Helping With Mental Challenges of Diabetes
For a caregiver, spotting depression begins with listening well
Diabetes management involves caring for both body and mind. As with any chronic illness, the daily challenges of dealing with diabetes can take a toll on both people living with the condition and their loved ones. People with diabetes are more likely to face depression and stress than those living without the disease. So it’s important for caregivers to provide support and help where they can—and to know where to turn for help.
But first, a caveat:
Know what you can do and what requires help from a professional.
There’s a difference between someone feeling stressed or a little bummed out from time to time, and diagnosable depression or anxiety (see “Signs of Depression,” below). If your loved one with diabetes is at risk of hurting himself or herself or others, it’s important to get the person to an emergency room or psychiatrist immediately.
That said, if your loved one is feeling burdened by the weight of living with diabetes and dealing with stress, irritation, or sadness, there are things you can do to help.
Ask questions, and listen to the answers.
You want to be of service, but you don’t want to badger. The best way to help people is to ask what they need, says Jill Weissberg-Benchell, PhD, CDE, of Northwestern University’s Children’s Memorial Hospital. “Some people find it incredibly helpful and supportive [when asked], ‘What can I do to help you?’ ” she says. This way, you don’t presume to know what your loved one with diabetes is going through, and the person can make specific requests. It might be that you help pick up supplies, spend some time talking, or just back off a bit.
And when you get an answer, make sure you’re actively listening. Korey Hood, PhD, of the University of California–San Francisco School of Medicine, suggests putting down your cell phone and anything else you’re doing so you’re available for a real heart-to-heart. Restate what you’ve heard and ask if you’ve understood correctly. “It gives people a chance to tell their story,” he says. “The term that gets used in this
area is ‘validation.’ What you’re doing is validating the person’s experience as real. It’s important.”
Avoid the blame game.
While you should definitely ask questions, one thing you shouldn’t ask is why your loved one’s blood glucose reading is what it is. Even if you’re trying to help, it can feel as if you’re scolding the person for a high or low reading. “Understand that a person with diabetes does not have 100 percent control over their blood sugar,” says Barbara Anderson, PhD, professor of pediatrics and associate head of the section of psychology at Baylor College of Medicine. “That’s what’s so frustrating and demanding about this disease: It does take some of your control and spontaneity from you.”
Find support outlets together.
Sometimes, people with diabetes are looking for support from others who understand what they’re going through. It doesn’t mean you’re doing a bad job as a caregiver—far from it. It just means they want to talk to someone else who’s been through an episode of hypoglycemia or who is tired of daily injections. “Sometimes I think a person with diabetes can feel less isolated talking with somebody else who has diabetes,” Anderson says. She suggests finding in-person or online support groups that you both might benefit from. There are caregiver support groups as well as online groups for people with type 1 diabetes, type 2 diabetes, kids and teens, and more, including those offered by the American Diabetes Association (see “Reaching Out,” below).
Take care of yourself.
Caregiver burnout is a real issue for many people who help someone else care for a chronic illness, so it’s important to look after your own mental and physical well-being. That way, you’re able to care for your loved one and yourself. Caring for yourself might mean setting boundaries (explaining what you can and cannot help with) or taking an inventory of diabetes management responsibilities with your loved one, says Hood. “It is helpful to think about what your limits are and to really clearly define [if] this is too big of a problem for [you] to take care of,” he says. “You have to just get everything out there before you can really move forward.” If you are feeling overwhelmed, though, be sure to talk to your primary care provider or a therapist.
Signs of Depression
If you have three or more of these symptoms, or just one or two but have been feeling bad for two weeks or more, it’s time to meet with a doctor or therapist:
Loss of pleasure: You no longer take interest in doing things you used to enjoy.
Change in sleep patterns: You have trouble falling asleep, you wake often, or you want to sleep more than usual, including during the day.
Early to rise: You wake up earlier than usual and cannot get back to sleep.
Change in appetite: You eat more or less than you used to, resulting in a quick weight gain or weight loss.
Trouble concentrating: You can’t watch a TV program or read an article because other thoughts or feelings get in the way.
Loss of energy: You feel tired all the time.
Nervousness: You often feel so anxious you can’t sit still.
Guilt: You feel you “never do anything right” and worry that you are a burden to others.
Morning sadness: You feel worse in the morning than you do the rest of the day.
Suicidal thoughts: You feel you want to die or are thinking about ways to hurt yourself.
Source: American Diabetes Association
Are you looking to connect with other people with diabetes or other caregivers? The American Diabetes Association’s message boards are a good starting point for people with type 1 or type 2, the newly diagnosed, teens, parents, caregivers, and others. Visit diabetes.org/messageboards to get started.