The psychological effects of living with Diabetes Mariella Meachen D.N.O. B Psych Hons. Psychotherapist ECP Holder
Aims & Objectives To understand how diabetes affects the whole person To become aware of how living with diabetes is an ongoing process of emotional healing To become aware of the different emotions that are experienced as part of the grieving process To highlight the importance of psychosocial support/ counselling/ psychotherapy as part of the treatment for persons with diabetes
Like in all chronic/ progressive diseases living with diabetes can be extremely challenging We need to pay attention to the: Physical aspect Psychological aspect Social aspect Spiritual aspect
Being diagnosed with diabetes is a major life stress and therefore it requires dealing with psychological challenges: Grief Denial Anxiety Depression Shame Guilt
GRIEF 1. That follows being diagnosed as a diabetic 2. Grieving day to day losses 3. Grieving at the onset of complications
Grief cont Then Emotions most likely to accompany the initial feeling of disorientation are denial and anxiety. Later, depression becomes more prominent.
Denial is: A common reaction to chronic illness A defence mechanism by which patients avoid the complications of an illness A subconscious blocking out of the realisation of the actuality and implications of the disorder
Denial cont The patient may act: As if the illness is not serious As if it will go away shortly As if it will have no long term complications In extreme cases the patient may deny that he/she has the illness.
When is denial beneficial and when is it not? Denial is useful in helping patients control their emotional reactions to illness. Denial will probably interfere with: the patients ability to monitor their conditions their ability to take initiative in seeking treatment their ability to follow through when they must act responsibly to co manage their illness
Denial cont.. Questioning reality: Is it true? Am I really a diabetic? Moving inwards to search understanding: How did this happen? Could anything have prevented it?
Denial cont Then the finality of the loss gradually sinks in This indicates the beginning of the healing process All the feelings that were denied begin to surface.
Anxiety Anxiety is common at diagnosis and intermittently throughout the course of diabetes.
Anxiety cont Factors that cause anxiety: Anticipating lifestyle changes Sudden realisation of one s mortality and vulnerability Dependency on health professionals Knowledge of possible long-term complications Fear of the future Hypoglycaemia Personality
Depression Depression is common and often a debilitating reaction to chronic illness. Sometimes depression may be a delayed reaction to diabetes because it takes time for patients to understand the full implications of their condition. Assessment of depression can be problematic.
Shame & guilt are two major forms of negative reaction to the self Shame is the feeling that accompanies the experience of being not ok and/or not enough Guilt is the feeling that accompanies the experience of doing something bad, of hurting someone, of breaking some moral or legal code
I want to highlight: 1. The importance of providing a service which offers psycho-social support 2. How we refer patients to a psychosocial service 3. How to help our patients to take diabetes seriously & actively, but not fearfully
Specific issues that are addressed in psychosocial support/ counselling sessions: Focus on what the disease means to the client Responsibility Stress management Anxiety Difficulties adhering to diabetes treatment Interpersonal difficulties Working with shame/guilt Increasing patients support system
Thank you for your attention