Joe Solowiejczyk, a nurse, diabetes educator, and family therapist, talks about the concept of Diabetes Distress¹, in which a person feels the emotional states which are normally associated with depression, but at a level that is not severe enough to be diagnosed as depression. On the outside, a person seems to be doing alright; they score high in coping abilities and don’t talk much about how diabetes is a struggle. Externally, it may appear that there’s no problem, but internally, a person may feel sad, overwhelmed, anxious, or alone. This describes me almost perfectly for the first two years after my son was diagnosed with Type 1 Diabetes. I did what I needed to do to keep him safe, to react to highs and lows, and to adjust his insulin doses. But in my mind and heart, I was tired; sometimes I would burst into tears over something minor – no test strips left in the container, an ad on TV with a laughing child; sometimes I would get angry that other parents didn’t have to weigh and measure their child’s food before they could feed him; often I would worry about my son’s blood sugar going low in the night, or how that 25.6 at the last BG check was damaging his body. Will he be bullied when he enters school? Will he be able to pay for his diabetes supplies when he grows up? In some ways, my worries echo those of most parents, even whose children do not have a chronic illness. But compared to life before our son’s Type 1 Diabetes diagnosis, I was struggling; my worries were beating me up.

Psychologist and diabetes expert Dr. Richard Rubin describes a similar phenomenon which he labels “diabetes overwhelmus²”, in which the physical and emotional burdens of diabetes care create stress levels that are so high, that a person’s coping mechanisms break down. When we feel overwhelmed, we may adopt a “why bother” attitude; we may either give up on diabetes care altogether, or become at least become less active in doing what needs to be done. Less proactive attention to diabetes-care leads to reduced control (more BG swings, more frequent out-of-range blood sugars), which in turn increases the stress of diabetes care; we get frustrated more because our efforts don’t seem to be having an effect.