Everyone worries about their health at some point, but people with diabetes have the potential for a lot more worry and stress in their lives. And your worries may increase if you and your doctor are not on the same page. Gary McClain (aka Dr. Gary) is a frequent contributor on Diabetic Connect and a licensed therapist who often treats the mental and emotional challenges associated with diabetes. He returned as the expert guest for this week’s Twitter chat, and was joined by host Jewels Doskicz, who is a registered nurse, type 1, and mother to a child with type 1 diabetes. They discussed coping strategies that can help you reduce the worries and anxiety that may come with diabetes.
Q. How has diabetes affected the way you look at your life?
Dr. Gary: My clients often talk about how their diagnosis has been a wake-up call in their lives to take care of their health. Being diagnosed can cause you to take your health much more seriously and not take it for granted.
Jewels: It’s always a balance of opposites. I aim for Zen, while diabetes, a pain in my brain, is vying for my attention. When diabetes is seen as a hardship or burden, it may be too heavy a load to carry. Redefine it as needed.
• I feel I have a more realistic outlook on life than some of my non-diabetic friends. I am more positive and I try to live life to the fullest.
• It turned me into an advocate for healthy living.
• I have learned to go beyond the superficial and value things for what they are. Diabetes pushed me to become an explorer.
Q. Is there a difference between your perceived health status and your actual health? If so, why do you think this difference exists?
Dr. Gary: It is only human nature to begin to ask “what if” and then to worry that something bad could happen with your health. It’s normal to worry, but your worried thoughts don’t have to control you.
Jewels: Worries about health can be toxic. Positive thoughts about perceived health can influence our actual outcomes. Diabetes is a labor of love. It’s easy to get caught up in the minutiae, but it’s the larger picture that matters most.
• Absolutely. I was diagnosed in the best shape of my life and then I gained nearly 70 pounds after diagnosis. But people think I got diabetes because I’m fat.
• Yes, I feel much healthier now than I did 5 years ago, but there are things that are less healthy about me now, so it depends on the angle.
• Whenever I’m asked about my health I answer “excellent” because research shows that leads to a longer life.
Q. In what ways do health-related worries impact your everyday life? Do you feel like it’s something you have control over?
Dr. Gary: Let’s not forget that it is possible to be so worried about your health that you assume you are doing poorly when you are actually doing fine. Over-worry can lead to a constant state of stress which, in turn, can negatively affect your emotional and physical wellness.
Jewels: When one realizes that you can still kick diabetes in the booty and not perseverate about it all the time, that's a win. Worrying about blood sugars is always part of our life with diabetes. It can be mitigated, but not obliterated. Worrying creates a false sense of control. The reality is, worrying with diabetes never ends and if you let it exhaust you, it will.
• I tend to just take those worries in stride. There's not much of a reason to dwell on them because it'll change again tomorrow.
• I don't worry about them. I do what I can and I let the chips fall where they may. I have enough stuff on my mind every day.
• I control my A1c, but I feel like I have little control over the complications.
Q. How do you decrease the stress and worry that inevitably come with managing a chronic condition?
Dr. Gary: Doing things to keep yourself calm and relaxed helps, whatever that is for you. Getting outside. Relaxation exercises. Talking it out. There is a lot to be said for a good vent. When things build up, sit down with someone who is willing to listen. Let it out. Also, watch your self-talk. Give yourself positive messages, encouragement. You may be dealing with a lot, so get on your own side.
Jewels: Worry is a side effect of the unexpected, which is a hallmark of diabetes. I buy into the concept of quiet time. I harbor most of my worry around my daughter's diabetes, not my own.
• I start every day with a refocus on the things I have to do that day to stay healthy.
• Stress is a feeling of inability. Developing confidence and accepting facts decreases worry and stress.
• Take a deep breath. And always remember to do what you can. If something is out of your control, you can't do anything about it.
Q. When I have a positive visit with my healthcare provider, the dialogue goes like __.
Dr. Gary: It means so much when the doctor gives you an attagirl/attaboy and tells you to keep up the good work. Of course, this isn’t all about pleasing your doctor. But if you respect their opinion, their acknowledgment means a lot. My clients also tell me how much they appreciate basic information and straightforward facts and advice. They want to hear: “here’s what to do.”
Jewels: “You're so healthy and are taking such great care of yourself. Be proud.”
• “Things are looking good, but here are some more places you can improve.”
• It starts with “we”
• An acknowledgement of how well I'm doing followed by suggestions to do even better. I'm my own expert, but sometimes I need a boost.
Q. Describe a time when a healthcare provider created worry for you. What would have improved your interaction?
Dr. Gary: My clients tell me sometimes the doctor seems concerned but doesn’t explain why. This leaves questions with the patient. It seems to me that inadequate information leads to worry. Doctors are often in a hurry, and don’t take time to fully explain.
Jewels: My favorite provider words are: "I'm here for you and we will get through this together."
• Doctors are under a lot of pressure. But they still need to take at least a few minutes to read your records before they make some decisions.
• An ophthalmologist once created worry before he actually looked at the backs of my eyes. We had a little talk and he got it.
Q. When someone said __ to me, it helped me to cope better with diabetes-related worry and stress.
Dr. Gary: It’s amazing how far a few words of kindness and support can go toward helping someone to feel less stressed out/more hopeful.
Jewels: “The future is bright and diabetes won't stop you from accomplishing your dreams and aspirations.”
• “You’re doing great.” And “I don’t think I could manage what you do on a daily basis.”
• I read about the devastating effects of worry and stress. Then I realized that diabetes may not be toxic—we may be making it lethal.
• "You can do this on your own and don't need me. But if you do, call"
Thanks to Dr. Gary and Jewels for their insights. Join this conversation by commenting below, join our next Q&A via Twitter on Tuesday February 14, 2017 at 9:00 p.m. ET using the hashtag #DCDE.