I am in the market for a new insulin pump and decided to use my twitter account to see what the world had to say about the pumps on the market and diabetes in general. I happened across a post about the prevalence of depression and diabetes. It suggested patients with diabetes need mental health services and more involvement with the Psychiatric community. Frankly, it ruffled my feathers! I was offered antidepressants years ago when I struggled with the reality of this life long ride with little chance of getting off. I passed. I ended up seeing a therapist who helped me build coping skills and peel back the onion a bit to understand how my life up to that point was influencing my day-to-day happiness. Turned out diabetes wasn't my problem. It was how I managed problems. A lifetime of avoiding conflict, trying to please everyone and not facing some hard realities, left me unprepared to deal with this situation that I couldn't run from, couldn't do perfectly and I was letting define my worth as a human being. Learning that my blood sugar readings were not a judgment of my character, that I could still dream and do things I wanted, and that if my diabetes management became inconvenient for people, then so be it. I was worth the effort. You might call that situational depression, but I refuse to say I have mental health issues. Who wouldn't feel a bit down when forced into a new way of life, one that you had no choice in?
I started to do a bit more research and came upon what I believe is an "aha" moment for the medical community. When a patient is diagnosed with a chronic illness, their previous way of life dies. It is a loss they must mourn. It doesn't mean their new life can't be wonderful, but it will be different and to fully move forward they must come to terms with this loss. They must grieve. There are five stages of grief: 1- Denial (not me!), 2 - Anger (why me!), 3- Bargaining (maybe it’s just temporary, the diagnosis is wrong, I need a second opinion), 4- Depression (this sucks - my life is over), 5 - Acceptance (this is my life and I will make the most of it).
Look at stage 4 - It's depression! A normal part of the grieving process! Not a mental health issue or a psychiatric problem that requires medication to placate your emotions. Just something we all go through, but sometimes we need a little help figuring how to get through it. What if more people went through grief counseling to understand their loss, deal with their emotions and come to peace with their new situation? From my years at the bedside, I would say there is a large majority of patients stuck in denial, anger, and depression. We medical folks might even label them as "non-compliant” (I despise that term BTW). If they are stuck being mad, hating their life, feeling helpless or avoiding their reality all together who would expect them to do what is necessary to manage the day to day care that diabetes requires?
I am confident the therapy I have done over the years to learn about what makes me tick has done more to control my A1C than any amount of diabetes education ever could. I have grieved and long ago accepted this gift that is diabetes (yes I said gift - more on that another day). It has taught me more than it has ever taken.