Finding Hope Following a Diabetes Diagnosis
It can be stressful and tough to accept having a chronic condition. A diabetes diagnosis can be easier to deal with if you can find significant support.
Following a diabetes diagnosis, a person may experience a range of emotions that are typical and may linger for weeks, months, or even years.
These feelings may in some instances lead to depression, which is two to three times more common in people with diabetes. Others process and reflect, but everyone responds to it differently depending on their situation and personality. For instance, a person may find it more difficult to accept their new diagnosis if they are told they must start taking daily shots or other serious treatments.
Dr. Susan B. Trachman, a psychiatrist who specializes in assisting people in making sense of undiagnosed medical problems, noted that receiving a diagnosis of a chronic illness is not easy information to process. Patients may experience issues with identification and self-worth. To handle their diagnoses, people with chronic illnesses need to develop new coping mechanisms as well as alter their lifestyles.
She claimed that a person's own body being betrayed can result in typical feelings of guilt and denial, however, some people may react with acceptance. She noted that several studies compare dealing with a chronic disease to the grief process.
Most people with diabetes experience a range of emotions when they learn of their diagnosis, whether it comes as a complete surprise or as the end result of a protracted battle with symptoms. Some would even draw a comparison between this and the grieving process following a loss. Since then, others have utilized the same phases to describe mourning processes following other significant events, such as being diagnosed with a chronic illness or going through a divorce. Dr. Kubler-Ross first described stages of grief people frequently suffer after death.
Following their diagnosis and in the years that follow, people with diabetes may experience the following phases of bereavement.
Surprise and denial
At the age of 18, Krishna Kaliannan, who is now the creator of the low-sugar, high-protein snack and cereal line Catalina Crunch, recalled being "shocked" by his type 1 diabetes diagnosis.
I was an athlete in excellent form, and I mistakenly believed that diabetes only affected older, overweight individuals.
Many of her patients, according to nurse and specialist in diabetes treatment and education Rachel Kohls of Texas Diabetes and Endocrinology in Austin, first feel this reaction.
"Some people are in denial and disbelief, perhaps because diabetes has never run in their family. Some people get tearful and terrified," she said. However, I believe that the majority of my patients initially feel overwhelmed.
This stage, where people are surprised by the news, may linger for a time or may last only briefly. Trachman cites a few instances of denial-related thoughts she has witnessed individuals have:
There are worse things I might have than diabetes, therefore it's not a huge problem.
But I feel great!
Why even try to take care of it? I must pass away at some point from something.
Denial "may sometimes be a healthy protection mechanism," according to Kohls. "It can help the patient process the facts and eventually accept the diagnosis."
She discussed how our thoughts fight off unpleasant emotions brought on by the new reality. However, if the denial persists for a time, it may worsen health compared to people who overcome it. According to her, "[those in denial] are more likely to skip a [diabetes-friendly] diet, exercise, and other helpful measures to manage their disease."
Kohls continued, "People in denial could not even follow through with appointments." I do have a small number of people who are still in denial months after diagnosis, and many people get disease weariness years later, she added.
Anger
After being denied, Kaliannan claimed that he rapidly turned "red-in-the-face enraged."
"I was outraged that she had the gall to tell me what I could and couldn't eat," he said when the diabetes educator told him to quit eating a long list of wonderful foods, including all the sweet items he loved. "I actually resolved to keep eating all the sugary food I knew I wasn't meant to eat out of spite," he said, adding that he soon realized this wasn't a healthy way to live.
They can believe that diabetes is a death sentence and have no idea how their life will be in the future, according to Kohls. They might not want to take their medication.
Anger can occasionally be linked to feelings of overwhelm that comes with learning about diabetes and having to schedule follow-up appointments.
Imagine receiving a diagnosis of a chronic, lifelong condition that is known to lead to numerous complications and only receiving a 30-minute initial appointment with your endocrine provider—or even less time with a primary care provider—to address all of your queries regarding the pathophysiology, diet, exercise, medication, impact on your life, work, relationship, financial burden, etc., according to Kohls.
Bargaining
"Please God," or "I'd give anything to turn the clock back." These are typical cognitive patterns of individuals in the bargaining stage following a diagnosis when they frequently experience shame or remorse.
