Monday, December 16, 2013

Burnout: When Managing Your Diabetes Becomes Too Much

If you have diabetes, then you know that taking care of yourself can feel like a full time job. Blood sugar levels, which becomes the central number in your health universe, can be affected by many common activities of daily living - and it can feel exhausting. Many diabetes management behaviors are in-line with recommendations we are familiar with for everyone - eat well, exercise regularly and manage your stress, are some of the main ones. But it can feel entirely unfair that while other people can sometimes eat well and at other times splurge, managing your diabetes requires one to be on their best behavior - most of the time. Falling of the wagon, like you see friends and family often do, is not an option. No wonder that burnout is a chronic risk for diabetes sufferers.

And while keeping a handle on stress levels is one of the key factors in managing diabetes, managing diabetes can itself contribute to stress. This creates a cycle that when it gets too bad can lead to depression, which leads to less effective diabetes management coping skills and so on. In fact, in a recent study conducted by the Harvard School of Public Health, it was found that women suffering from depression were 17% more likely to contract Type 2 diabetes, and that women struggling with diabetes were 28% more likely to end up with depressive symptoms.*

According to the lead researcher on the study, while BMI may account for some of the findings, the likeliest reason for this correlation has to do with stress. Cortisol, the main stress hormone found in the body, is often found at elevated levels in people with depression - and in turn it plays a negative role in blood sugar levels and insulin resistance, increasing risk factors found in diabetes. 

The feeling that one has to be on "their best behavior" all of the time when managing this illness is not limited to food and exercise. Relationships, too, take on extra importance as diabetes sufferers need to look for extra support and understanding from the important people in their lives. Those people in turn need to be supported in order to be adequate supports to you - and need to be educated to the needs of diabetes management just as you are. 

If you have diabetes, remember to ask for help when you need it. Find your supports and use them wisely. Remember that managing your illness is doable and manageable and perhaps may even be an opportunity to "do all the right things" that we are all supposed to be doing anyway. But also don't forget to give yourself a break - diabetes management is a marathon not a sprint. And while getting into a comfortable routine is crucial, so is the realization that as your life circumstances and body changes, so can your relationship to food, exercise, your medical procedures, and to friends and family. If you find yourself experiencing "burnout," which may include feelings of anger, sadness, helplessness, withdrawal from activities of everyday living, and "forgetting" to take care of your diabetes regimen, then it may be time to sit down and reexamine what has been going in your life, and most importantly, not to forget to ask for help. Diabetes is easier managed when you are not doing it alone.

* As reported in WebMd:

I am a Licensed Psychologist. Many of my patients are older adults, and while illness is not necessarily linked to aging, some of my patients also suffer from chronic pain and other physical ailments. My office is in Conshohocken and I can be reached at (484) 534-8830 or at For more information please go to

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