The psychological impact of diabetes
Having diabetes can affect people both physically and psychologically. In this blog we share a few ideas and CBT-based techniques to help with managing the effect diabetes might be having on your mental health.
Stress and anxiety: Many people with diabetes will also experience anxiety, as a result of worrying about managing their condition, fears about the future, and general concerns about functioning on a day-to-day basis. CBT can help you learn to manage your worrying, and overcome certain behaviours that are driven by anxiety – such as avoiding situations that are potentially difficult or challenging, which could end up limiting your enjoyment of life.
Relaxation techniques such as breathing exercises or mindfulness and meditation can help. If you experience periods of extreme anxiety or feelings of panic – perhaps when you need to do something you fear, or which seems overwhelming – you could try a strategy called graded exposure. This is the process of slowly moving towards tackling a situation you’ve been avoiding, but which is important to you, in small steps.
For example, imagine someone who’s dreading taking the bus to a doctor’s appointment. They might start by simply waiting at the bus stop. Next day, they’ll get on the bus and ride one stop, then two stops, then travel halfway. On the fifth day they’ll get a taxi all the way, and catch the bus back. The final step is going all the way there and home on the bus. Exeter University has a helpful free workbook about using graded exposure to face your fears..
Low mood: This can be triggered by the changes diabetes has brought about in someone’s physical health, their relationships with family or friends, or their living situation. CBT uses methods designed to help us manage your mood through changing behaviours and your relationship to the thoughts and feelings you have, in a way that has been shown to benefit people with diabetes.
If you’re experiencing low mood, it’s healthy to engage in restorative and meaningful behaviours which will give you a sense of pleasure or achievement. These might include making sure you stay connected with friends and family, continuing with hobbies that help you unwind, or spending time outdoors in nature.
Lack of energy or motivation: You might have less physical energy as a result of your condition, but some people with diabetes also find they have less mental ‘get up and go’ than they once did. This can be a big challenge, having an impact on general everyday functioning as well as specific behaviours such as taking medication at scheduled times.
While you may well need to re-evaluate and adjust your lifestyle following diagnosis, it’s important to continue doing things that are beneficial to your health and wellbeing as far as is possible. It’s worth spending some time identifying what these activities are, and committing to make them a priority. This might mean you need to set clear boundaries and be assertive with others – for example, saying “no” when you’re under pressure to do something that isn’t on your ‘priority’ list and which will drain your energy.
CBT explores ways of breaking down behaviours and activities into smaller chunks in order to make them more manageable if your energy flags. Setting realistic goals based on your new priorities is also a good way of adjusting to a changed lifestyle, while giving yourself motivation. You’re more likely to be successful if you make sure each goal is SMART: Specific, Measurable, Achievable, Realistic and Time-based, which means you commit to achieving it within a certain period.
If you experience low mood, stress or anxiety as a result of having diabetes, cognitive behavioural therapy (CBT) can help you manage these feelings by changing the way you think and behave. Ieso offers online CBT treatment that you can access from home – find out more here.