• Please Remember: Members are only permitted to share their own experiences. Members are not qualified to give medical advice. Additionally, everyone manages their health differently. Please be respectful of other people's opinions about their own diabetes management.
  • We seem to be having technical difficulties with new user accounts. If you are trying to register please check your Spam or Junk folder for your confirmation email. If you still haven't received a confirmation email, please reach out to our support inbox: support.forum@diabetes.org.uk

Psychological Support

TrevorMorgan

New Member
Relationship to Diabetes
Type 2
Pronouns
He/Him
Hello there

I have just read an article in the Balance magazine by Niall Anderson about psychological support. It is a very good article about the support for a diabetic which should not just be medical but a psychological condition too. All very well and good but how much psychological support did you get when you were diagnosed? I suggest very little unless you went private. I was lucky my wife, especially, and the extended family all supported me. Others may not be so lucky especially if they live alone.

It's my opinion that everyone is given support before they get diabetes and we should all change our mental attitude to it.

Recently, I watched, on television, old film footage from the VE celebrations in London in May 1945. Everyone was cheering, climbing telegraph poles or waving from the roof tops. The peace was not the only thing that they had in common: they were all slim , some would say skinny. T2DM was almost unheard of owing to poor diagnosis but mainly because no-one was malnourished. Nearly everyone ate wholesome food which they cooked themselves. They did not eat too much. They also exercised by walking their kids to school instead of driving them because most did not have cars. They walked to the posting box instead of driving.

Most of those cheering people would be regarded as deprived of food these days. No doubt they were stressed, but T2DM was rare.

From the 1970's, onwards T2DM started to take over as the primary form of diabetes. What caused it? I suggest that we all got used to excesses; too much food in general, too much junk food, too much lounging about watching television, not enough exercise.

When I look at my own case, in 1972 I was 178 cms and weighed around 61.5 kg. Nowadays after being diagnosed with T2DM I have had to go back to my 1972 weight to have any hope of achieving remission.

Most of my working life I travelled for my job and stayed in 5 star hotels and ate like a king, I had to work hard but i didn't have time to exercise hard. My weight went up to about 85 kg and most of it was around my tummy. I realised this when, one morning, in a five star shower I looked down and couldn't see my penis properly! My paunch was too big.

When I stopped travelling I followed NHS advice and got my weight down to 76 kg and luckily I could see that my penis was still there. I started jogging and walking again sometimes running 10 k per day. All of this was to no avail; the damage had already been done. The seeds of T2DM had been sown along with a genetic pre-disposition for pre-diabetes. Many people much heavier and, should I say, fatter than me do not get diabetes - so good for them and good luck. I think that my exotic and sometimes excessive lifestyle, which some were envious of, got the better of me. I did not, in my opinion, eat too many potatoes compared to some of my friends and family who quite often scoffed more than I did. Obviously, I did eat too many potatoes even organic ones and one croissant a week too many.

What has this got to do with psychology you may ask? Well, NHS advice tells you not to eat too much sugar, etc. It tells you that if you are overweight or obese then lots of nasty health problems will be conferred on you. Who wants to be told they are obese - it's an insult. Who wants to be told what to do, I don't as I am responsible for my own health. I want to be educated and told the facts and then make my own mind up, surely that is the responsible thing to do from a psychological point of view. I did not know that it is visceral fat that is the danger coupled with a genetic pre-dispostion - in my case. Had I known the full facts then I could have taken remedial action to prevent this cursed condition. Is personal health on the school rubric to educate our children?

While we are on the subject, I am constantly being told by many in the medical profession that I am too thin and what would happen if I had to go in for an operation? It does not help me, mentally, to be told that I am too thin especially by the medical profession; only my GP has told me that I am not too thin. I am not under nourished and all my health check readings are now good except for my Hba1c which indicates that I have the blood glucose levels of a pre-diabetic, no I don't, as I am a diabetic and will remain so.