At this point, it's critical to emphasize to the patient that a diagnosis may not always be the result of "having done certain things incorrectly. According to Kohls, some diseases are inherited and have nothing to do with poor lifestyle choices.
This is particularly true when it comes to the myth that type 2 diabetes is brought on by being overweight or living an unhealthy lifestyle. A medical team's assurance is crucial at this point as well. "It is helpful to remind the patient that [diabetes] is a very manageable disease and that a [full and healthy] life is feasible with adequate behavior adjustment and medicine," she continued.
Trachman refers to them as "protective variables," because they have a significant impact on how a person sees their diagnosis. Examples of protective factors include a high-quality and helpful medical team and a personal support network through family and friends. Protective variables are circumstances or support that assist someone in coping with a traumatic experience, like receiving a diagnosis. They can also influence how a person progresses through the stages of grief and how much or little these feelings affect them.
When it came to having a positive reaction to and accepting their diagnosis, she noted, "those perceived as most supportive were most beneficial."
Depression
At the time of his type 1 diabetes diagnosis at the age of 12, Mastering Diabetes co-founder Robby Barbaro recalled, "I do remember being quite depressed in the hospital and crying about the whole thing."
Trachman claims that individuals in this stage following a diagnosis frequently have thoughts like:
"I feel such sadness.
What is the purpose?
I yearn for the days before diabetes.
She points out that dealing with this emotion after a diagnosis differs greatly from clinical depression. In fact, processing these emotions might potentially be a sign of development.
"It shows that the individual is aware of the certainty of the diagnosis, which is crucial for progress and resolution. It's possible to feel hopeless, but like with sadness, it usually passes, she said.
But if it doesn't, the diabetic medical team should keep an eye out for this need and seek mental health interventions.
Acceptance, optimism, and even thanksgiving
A person is in acceptance once they have adopted the attitude that "I can take charge and manage this" and "It's going to be okay." Acceptance suggests that the patient has accepted the diagnosis rather than viewing it as an intrusion to be resisted or fought, according to Trachman.
This stage is attained by some people more quickly than others. And some people might never experience this. Because his older brother had been diagnosed roughly ten years before him, Barbaro claims he was able to move quickly toward acceptance while watching his family deal with the difficulties.
"I don't recall going through many difficulties or several stages. I believe I entered a condition of acceptance rather quickly," Barbaro claimed. He claimed that six years after his diagnosis, he began to feel grateful for the chances it had brought about.
"I was inspired to learn everything I could about health and well-being as a result of it. I think that type 1 is a catalyst for my improved health, he remarked. "If I didn't have this drive to be as healthy and insulin-sensitive as possible, I'd probably be putting junk food into my body and causing other chronic diseases, and statistically speaking, I'd be eating myself into a significant risk of being impacted by our country's number one killer, heart disease."
The diagnosis, according to Barbaro, was the beginning of his path and life's mission. He is now a diabetes coach and the author of the New York Times bestseller "Mastering Diabetes." However, he needed his support system to follow that course. I believe I've been fortunate to be surrounded by people who choose to make the most of the cards they've been given, rather than playing the victim card, he added.
Acceptance does not, however, automatically entail liking your illness. But emotions related to diabetes never totally disappear, Kaliannan said. For instance, every so often, I'll grumble to myself that getting ready for bed takes twice as long for me as it does for my wife since I need to take insulin and check my blood sugar.
Advice for handling the grieving process
Trachman offers some advice for everyone going through post-diagnosis emotions, regardless of stage, in addition to having a meaningful support system at home and through your medical team:
You can feel more in control by getting information so that you are aware of your alternatives for assistance and treatment as well as what to anticipate.
Daily exercise is beneficial for managing glucose levels as well as your mood.
Controlling inflammation, which has a role in many chronic illnesses including diabetes, by maintaining a regular sleep schedule
using a 10-minute meditation app, as research shows that meditation can help people better manage their challenging emotions (Trachman likes HeadSpace)
Seeking social relationships (not social media), as having a strong social network serves as a protective factor.
Finally, if you are having trouble managing your emotions or believe you may have a mental health disorder at any time during the emotional healing process, contact your medical team.
