When one becomes ill with any disease whether it's diabetes or lupus or even cancer, well-wishers come out of the woodwork to offer advice. There are some generic types of conversations that you can expect, however when you hear the words, they still sting. They have an interesting response in the person they are meant to "cure", and that is shame and guilt and sometime just plain anger. To give you examples, please allow me to use my life, but you can substitute your family, friends, and acquaintances.
The first is the "kind" friend who tells you that if you would just pray more your disease would be cured, as if we all haven't turned to our own interpretation of a higher power to ask, "Why?" and "How Can I Cope?" The underlying hypothesis is that their religion is the correct one and that they, therefore, know the secret of health. Also with that comes the underlying thought that maybe you are being punished by their powerful higher power for some sin (remember the frightening statements about those who were dying from AIDS?). If you haven't heard these thoughts, you will at some time in the course of your coping with diabetes. It reduces your trials and lancet sticks 4-6 times a day, injections, exchange counting, daily exercise, and fears, to nothing. The simple answer is the correct one and you must feel shame and guilt for not being good enough to know it. I react to these conversations with anger that someone I know thinks in such simplistic, black and white ways, but also with sympathy for them as life is so much better when you actually have to think things through for yourself and you control your destiny. I rarely argue because they tend to have recipe type answers which just make me more angry.
My favorite is the "magic cure" that I was too dumb to have read about. Once when we were writing a book, one senior editor, supposedly an intelligent person, called and asked why we had not included, in the medical section of the book, that cinnamon could cure diabetes. I called and left her a message that if there was any verifiable and replicated scientific research that proved this, that every diabetic would walk around with a cinnamon sticks in the mouth. Want to feel guilty? Have your loved ones scour newspapers and journals on a daily basis and then call you with the new cures. When you don't jump or when it doesn't work, how sad they are. Their efforts double. You must read the articles, get the calls, e-mails, etc., and stifle you frustration as they love you and want you to be healthy. I am convinced this is a true statement, but they are also looking to regain control of their lives by making you not sick. Don't fall for this one. Once when I was first diagnosed and I had figured out how to control by blood glucose levels, we took our first trip to visit my family since DDay (Diabetes Day). They had been destroyed by my diagnosis and as I said before, these loving, but controlling people were uncomfortable with my testing materials, syringes, schedules, and new eating style. We arrived in time for dinner. There were 20-some people around that table and the conversation and looks made my blood glucose level zoom. Next morning after we left to go on with our trip, I took my blood glucose level and wonder of wonders, it had gone back to normal. As for the articles in the paper and magazines, if you will just set limits about the nature of what sells printed materials, the intelligent friend or family member will stop. It is a waste of time. If something really important happens, we'll all know and we'll be the ones celebrating.
Another favorite is the person who tells you about all their relatives and friends who have had terrible complications from diabetes as if we wake up each morning and think to ourselves, "how can I ruin my health today so that I can go blind, lose a foot, or have a heart attack?" Listening to these people is a very long "low" and does not help anyone. After the first few words, we all tune the conversation out as it very depressing or we go into denial mode think that will never happen to me. Underneath, we may well feel ashamed that we have the same disease that causes these catastrophes, and lots of anger that we are listening to this diatribe. Be brave and tell this person that you're not sure the topic of conversation can help, and that you do what you can to control your diabetes.
One thing I know is that shame and guilt can make us depressed, that is, to feel hopeless and helpless. Let's talk about what these look like and what to do when they occur. First let's look at denial. As I said before, denial is a normal reaction. If you don't believe me, watch an overweight person eat for just one day and then ask them what they ingested that day. Many will not remember standing at the counter eating a half gallon of ice cream. The trouble with denial and diabetes is that it stops you from learning what you need to know for your own care. It may well help us from becoming overwhelmed by terrible things in our lives, but when used inappropriately it can become a family affair allowing your spouse to think that diabetes is not serious, thus setting you up for cheating on your diet, not taking your meds, or not becoming an expert on diabetes. What does denial sound like?
