Diabetes distress is a concept, developed by psychologist Dr. Bill Polonsky and his colleagues, which specifically addresses the emotional distress that arises from living with diabetes. It is different from clinical depression, which may be due to life stresses that are unrelated to diabetes. Clinical depression can be treated with psychotherapy and/or anti-depressant medication. On the other hand, diabetes distress does not require anti-depressant medications to improve mood.
Ideally, treatment for diabetes distress is provided by a psychologist (or psychotherapist) who specializes in the stresses associated with diabetes management. Cognitive behavior therapy (CBT) is an effective method used to reframe your thinking to improve your feelings about yourself and your stressful situation. The goal of CBT is to challenge your negative thoughts so you can better manage your self-care and improve your blood sugar management.
What are the main areas of diabetes distress?
Diabetes distress can be categorized into four areas related to living with diabetes:
Emotional burden. Feelings of frustration, anger, or anxiety about living with diabetes.
Regimen distress. Feelings of failure, inadequacy, or burnout related to keeping up with one's treatment regimen.
Interpersonal distress. Not feeling supported by family or friends due to one's diabetes (including conflict with the "diabetes police").
Physician-related distress. Difficult relationships with healthcare providers.
How can CBT help?
Diabetes distress can derail your diabetes management by having a negative effect on your self-care. Patients experiencing significant diabetes distress may have difficulty feeling motivated to follow their diabetes regimen, which could then negatively impact their A1c level.
CBT can help change your negative thoughts (cognitions) into more reasonable thoughts and change maladaptive behaviors into healthier self-care actions. Along with improved thoughts and actions, you can feel empowered to manage your diabetes and not let diabetes take control of you. A specialist in diabetes psychology (or a diabetes-focused mental health provider) can validate the normalcy of your feelings of being overwhelmed and burned out. Although life stress is unavoidable, feeling distressed is not. By using CBT strategies, you can change how you respond to life's stresses and feel better about your diabetes management. Changing your attitude and your actions can make you more likely to take better care of yourself and feel good about your efforts.
Additional coping strategies to manage and reduce diabetes distress
Other healthcare professionals who could help reduce feelings of distress might be:
Your healthcare provider (endocrinologist), who can make changes to your diabetes regimen (if needed) to better manage it;
A Certified Diabetes Educator (CDE), who can provide additional education/guidance or encouragement to help you reduce feelings of distress; and
A peer support group where members can share their coping strategies.
Useful resources to discuss the stress—and distress—of living with diabetes can be virtual:
Diabetes Online Community (DOC). A widely spread group of people who live openly with their diabetes on the Internet.
Diabetes podcasts. These include Diabetes Core Update from the American Diabetes Association.
Diabetes websites. You can find articles aimed at helping a Person/People With Diabetes (PWD) not feel alone in their struggles with diabetes management.
Visit my website at AskDrBev.com to view links to my articles about coping with the emotional issues of living with diabetes. For inspirational stories of successful women and men with diabetes, check out my two books available on Amazon.com: MY SWEET LIFE: Successful Women with Diabetes and MY SWEET LIFE: Successful Men with Diabetes.