(BPT) – Managing diabetes is as much a mental game as a physical one. In addition to taking medication or insulins, monitoring blood sugar, eating healthy, getting regular physical activity, and often experiencing physical symptoms of low and high blood glucose, people with diabetes also need to be vigilant for a serious potential complication that is often undiagnosed: depression.
Multiple studies show people with diabetes are at higher risk of depression. One study found 11 percent of people with diabetes experience major depression, and of those nearly a third are clinically depressed, according to research published in the Diabetes Atlas. Further, studies show about 45 percent of all diabetes patients have undiagnosed depression.
People coping with psychological issues and diabetes also don't feel they're getting the support they need; the DAWN2 study found that while 52 percent of health care professionals said they regularly asked patients with diabetes how their lives were affected, just 24 percent of people with diabetes reported they were being asked this by their health care providers.
"People with diabetes must manage their disease 24/7, 365 days a year, mostly on their own or with the help of a parent or caregiver. That constant need for attentiveness can lead to increased stress," says Alicia McAuliffe-Fogarty, a clinical health psychologist and vice president of lifestyle management team at the American Diabetes Association (Association). "Medical providers are trained to help people manage the medical aspects of their disease, but they may not have as much knowledge about the impact psychosocial factors can have on the mental health of people living with diabetes."
The Association recommends everyone living with diabetes have a mental health professional as part of their health care team. "Everyone is different, so it's important people with diabetes get individualized, patient-focused care that includes a mental health component," McAuliffe-Fogarty says.
In addition to care from a mental health provider, people with diabetes can take steps to manage their own mental health, including:
* Manage stress -- Stress can affect your blood sugar. When you are upset or feeling stressed, your body makes stress hormones that can make your blood glucose go up and make diabetes harder to manage. Stress can also make it harder to think about taking care of yourself-- you may eat too much or not enough, you might not exercise, or you may forget to take your medicines. Trying to figure out how to manage stress is important - from deep breathing, to listening to music, or enjoying a hobby. Figure out what works for you.
* Find a support network -- Living well with diabetes requires support, so do your best to surround yourself with friends, family and trusted health providers. You can also find support through online or in-person support groups, where you will find others who understand the challenges and triumphs of daily diabetes management.
* Give yourself a break -- Yes, managing your diabetes well can be the difference between life and death. But dwelling on that aspect of the disease, and putting undue stress on yourself every day, doesn't do you any good. Instead, focus on the fact that diabetes management is just like anything else in life -- there will be good days and bad days. Don't add stress to your life by expecting perfection from yourself.
* Set reasonable goals -- You need room to learn and grow in your diabetes management. Baby steps and small changes -- such as adding physical activity and making healthier food choices -- can set you on track for success, while not stressing you out with unrealistic expectations. McAuliffe-Fogarty advocates the S.M.A.R.T approach to goal-setting: Specific, Measurable, Achievable, Realistic and Time-bound.
* Have a stellar health care team -- Diabetes management requires a team approach, and you should have health care professionals such as an endocrinologist, dietitian and primary care physician on your team. It's important to also have a mental health professional on your team. He or she can provide initial and continuous mental health assessments, from diagnosis and throughout your diabetes journey.
To learn more about diabetes management, and the relation between diabetes and depression, visit diabetes.org.
* Eliot LeBow LCSW, CDE
Visit my website here: http://wwwdiabetictalks.com
Donna Lalwani, Director of Special Events for The American Diabetes Association.
“I would like to bring up Mr. Eliot LeBow, who is a subject matter expert and has been an Emotional Health and Wellness Advisor for the American Diabetes Association.
Because, he also got involved with the Step Out Movement to stop diabetes & really has played a leadership role in leading many workshops & he as well has done a lot of outreach online in the social media community.
Spreading the message about diabetes awareness and ensuring people get accurate information & remedies.
He is one of only a hand full of individuals in the US that does a lot of important health education coaching to fellow individuals who live with diabetes. He will be sharing a little bit more on the relationship with the mens health and wellness as well as positive sexual health. Offering some ideas and strategies on how to do that both in living with diabetes as well as passing along as a caregiver for someone we care about. So I would like to introduce Mr.
Eliot LeBow to please come up…
“How out of control blood sugar impacts our mental and physical reality.”
By Eliot LeBow LCSW
When blood sugar is high or conversely too low, a diabetic will have distortions both mentally and physically. When blood sugar levels return to normal and reality kicks us right between the eyes, what then? Every situation is different. There are ways to prevent these distortions from happening or managing them so less or no personal damage occurs.
A few years back John was dating this beautiful woman. John would think about her all day. When John was with her, John was filled with excitement and delight. But something happened at the end of their 6th date.
John always considered himself a virile man who could sustain an erection for hours on end so erectile dysfunction was the furthest thing from his mind. Well, you probably know what happened next but let me move along and not belabor the point.
This was an embarrassing and scary moment for John when he didn’t have an erection. Luckily, she was really cool about it. The next day they went out to dinner and shared a great chocolate lava cake. John adjusted his insulin and thought things were going great, but in the back of his mind his was still thinking about it and very worried.
They got back to his place and set the mood; scented candles, soft jazz in the background and dim lighting. Everything was perfect except John. He was excited and eager, but he did not rise to the occasion.
“What is wrong with me?” John thought to himself and then a little voice in the back of his head answered him. John went to check his Blood Glucose (BG) levels.
WOW!!! 390 — John couldn’t believe it! John calculated everything perfectly, but somewhere John missed it. Here’s what John missed:
o John missed the fact that they finished dinner an hour ago. It’s hard for insulin to burn off complex sugars like Chocolate Lava Cake so his blood sugar went higher than normal for after dinner.
o Next, John probably underestimated the amount of carbohydrates in the meal itself.
o Last, John was so stressed out about the previous night that his body was releasing extra Cortisol.
Cortisol is a hormone released by stress. Anxiety activates cortisol (glucose) secretion, which releases it into the body. This can and does cause BG imbalances such as hyperglycemia.
So John went around for several days worried that he was going to have to take Viagra to rise to the occasion. In reality, John just needed to test his blood sugar and wait.
The next time they met, they watched a movie while waiting and enjoying their time together. A few hours later after making sure that his blood sugars had stabilized at 120, they tried again and no Erectile Dysfunction for this virile man this time. They did it right.
In reality, the symptoms of diabetes can mimic other psychological and physical illnesses. Be careful and double check that what your patient is experiencing isn’t diabetes-related.
(C) 2011 Eliot LeBow LCSW, All rights reserved. www.diabetictalks.com
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