One bite won't hurt me. I'll go to the doctor later. My diabetes isn't serious, I don't take insulin shots, just pills. The pains will goes away, the sore will heal, my eyes will clear. These thoughts lead to more dangerous thoughts like: There isn't any healthy food at work. It's too hard to pack a lunch. It's too expensive to care for myself. I can't ask my family to change the way they eat, and I don't want to eat alone. I'll only smoke 3 cigarettes a day to keep my weight down.
Read enough? How do your control the destructiveness of denial in your life? The first thing is to make sure that your significant other knows about this disease. You must become an expert yourself and then share the information. They must know that helping you remain healthy is a loving kindness, not an intrusion. To tell the truth, your diet should be theirs and so your taking care of yourself will make them more healthy, so guilt be gone.
Now let's look at anger. Being ashamed of being different, perhaps "weak", can make anyone angry. When this happens, we rage at our new life which is full of finger lances, meds, special times to eat, and carbo counting, as well as exercise and a daily time table. Many feel our positions in our families change. We are now less of a man or woman and have become the invalid of the group. Denial may well raise its ugly head. What happens then is that the anger allows one to not care for your diabetes, and thus their lives do not change, but when this occurs the blood glucose levels become out of control and the person feels worse physically, thus making them even more angry. And so the cycle goes on. How to stop the cycle is not always easy, but the first thing is to figure out exactly what is making you angry and how are you allowing this anger to rule your life. You can do this on a daily basis by asking yourself what made you angry on that day. Look for similarities. Is it others' comments, carrying around your supplies, falling asleep after meals, missing out on foods you used to like? How do you handle these situations? Do you feel hopeless or helpless even after you think you have responded to the situation? Have you accepted your diabetes or are you still at sea about your ability to cope on a daily basis with a chronic disease? How can you help yourself? For one thing, don't expect to learn to live with this disease overnight.
Keep a journal about your days and make sure you reread these pages each week. You'll see your growth. Exercise. It makes anger abate. It's those endorphins you read about. Work at remaining you and not being just a diabetic so that you can enjoy your friends, work, social occasions, and family. Talk about how angry you are with some persons you trust. Don't do this all the time or you'll soon find your list of friends dwindle, but as you learn to live with diabetes, others will understand what you deal with 24 hours a day and they will begin to respect you rather than pity you, and this will add to your own self worth and decrease your anger. This does not mean to become hypoglycemic on purpose. The same will happen as they watch you care for yourself and your dedication to eating well and caring for yourself. I can't tell you how much easier it is to ask for donations from friends when they have spent time with you, and respect isn't bad. If worse comes to worse, go get help. No one should live that anger or rage for much of their lives. It's debilitating.
Finally, let's deal with depression for a bit. We have discussed this many times on this web site, but let's go over the symptoms one more time. Have you lost the sense of pleasure and interest in things? Have your eating or sleep patterns changed? Are you eating more or less, can you fall asleep, do you get up in the middle of the night or are you very tired all the time? Have you lost your energy? Do you feel guilty? Is life not worth it? Are you nervous too much of the time? Do you note a loss of concentration? If you have these symptoms, do get help. If you see a physician, they can rule out other diseases like thyroid disease, side-effects of other drugs and effects of drug or alcohol abuse. The good thing about depression is that it can be helped both by medications and by talk therapies or both, and since a large portion of Americans will be treated for depression during their life times, you will certainly not be alone. Just don't wait to get help. Depression will fuel your poor self care. It's hard to take care of diabetes when you are not sleeping, or sleeping all day, gaining weight, raging at others and yourself or thinking of overdosing.
OK. You know what can happen to you when you deal with shame, guilt and anger. You have an idea of what to do. The new year and new Millennium are here. Let's start it out with caring for ourselves. We expect to see you here for many years, at least for the next hundred or so. Thanks in advance for making it a better life for yourself. You count.
