Last night’s DSMA chat on twitter was about dealing with other chronic conditions related or not to diabetes. At the end of the hour everyone was talking about depression and how difficult it makes to manage any condition that requires us to care about ourselves and keep some kind of discipline. The biggest question was if we thought mental treatment should be required for people who have to live with a chronic disease like diabetes. And this is what I think…
While I don’t think mental help should be required for people who have diabetes (and other chronic conditions), it should be greatly encouraged by health professionals. I understand that not everyone wants to be open about depression because it’s so stigmatized, but in my personal case I thank my endocrinologist for making treating my depression a priority. Let’s go back to November and we can see a big 8.6 A1C result because I was in such a rut I just didn’t have the will to live. Forward to now, after I listened to my doctor and went to seek for help (again… because my depression is recurrent) and my A1C last week was 6.4.
We all need motivation to accomplish things in life. Now add to that the fact that you have to live and deal with an illness every single day… you tend to fall off the wagon quite often (at least I do). Imagine all your motivation just goes down the drain and it’s so much more than just a bad day. Weeks pass and you don’t feel better, your whole body aches, all you want to do is crawl on the floor and you feel like you simply don’t belong. Imagine the impact that kind of episode can have in the management of a condition like diabetes that requires so much discipline?
I for one I’m glad I listen to my doctor. And I’m glad that my psychiatrist told me my antidepressants are just another medication for diabetes. I’m glad that I started doing something for myself because now I have the energy and the motivation to do what I’m supposed to do every single day. And the most important thing is that I have a clear head to understand that I don’t have to be perfect to take care of myself.
So if you’re dealing with depression, please share it with someone who can shed some light so you’re not so lost in the dark. More often than not other people will tell you they’re going through the same thing. If you are capable of being outspoken about depression and chronic diseases, then speak out loud for other people to understand they’re not alone. And if your doctor recommends you to look for help, just do it… you’ll be grateful.
The DSMA Blog Carnival this month is about what can we do to help stop depression from hitting our community during the winter months.
Believe me, it’s not easy battle. Depression can undermine even your most minimal efforts to keep your diabetes in check. You lose motivation, you lose self-esteem, you stop caring. With that comes not checking your blood sugars, not eating well, not taking your medications and consequently you can end up like me, with an A1C of 8.6% — How did I get there? I don’t care. What I care about is the fact that I did what I was advised to do and I’m here waiting for my latest A1C result, which I’m convinced will be much better.
So, what can we do to help?
- Listen. Actually, ask! In my opinion, when you’re in a community where you get to know people well, you can tell when something is out of place. There are keywords that we can learn to identify to realize someone is having a hard time with depression. So yes, don’t be afraid to ask someone if they’re doing OK. Most of the time just having someone who cares is enough to makes us do something about our condition.
- Remind the people in your community of all the good things they do and how much you admire them. I can tell you for a fact that when depression hits, it’s very difficult to see the light at the end of the tunnel, but it is there. And just a few kind words can help you see it a little bit better.
- Tell people it is OK to ask for help and advise them to do so. I believe in doctors, I believe in psychologists, I believe that sometimes medication can at least help you bounce back so you can take the reins of your life and do what will eventually get you on the right track.
- Don’t dismiss people’s feelings and don’t think that it’s just a matter of forgetting about it and do stuff. Depression means you’re so out of motivation than when someone tells you to just get up and get going feels like a huge slap in the face. Ask how can you help, and react lovingly. Most of the time we know what to do, we just don’t know how to. Offer your advice with compassion.
- Just be there. Support, comfort… that’s what we need. No pity, no validation of negative feelings, just a kind word to remind us there is a way out.
You don’t know how badly depression can affect your management of a chronic disease until you’re out of it and you can look at the situation objectively. 2011 was a very difficult year for me, mostly because there was such a huge imbalance of chemicals in my body that I simply stopped caring about everything. Things I used to enjoy became an annoyance and I had this horrible feeling that nobody even acknowledged my existence in the DOC. The Diabetes Sisters Weekend for Women conference went by and I felt like a zombie, I barely attended the sessions and I was a total stranger to the lady I shared rooms with. Then I was in San Diego for the Roche Social Media Summit, and while I tried really hard to participate as much as I could, I still felt like I was in a parallel universe of sorts. I thought I was some kind of joke for calling myself a Diabetes Advocate, when I wasn’t actively doing anything… I wasn’t even posting on twitter.
Then November came and I went to see my endocrinologist, told him about how horrible I felt, and he sent me to see a psychiatrist who could help me figure out why depression came to kick me in the butt again. After a long talk with the psychiatrist, who I have to say I liked very much, he decided to add Wellbutrin to my Prozac and see how it went. So far, so good… It’s even helping to control my appetite, and that is always a plus when you are obese. I will meet with a health psychologist on Wednesday and she will help me trace the map for the changes I need to implement in my life so I can grab diabetes by the horns and manage it more efficiently.
