A workload that does not switch off
Management of diabetes can be viewed as a perpetual full-time job with no vacations. In this job there are hundreds of things to consider and countless decisions to take every single day – and each one of them has a direct impact on our own life and well-being. The mental burden and the sense of loneliness that this imposes on people living with diabetes is associated with an increased risk of developing psychological distress and mental health disorders.
However, as a type 1 diabetic, it can be frightening to start exercising because of concerns about fluctuating blood glucose levels. And even when we are able to cross that fear barrier, it is not simple to exercise and maintain blood glucose levels within the desired range.
How does diabetes affect mental health?
Diabetes is a disease that places a high burden on people diagnosed with it. Living with diabetes requires close monitoring of blood glucose levels, management of diets and insulin dosages, resolving therapy side-effects, and frequent adjustments around both expected and unexpected life events.
It is a disease that demands constant and lifelong self-management. Every single day, people living with diabetes must take hundreds of decisions directly related to their diabetes management. The permanent cognitive load that this entails can result in individuals feeling fatigued and overwhelmed. In addition, the stigma associated with the disease and the strain that diabetes can place on social relationships all lead to a high emotional burden and have a significant impact on the quality of life of people living with diabetes.
These are among the reasons why more than 40% of people living with diabetes report poor levels of psychological well-being and at least moderate levels of diabetes-related distress. It also helps explain why people with diabetes are at a significantly higher risk of developing mental health issues, such as anxiety and depressive disorders.
Left unaddressed, diabetes distress can potentiate the feeling of powerlessness and detachment towards the disease. It can lead diabetics to neglect therapy and disease management, thus exacerbating poor glycemic control, worsening disease outcomes and further deteriorating their mental health.
Positioning mental health care as a central component of diabetes management is critical to improving disease outcomes and the quality of life of people living with diabetes.
When exercise feels discouraging
Finding the right strategies to keep blood sugar levels within a safe range during and after exercise is not easy and can be extraordinarily discouraging.
I know it because I went through the same frustrating process alone myself.
My experience of fear
As someone with diabetes, it can be incredibly daunting to exercise. Personally, it took me two years since my diagnosis of type 1 diabetes to find the courage to do it.
Years after avoiding exercise through fear of hypoglycaemia, I completed a 10 km swim in Austria’s Hallstätter See. This embrace captures what that moment meant to me. Finding confidence will look different for everyone; this was one milestone in my own journey.
Individual experience and coping
It is important to underline that each person’s experience with managing their diabetes is unique. Disease burden is not uniform among everyone living with diabetes. But even in cases where disease burden is high, diabetes distress can be obstructed by firm resilience and effective coping mechanisms – gladly, there are many examples of people with diabetes around the world living a fulfilling life who even use diabetes as a source of mental power to keep pushing their goals and achieve their ambitions.
We can use neuroscience knowledge as building blocks to strengthen our coping mechanisms towards adversity and help us break free of some of the constraints diabetes imposes on us. I firmly believe that this sits at the center of a fulfilling and stronger life.