lead to the outcome I want?”
  • Seek assistance. If you think you may be suffering diabetes-related distress, consult your diabetes care provider or your GP. While you don’t need a referral to see a psychologist, your health professional may be able to recommend a psychologist who specialises in diabetes. The APS Find a Psychologist Service can also help. The online, telephone and email referral service puts you in touch with more than 2,400 psychologists across Australia.
  • Access online resources. The Type 1 Diabetes Network  has a professional listing while Diabetes Counselling Online offers free diabetes support through closed Facebook groups. Plus, check out the information, advice and resources at Diabetes Australia .

*Member of the Australian Psychological Society