Anxiety and Grief

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My phone client Roscoe was diagnosed with Type 2 diabetes three years ago. He’s doing well, with an A1C of 5.9. “But I’m still scared,” he told me. “And I’m still sad. Do these feelings ever go away?”

I don’t get that question very often. Not because people don’t have those feelings, but because they’re afraid to bring them up. I give Roscoe credit for being brave enough to ask, but what should I tell him?

Let’s face it: Even well-controlled diabetes brings loss (grief) and fear of loss (anxiety). We may lose our sense of ourselves as being healthy; as being people who never have to check blood sugar levels or take medicines; who are free to eat whatever we want, whenever we want it.

If diabetes is not entirely controlled, we may lose energy and feel fatigued. We may have mild symptoms like blurry vision or numbness. Complications bring worse symptoms and losses, as many of our readers know too well. All these things hurt emotionally. They will make us sad sometimes and can easily push us into depression.

Like all chronic conditions, diabetes also brings fears about the future. Fear of complications causes worry, which can raise blood sugar and blood pressure levels.

Diabetes brings other anxieties, too. Will we have enough money, will we be able to keep our job? Will we still be attractive to others? Will we still be able to do the things that are important to us?

People with diabetes, like almost every adult in the world, have other losses and fears that have little to do with diabetes. How we deal with those hard feelings means a lot for our diabetes and our quality of life. A life colored by too much sadness and fear will probably not be enjoyable or healthy. Let’s think about how we can cope better with these concerns.

I certainly don’t have all the answers here, although I have researched the issue. That’s why I’m asking for help. What reduces your anxiety, and what comforts you when you need consolation?

• I know that when I worry about the future, the best thing I can do is try to do something about it. If my legs are getting stiffer from my multiple sclerosis (MS), doing more stretches to loosen them makes me feel safer, even if the symptoms don’t improve. If I’m worried about global warming, I can reduce my personal carbon use, educate others, and advocate for better environmental policies. It might or might not help, but doing something about a problem makes you feel better.

So if you’re worried about complications, improving your glucose control, even a little, will make you less anxious. If you are starting to have symptoms, such as numbness in your feet, keeping your feet warm, comfortable, and moisturized, and lowering your A1C may help your symptoms and will reduce your fear.

• In dealing with grief and fears, I think it’s valuable to name them. If you’re like me, you don’t want to dump your feelings and fears on a friend or loved one. I don’t want to make people uncomfortable or sound like I’m whining. Most of all, I don’t want to face the reality of those losses and fears, whether they’re about my own body or others’ or the world. But keeping them inside and unnamed is worse.

Tell someone else or at least write down for yourself the things you are sad about and the things you fear. Cry about them for a while if that helps.

• But don’t obsess about them. Diabetes can consume your whole life if you let it, and that’s not good.

At the beginning and when things are changing (new symptoms, new meds, new relationships, or whatever), pay close attention to keeping good control. But thinking about diabetes 24/7 is not likely to help, in my opinion. Each person has to find the balance that works for him, and that balance may change as circumstances change. A life without fun, pleasure, or relaxation is not likely to be healthy, happy, or very long.

It also helps me sometimes to remember that others have it worse. I may be disabled, but at least I’m not homeless or living in a warzone. That argument doesn’t work for everyone, but remember that diabetes is not the worst thing in the world. There are treatments and self-management tools that can lead you to a healthy, enjoyable life, possibly a better one than you had before diagnosis and better than most people have.

So that’s the best I’ve come up with for my client Roscoe. For me, I manage to be happy most of the time, but some sadness and fear are always present if I look for them. When it comes to coping with anxiety and grief, what practices and strategies work for you? What could you use some help with?

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