Word out there is that chronic illnesses are accompanied by depression. It isn’t news that diabetes puts a heavy toll on our mental health, making it even more complicated to manage. But in my case, depression came first. I was diagnosed with depressive and generalized anxiety disorder when I was 19 years old; my type 2 diabetes diagnosis came at the age of 26. I see my life before and after depression, and I’ve had many challenges I’ve been able to surmount with the help of my loved ones and my team of health care providers. However, given the nature of diabetes, its constant drip of stress and second-guessing, depression always seems to be the tallest hurdle for me to jump over. My medical record shows “Recurrent Major Depression in Partial Remission” – just like diabetes, depression is always there, and I need to tackle it persistently.
When I go to see my endocrinologist, the first thing he asks me is how I’m feeling. He knows I won’t take care of myself or my diabetes management if I’m going through an “episode”, as I prefer to call it. One of the most useful pieces of advice I’ve received came from my psychiatrist, who told me to treat my SSRI* medication like I treat my diabetes medication. When I don’t listen to that kind of advice, everything starts dropping like a line of dominoes. My SSRI allows me to CARE. That’s what I need to do, no matter how difficult it is, I need that constant motivation to do what’s right. Not to be perfect, but to love myself.
For some reason, 2016 was a very difficult year. I let it all go, I didn’t take care of myself, and I let my depression run rampant. When I finally decided to go back and see my doctor because I knew I needed help, the lab results hit me like a ton of bricks. It was the biggest reality check in the almost 20 years I’ve lived with diabetes: My A1C was 12%, and my kidneys were struggling. As depressed as I felt, I followed directions, and for the last three years I’ve been able to keep my A1C under 7%, and my labs always come back showing results that meet my target. The trick? I made a commitment to myself to take care of my mental health first!
Caring for your mental health is not only about taking medication if you have a prescription… it involves so much more! From choosing who you surround yourself with, what battles you fight, and deciding what makes you happy. I know it sounds easy… well, it is. For the past year, I’ve been trying to allow myself to simply BE. I think most of our inner struggles come from the fact that we have a preconceived idea of what we’re supposed to be based on society standards instead of just letting it happen. Regular mindfulness meditation has been a godsend; it has helped me to concentrate on what’s important, reduce my anxiety levels, but most importantly, I’ve become kinder and more compassionate to myself.
Managing my blood glucose levels while riding the depression and anxiety roller coaster isn't easy, but I have learned to identify the challenge as soon as it presents itself. I'm a rather reserved person, and I have a little difficulty reaching out even to my friends, but I have great support at home. My husband is attuned with my feelings, and he knows when I'm struggling, and he tries to provide any help he can. For example, he does most of the cooking, so he always tries to make things that are healthy for my body and my mind. He knows when I need to get out of the house, to be in touch with nature, which has an especially soothing effect on me. It's invaluable to have someone who understands, supports, and encourages me to keep going.
When I can't rely on my husband to save me from despair (because he has a life of his own!), I have to come up with my own ideas to help myself. I discovered keeping a bullet journal is my road to sanity. I track my medications, my meditation, and my health or unhealthy) habits. It doesn't matter how I'm feeling, I still have that journal to hold myself accountable. It's a good feedback loop that motivates me to take care of myself.
I call my depression "Randall" like that monster in Monsters, Inc. that steals children's laughter and happiness with that horrible vacuum thing. I don't let Randall wreak havoc in my life, and when he starts to show his ugly face, I'm equipped with the tools and the knowledge to face him. My diabetes seems more manageable when my mind is at peace.
* Selective Serotonin Reuptake Inhibitors (SSRIs) are a type of antidepressant that works by increasing levels of serotonin within the brain. They may also be used to treat anxiety disorders.
Bea S was diagnosed with type 2 diabetes in 2001 and has been an active diabetes advocate since 2007. Bea was part of the Diabetes Social Media Advocacy team, the Diabetes Hands Foundation advisory board, and the co-host of DSMA en Vivo, an internet radio show geared toward the Hispanic community living with diabetes. Bea is currently working on becoming a PODS Meetup leader with DiabetesSisters. Originally from Colombia, Bea lives in the Chicago area with her husband, two cats and a bird who think he’s king of the world.