At our last Diabetes Sisters meeting on May 10th in Princeton, NJ, we played the "Common Tests and Procedures Game." It always amazes me how complicated diabetes management can be and as we compared our knowledge about tests for A1C, blood pressure, cholesterol levels, dental, eye, foot and kidney function I observed the mood in the room. Some of our group members looked visibly upset and it opened up a discussion of being overwhelmed by the tasks of managing our health.
One woman, mother of two young children, and Type 1, was in tears because of the endless daily demands of parenting, working and the difficulty of making time to de-stress so she could take care of herself. After all, we know it takes time and energy to eat properly and to exercise. The anxiety about her highly elevated blood sugar or fear of a hypoglycemic episode just felt like too much to handle. All this stress had brought her mood low and who could not empathize with her about the difficulty of managing it all?
And another member who has the co-morbidity of congestive heart failure and Type 2 spoke about her frustration about maintaining weight loss. At a recent doctor's visit the physician had recommended bariatric surgery. But after just recently recovering from open heart surgery the prospect of another surgical procedure made her depressed and angry. "I am trying!". How relentless is the struggle to keep exercising and eating healthfully when progress is slow? When the solutions seem out of grasp because you need some serenity to take better care of yourself and life does not stop so we can take the time out we need to focus on ourselves.
Our group represents a cross section of life with diabetes, the up and down cycle of being in or out of control of coping with the management of our disease. I have observed the mood cycle of anxiety and depression that is a feature of this disease. It is apparent that when group members are in better control they have improved mental states. I speculate that improved well being is a virtuous cycle- eating well, exercising, resting sufficiently and not being too stressed creates more stable blood sugar. Stable blood sugar effects our mood biochemically. Our improved self care makes us feel better psychologically- we are successful at doing what is best for ourselves. When we fall off there is the physiologic consequence and a sense of failure and despair. Why bother? It is like falling down a mountain and having to climb back up again.
Back to our group, we catch each other when we fall down the mountain. We recite what we have to do to stay well. We know the cycle is delicate but we can only take one step to begin again. We offer this hope with love and compassion.
Happy Mothers' Day