Along with my medical resources and my wonderful husband also comes the DOC, in which I’ve been trying to participate more actively and I know it will require a little bit of effort to make myself known to everybody, which is my goal. The fact is, if it wasn’t for the DOC I would probably not care about my diabetes as much as I do and I wouldn’t educate myself about diabetes like I do. I’m very happy that I finally took the time to go to blogrolls and I found a bunch of type 2 diabetics I can relate to.
So with this renewed motivation I hope to FINALLY take the right steps and stay on the right path for a healthy life. And what better way to help yourself than sharing with others. So I revamped my blog, got my a funny domain name and I’m reading d-blogs with discipline and interest. It feels wonderful! I missed me.
This is the story of a woman with recurrent depression and the bad habit of not taking her Prozac for as long as she should. Anyone who has suffered from clinical depression knows how the cycle goes: you feel like caca, you take the meds, you start to feel normal, you stop taking the meds, you feel like caca and round and round we go. That pretty much sums up my life for the last… I don’t know, 18 years? I talk about my depression as openly as I talk about my diabetes; for me, they are both chronic.
My last bout of depression hit as the days started to become shorter and no one needs to be a rocket scientist to know that winter time doesn’t help much when you deal with any mental issues. My problem is that I ignore things for too long until one day everything explodes (or should I say implode?). My home life starts to suffer, my relationships start to suffer and then I walk like a person with a death wish. It really is a time bomb, especially when I have to take care of my diabetes and that is a 24/7 job; I can’t slack.
So when I saw my endocrinologist yesterday and he saw my latest A1C the first question he asked was “How’s your depression?” and I answered “Rampant!” — I’m grateful that I have a doctor who knows I’m much more than just the test results he gets from the lab. And he was more concerned about giving me a referral to a good psychiatrist than doing any medication adjustments. He knows I will not be able to effectively manage my diabetes if I have this huge black cloud over my head making me feel like all I want to do is die because I’m overwhelmed.
Waking up is the hardest part. I look at the day ahead like a haunted forest and I have no map. But I realize that in order to keep going, I just have to keep going. Kind of like Albert Einstein said, “Life is like riding a bicycle. To keep your balance you must keep moving.” And even though I don’t want to keep going, I have the right people in my life to remind me all this is worth it and things will get better. I have people to keep me in check, I have people to make me laugh, I have people to keep me busy.
And then I have my husband, who understands what I’m going through and doesn’t judge even if I become this ubber-bitch sometimes. A husband that asks me to look at the ornaments on my Christmas tree and reminds me that we’re together, that I have people who love me and that there are people I love.
So if Prozac is what I need, Prozac is what I’ll take.
Diabetes + Depression. It’s a constant, double struggle. You need motivation to get your life and health in order, and there’s this extra weight on your shoulders pulling you down. Been there, done that… still deal with it every single day because my depression seems to be as chronic as my diabetes. It makes things harder in every sense with the lack of energy, the low self-esteem that comes with it and the feeling that it doesn’t matter what I do things will never get better. So why bother?
Sometimes I wonder if I’m just lazy with my diabetes, but then I figure I’m not the only one who wakes up some days wishing it’s all gone so I don’t have to work on it because it’s darn annoying. I look at myself in the mirror and I see (I know!) I have to do so much better than this and stop using excuses. But for me, it’s not only about food choices, exercise and taking my medication… I struggle very hard to keep my sanity as well. I know that if I forget to take my happy pills everything else will fall apart. Then it becomes a vicious cycle: my diabetes and my weight issues make me depressed, and my depression takes away my motivation. It’s so much fun… NOT!
During the Roche Social Media Summit I had the chance to listen to Dr. William Polonsky from the Diabetes Behavioral Institute. He basically said we need to take a vacation from diabetes from time to time and do it smartly. I wrote some about it in my previous post. At the end of the session people started sharing personal stories and I was afraid to talk. First because I’m stupidly conscious about my accent, and second because I avoid public speaking like the plague, especially when it’s about feelings and personal trials and tribulations. But then I gathered some courage and I told everyone in that room how I feel: Sometimes I think I’m not worth it. Sometimes I think it wouldn’t be a big loss if I wasn’t around. I heard all kinds of “What are you talking about? I’d miss you! You’re wonderful!” — I technically know all that, but my depression speaks too loud sometimes.
After I was approached by several people to thank me for saying what they feel but are never able to express, I felt like some of that weight was lifted off my shoulders. I’ve always know I’m not the only one dealing with depression and diabetes. But knowing that I can openly talk about it and ask for help and support certainly makes things easier. Especially when I can related to those who have to fight the diabetes dude every day.
I know that my health will greatly improve when I start making the right choices, not just for a day but for a life. But in order to achieve that I need my mental checkout from time to time. And happy pills it is.