When you fail to achieve the required glucose readings you may start to resent yourself
By Dr T W Changamire
October is mental health awareness month – and we have been talking about issues related to diabetes in these columns – and so I feel talking about diabetes and mental health would be appropriate in the month.
Mental health is a state of emotional, social and psychological wellbeing. Mental illnesses are conditions that will affect your emotions, your way of thinking and the way you behave.
Mental illness may be a result of inability to cope with social and psychological stressors as well as physical ill health.
Diabetetes and Mental health
Diabetics are disproportionately at a higher risk of developing a mental disorder. Diabetes not only has physical effects but it also has mental health effects. The mental health impact of diabetes is often a neglected or missed topic of discussion by health practitioners.
Patients may also find it hard to recognise a mental illness or may fear raising the topic to the treating clinician. While the need to eat healthy, exercise, and constantly check on the blood sugar levels will improve physical health and mental health the opposite may occur and mental health deteriorates and results in stress, anxiety or even depression.
If a mental disorder develops, inactivity, poor eating habits and reduced monitoring occurs which all impact negatively on physical health. Mental health screening is advised in Diabetics to assist in achieving glycaemic control.
Diabetics are prone to developing mental illness. Fluctuating sugar levels between highs and lows may cause physical symptoms like fatigue, confusion, trouble with concentrating and anxiety. Aggression and irritability may also develop especially when the blood sugar levels begin to drop.
The stress of living with diabetes may also contribute to mood changes and emotional changes and anxiety. When you fail to achieve the required glucose readings you may start to resent yourself. You may also begin to feel powerless especially when you have made a lot of effort towards achieving control but the glucose levels remain high.
Depression is a common mental disorder. It causes feelings of sadness. It is the leading cause of disability worldwide. It can affect your ability to function at work or at home. Depression affects more women than men and it may lead to suicide.
It is different from short-lived emotional challenges. It lasts longer and may present with physical symptoms.
Diabetics are 2 to 3 times more likely to develop depression.
Diabetics and family and friends around them need to watch out for the following signs; loss of interest in the activities they used to enjoy, withdrawal from social activities or relationships, feelings of worthlessness, hopelessness and sadness, feeling empty, having thoughts of suicide or having thoughts of death.
Depression can be treated with medication and psychological intervention; it must be treated to allow the patient to achieve control of diabetes.
Anxiety is fear about what is to come. People with anxiety worry excessively about everyday situations. Anxiety is a mental condition that interferes with your ability to function. People with diabetes have a 20% more chance of developing anxiety compared to those without diabetes at some point during their lifetime. Management of diabetes is a major source of anxiety.
Anxiety may occur because diabetics are constantly worrying about developing hypoglycaemic symptoms in public if the diagnosis of diabetes means that they will die earlier, if they will be able to manage the demands of a self-care routine, and how the constant dietary adjustments and blood sugar monitoring may interrupt with their work or social routine.
Diabetics worry about what will their friends and family think if they found out about their condition and if they will treat them as if they are fragile. Diabetics also constantly worry about the long-term complications of diabetes. Anxiety is treatable.
Medication may be prescribed depending on the severity of the symptoms. Physical symptoms may develop like sweating and palpitations and breathing difficulties which will require medical treatment however most people with anxiety will respond to psychological therapy.
This is not a mental illness but it may lead to the development of mental ill health and physical ill health if it is not dealt with.
Diabetic distress develops usually when a patient has been trying to control their blood sugar levels but they are failing. This will leave them feeling like they are a failure in life, feeling like they are tired of living with diabetes and feeling like they are tired of trying because their efforts are not resulting in positive changes.
This feeling may become overwhelming and may lead you into slipping into a habit of missing doctor’s appointments and not checking on your blood sugar.
Whether you are a diabetic or not a diabetic we all experience stress. Stress is not good because it affects your decision-making and poor choices about diet and lifestyle. Stress may arise from relationship struggles, financial struggles, work-related issues or home-related issues.
It may also come from physical ill-health. A person who is stressed may express it by being angry or being very emotional, they may also start to develop physical symptoms. Diabetics need to make intentional efforts of taking care of their mental health by finding to cope with stress.
Diabetic distress can’t be treated by medication. Coping mechanisms include eating well-balanced meals, exercising, listening to music, vacation, reading just to mention a few.
It is very important for a diabetic to have a good social support system to help them cope with the lifestyle demands required to help them stay controlled and healthy. A good support system is important for early detection and recovery from mental illness.
Support may come from family, friends, co-workers and health care providers. It is important for the diabetic patient to recognise symptoms that are suggestive of mental illness and to speak to a health professional if such symptoms develop or if they are unsure. Anxiety, depression or diabetic distress will lead to poor glucose control and ultimately physical ill health.
Contact All In 4 Health – By Dr TW Ngwenya Changamire – for General Medical Consultation, health screening, medical check-up, health education and promotion. The Glen Marais Shopping Centre, 57 Veld Street, Glen Marais, Kempton park 1619
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