Dr. Jen's Diabetes Diary

As a Clinical Psychologist who has lived with diabetes for more than 25 years, I’m here to give you permission to find life with diabetes difficult. The demands of living with diabetes have been likened to a job; in which you work 24 hours a day, 7 days a week, 365 days a year with no break, no holiday, no reward, and no praise. I’m not sure about you, but I wouldn’t stay in a job like that for very long! However, the person with diabetes has no choice but to deal with these demands each and every day, perhaps all the while being told, “It’s only diabetes. What’s the big deal?”

However, you and I know the real story. Dealing with diabetes involves daily challenges, frustrations, and stress. Diabetes doesn’t just affect your body, it affects your emotions and mind too. It’s little surprise then that depression is very common among people with diabetes (two to three times more common in fact). But the good news is there are LOTS of ways to overcome it, too many to mention in this e-zine!

One excellent three-step strategy I ask my private clients to do to improve their mood is to increase the activities that give them a sense of pleasure and those that provide a sense of achievement. To feel good about your life, you must experience these two aspects to your activities, but when you are depressed, both of these are at risk. Depression means you are prone to not feeling like you want to engage in the activities that give you pleasure and tasks that involve a certain level of mastery or achievement tend to feel difficult to do.

So how do you find out which activities bring you pleasure and achievement?

Step 1: Fill in an Activity Diary

You will find an example Activity Diary below. Each hour of your waking day has a slot, for you to fill in everything that you do.

Example Activity Diary

Your Activity Diary

Step 2: Assess Your Levels of Pleasure and Achievement

Give each activity a rating for both pleasure and achievement. Score the activity on a scale of 0-10, where 0 is no pleasure/achievement at all and 10 is the most pleasurable/challenging task you could imagine doing. So each activity should have 2 numbers P=? and A=? Do not spend time wrestling too much between ratings (e.g., “Am I a 6 or 7?”). Just go for the figure that feels most appropriate.

Step 3: Increase Your Levels of Pleasure and Achievement

To do this, ask yourself the following questions:

1. Did my activities affect my mood? How?
2. What activities helped me feel better? Why?
3. What activities helped me feel worse? Why? Are these activities in my best interest to do?
4. Were there certain times of the day (e.g., mornings) or week (e.g., weekends) when I felt worse?
5. Can I think of anything I could do to feel better during these times?
6. Were there certain times of the day or week when I felt better?
7. Looking at my answers above, what activities can I plan in the coming week to increase the chances that I will feel better this week?

By being aware of and increasing the levels of pleasure and achievement in your life, you will feel more in control of your mood and the frustrations of diabetes will be less all-consuming.

Are you interested in learning more strategies about how to overcome depression, including the one simple change that will dramatically improve your mood right away? I’ve developed a brand new audio course that teaches you the precise ways you can overcome depression and burnout. To find out more, please register your interest at info@positivediabetes.com and a member of my team will be in touch! Life is too short to keep struggling on your own. I know, I’ve been there — I’d love to help you too.

You may use this article on your website, or for your own e-zine; however, there's one thing you MUST include: Dr. Jen Nash is a Clinical Psychologist registered with the British Psychological Society. Dr. Jen helps her clients find solutions with simple and highly-effective psychological strategies to gain freedom from the frustration and stress of living with diabetes. To sign up for her free Diabetes Diary, visit www.PositiveDiabetes.com.

Dr Jen Nash, Clinical Psychologist, www.PositiveDiabetes.com

With Valentines Day fast approaching, your thoughts may be turning to your
nearest and dearest. Have you considered how your diabetes is affecting your
close relationships – with your spouse, partner and those in your wider family
network?

Diabetes can cause a great deal of anxiety – often a lot more in those
around the person with diabetes rather than the diabetic themselves. This is
perhaps because while the person with diabetes is busy taking the lead with
their diabetes self-care, those alongside them are left with nothing they can
actually ‘do’ – and no way to discharge this anxiety.

This anxiety can express itself in a variety of quite contrasting ways. The two
most common are:

feeling blamed or hassled by your family; or the opposite
feeling isolated and/or unsupported by those close to you

You may feel that those close to you are observing you at every turn –
checking what you are eating and how much attention you’re paying to your
medication and exercise regimes.

Perhaps they criticise you for being overweight, or berate you for not keeping
good blood glucose control, which can feel very blaming. Or maybe they
seem to feel the need to ‘advise’ you at all times – which can feel more like
lecturing than helpful suggestions. Or perhaps they seem to tell everyone
you meet that “He/She’s diabetic, they can’t eat that” drawing everyone’s
attention to the ways in which you are ‘different’, when all you want to do is
blend in like everyone else. Or possibly the opposite is true and your loved
ones completely ignore your diabetes, leaving you feeling alone and isolated
without the help you would like to support yourself.

Whatever way diabetes is affecting your close relationships, here are my top
tips to help you better manage.

1. Start talking

For most people for whom diabetes is causing a strain on a relationship the
problem doesn’t get talked about in an open and straightforward way, rather
it becomes a source of arguments or resentments. The first step in making a
positive change is therefore to have a frank and honest conversation and get
things out in the open. If you and your loved one regularly argue about your
diabetes, this may mean you need to think about what to say beforehand so
it comes across as calmly as possible. Try stating what you are unhappy with
in a matter of fact way (e.g. “When you…..describe what they say or do, “it
makes me feel…..insert emotion – upset, guilty, embarrassed etc”) Make
clear that you don’t want to blame them, rather that you realise they love you

and are trying to help, but there might be more useful ways they can do so if
you think about it together.

2. Tell them how to help you

Be clear about what you really want and need from your partner. For example,
perhaps they are nagging at you to test your blood glucose more, when what
would really be helpful would be if they praised and encouraged you with a
smile and a hug when they did notice you test. Or perhaps they are berating
you for your need to lose weight, when what would be really helpful would
be if you could learn together how to prepare healthy meals, perhaps by
researching some cookery books or going to a class together.

3. Examine the part you are playing

Are you taking responsibility for your diabetes self-care? Often those around
you may see that you are ‘sticking your head in the sand’ about your diabetes
care and may feel at a loss to know what to do to help. Nagging or hassling
you may be the only way they know how to wake you up to the problem.
Perhaps you always say, “I’m fine” when asked about your diabetes, even
if it’s evident that all isn’t fine. Out of love and worry the person close to you
wants to help you to change. By being honest with yourself and those around
you about what you are struggling with, you can begin to take steps together
to improve your diabetes health, avoiding the need for your loved one to
resort to unhelpful nagging behaviour.

4. Seek professional help

If you have implemented the steps above and are still struggling, perhaps
because it is difficult for one or both or you to keep calm or to see one
another’s point of view when talking about diabetes, seeing a family therapist
or counsellor can really help you have useful conversations. Often having a
third, emotionally uninvolved person to listen and help you problem solve can
really help you move forward together productively.

By following these steps above, both your relationships with those close to
you and your relationship with diabetes will improve for the better. Now the
only thing left to do is figure out how to spoil your loved one this Valentines
Day!