Emotional Impact of a Diabetes Diagnosis

When you discover you or someone you know has diabetes, it comes as a shock. It may be devastating at first because diabetes is a disease. The individual experiences more than the physical symptoms. The disease sets off an entire roller coaster of emotional responses.

What are the Typical Emotional Responses?

The response to a diagnosis of diabetes can lead to many different and very powerful emotions. The most typical ones include[1]:

  • Denial – Most individuals go through a period of denial. They simply refuse to believe they have diabetes. They decide there has been a medical error. They tell themselves their doctor has surely made some sort of mistake.

With this emotion comes a sense that if you ignore it, the disease will either go away, or you will be able to deal with it at a later date. The problem with each approach is that it stops a person from taking control of the disease. It refutes the need for taking responsibility to manage the diabetes.

  • Anger – Anger is often a reaction to a diabetes diagnosis. It may be anger you have the disease. It may be anger you have to change your lifestyle to address the issues concurrent with the disease. It may be anger at yourself for not taking care of your health so you would not become diabetic.

This is all very normal. It only becomes a hindrance when you allow it to interfere with your ability to move on to accept responsibility for managing the diabetes.

  • Depression – Individuals who become diabetic often become depressed. It may be the result of feelings of isolation, loneliness or sadness you associate with the disease. It is appropriate to feel blue occasionally, especially when you cannot seem to get a handle on the requirements made upon you by the disease. It is not “normal” to feel hopelessly depressed for weeks on end. This, like anger and denial, will interfere with you coming to grips with the reality of diabetes.
  • Guilt – It is possible to feel guilty when you learn you have diabetes. You may feel guilty because you did not lead a healthy lifestyle. You may also feel guilty because you led a gluttonous life style. Guilt can lead to a more positive lifestyle, but it can also leave you wallowing in a morass of…well… guilt.
  • Bargaining – Everyone has attempted to bargain with themselves over something. The pattern is simple. If I do this, then maybe this will happen. While being helpful in getting you to reevaluate the current lifestyle you lead, the bargain you should be making is this: I will do everything possible to manage my diabetes in exchange for good health.
  • Acceptance – This is the final stage of the emotional gamut if it progresses in a normal fashion. Acceptance arrives after you have passed through all the other feelings and have decided you need to find out more and deal with it. It is the “responsible” stage. It is the stage that will help you take control of the situation and move forward.[2]

These types of emotional reactions may appear in different forms among younger children. While it is best to deal directly and truthfully with them, it may fall upon older children and other members of the family to help the younger child understand what is happening.

Adult Responses to a Diagnosis of T2DM

The diagnosis of T2D set off a whirlwind of emotional stress. The nature of the disease indicates the need for a revision of your current life style. Even your approach to simple matters may need to be addressed and altered if not changed all together. It is at this point, following acceptance, that the individual needs to get support from all facets of his life for all facets of the disease.

In order to step into the driver seat, rather than be a passenger, the individual needs to adopt a process of behavioral change as part of the strategy of therapy for T2D. This involves looking closely at 3 specific aspects or components of change. They are: choices, control and consequences. The adult needs to be fully engaged in what may be a major revolution of their lifestyle.  Behavioral change includes actions like separating from unsupportive family and friends for a while; eating alone until change in habits is complete; staying away from some people at work who like to tempt you with poor food choices; and so on. Behavioral change requires a level of support that most people have never requested or required before.[3]

Choices

It is up to the individual patient to accept the diagnosis. You must adapt and adopt the right attitude. It is about accepting the need to do whatever it takes to take control of your life. Only you can decide to take the tests recommended. Only you can make the decision to see the specialists and actually listen and understand what they are saying and, more importantly, accept and adopt their recommendations. Life may become a constant round of choosing one thing over another. Choice is a part of life. You simply need to make the right choice that will help you manage your diabetes in the best fashion possible.

Control

Exercising control is an important part of any form of diabetic therapy. You need to take control of what you eat, drink and do with your body. Only you can do this. No one else can force you to follow all the new regulations.

Consequences

Strategy is about knowing the consequences of your actions. You need to be completely aware of what will happen if you do not follow the recommendations of your medical team. For example, unmanaged diabetes can lead to a loss of eyesight or legs. Both are possible. Remembering this is a positive deterrent to some people. It may prove ineffective with others. Reinforcing the positive consequences of following through on your lifestyle changes may work better. Consider the benefits of an improved lifestyle. They include:

  • Weight loss
  • Improved self esteem
  • The ability to really appreciate life and what it has to offer
  • Better health

The Need For Emotional Support

It is not possible to stress enough the emotional support needs of any individual receiving a diagnosis of diabetes. Sympathy is not enough. Sympathy may actually promote a negative response, as will statements like, “Well, it could be worse.”  In the mind of the diabetic, the diagnosis is terrible enough. Studies prove the necessity of emotional support, even if it comes from peer groups on the internet.[4]

At times, all a diabetic may require is someone to listen. Good, practical advice is a bonus, but it is the listening skill that will help the most. It indicates that someone does care and is willing to stay a friend, companion or partner, no matter what goes wrong. Research has indicated how emotional support prevents the incidence of depression in those with T2D.[5]

Conclusion

A diagnosis of diabetes can lead to a gamut of emotions. There are stages of denial, anger, guilt, bargaining, depression and, eventually, acceptance. If you are to control the disease and not let the disease control you, you will need both physical and emotional support. The support you get from your medical team, family and friends will go a long way towards ensuring you do not let diabetes get the best of you and your life.

References

[1] American Diabetes Association (2009). Type 2 Diabetes. Your Healthy Living Guide. Alexandria, VA: ADA.

[2] Meltzer, SJ; and Belton, AB (2009). Diabetes in Adults. Toronto: Key Porter Books.

[3] Masharani, U (2008). Diabetes DeMYSTiFieD. New York: McGraw Hill.

[4] van Dam, HA; van der Horst, FG; Knoops,L. Ryckman, RM;  Crebolder, HFJM;  and van den Borne. BHW (2005) “Social Support in Diabetes: A Systematic Review of Controlled Intervention Studies.”  Patient Education and Counseling, 59 (1):1-12.

[5] Egede LE, Osborn CY (2010). “Role of Motivation in the Relationship Between Depression, Self-Care, and Glycemic Control in Adults with Type 2 Diabetes.” Diabetes Education, 36(2):276–83.

This article was originally published July 12, 2012 and last revision and update of it was 9/10/2015.