Many days of the week I weigh out my rolled oats for breakfast; 37 grams with 60 ml of whole milk plus water is around 30 grams of carbohydrate. I can do weight exercises after eating this and do 10 minutes stepping indoors and then run 6 k and come back home without feeling that I don't have any energy left or that I need a snack. My diabetic diet and slim weight have improved my resilience no end. Before I was diagnosed I would eat two large slices of brown bread and a large banana for breakfast before I attempted a run, after my jog I then had to snack on a couple of biscuits or a croissant to get my energy "back : some would not consider this to be excessive but for me it was. The result was T2DM.

It does not help my psychological health to be told by my friends that I should put a bit of weight on - I don't need to. I explain what would happen to me , as I would be back on Humulin again in no time. Often I see some of my friends and family eat too for their own good. I see some of the diabetics and pre-diabetics stuffing their faces just like I used to some time ago. I often feel like saying something to encourage those pre-diabetics or potential ones to stop eating too much and being excessive , but i keep my opinions to myself unless I am asked. Perhaps, I should be psychologically more forthright. The diabetic epidemic is upon us and we all have a responsibility to try to arrest it and reverse it. The government and the NHS are getting nowhere with this, so it is probably up to individual and communal action, at a level much closer to society in general, to find a solution.





mcuh
 
I’ve been seeing the importance of psychological support for people living with long-term conditions like diabetes gradually gaining momentum over more than a decade. It now seems to be much more of a staple part of paediatric diabetes care, and young people’s diabetes services, which is really great.

However I’m not sure it is breaking through all that effectively into adult care, and certainly remains a rare thing in primary care settings. Not least because of the pressures those services are under, and because of the relative scarcity of suitably trained clinicians who have the skills in psychological support in the specific context of diabetes.

As for healthy eating advice, and what is taught in schools - the messaging really hasn’t found a way to break through. Healthy eating advice has been very consistent since I was a child: not too much sugar, go easy on junk food, eat lots of fruit and veg, generally better to have home cooked than convenience/packet.

But the environment in which we live is voracious. And the food industry / takeaway industry / supermarkets guard their market share and profits jealously, and with vast marketing budgets.

We know what we should be eating. But there is so much temptation to eat and enjoy other things.
 
i have been given such support by my diabeties team im lucky to do so however i also have MH issues as well and dont know if this tipped the balance inmy way
 
When I look at my own case, in 1972 I was 178 cms and weighed around 61.5 kg. Nowadays after being diagnosed with T2DM I have had to go back to my 1972 weight to have any hope of achieving remission.
I found this part an interesting discussion. in 1971 I was 165cm and weighed 59kg. My doctor told me I was 6.5kg overweight, and indeed I was fatter than all my friends, a size 16. Nowadays, that would have been a BMI of 21.2 and he wanted me down to 18.1. All my life I have had my weight rammed down my throat by doctors. Psychologically it has affected me, making me reluctant to go to the doctor to be told the same old thing over and over again, no matter what, and to follow a yo-yo low fat and now low carb diet.
Now being diabetic and in need of a new hip, I MUST try and lose weight, but all I got offered was inappropriate fat busting pills. I'm aiming for 67kg which is just inside the normal BMI range but it's oh so slow progress.
 
I cannot repeat some of the things said to me about my ability to gain weight on quite small amounts of food if it is low in fat and high in carbs.
It began when I was a young adult, having left home and got married I was subjected to a constant barrage of the same information - that what I reported eating could not be possible. I had the same thing for almost half a century. I did really well on Atkins but it was described as a dangerous fad diet, despite me feeling and doing so much better on that way of eating.
Last year I tried a low calorie option - the slim shakes from Tesco and a small meal - two months in I had a blood test and my HbA1c was higher than expected, higher than for the 7 years prior to that.
After that result I tried to go back to what had become normal, but it seems impossible - and my waist has expanded from a year ago. My warm weather garments are tight.
I have had no support at all from my GP clinic - perhaps because I was successful on low carb, and have not failed to point out just what a state I was in when diagnosed, thanks to all the good advice on what constituted a healthy diet.
 
As a child i had a skinny brother and sister. I would always have second helpings if available. My brother and sister would look at me scornfully and say they had had enough. We liked cycling, climbed trees and played hopscotch. I left school still plump but now it is positively skinny. I was 8st 10 and 5 foot 5 with a 26 inch waist. My younger sister who was taller than me weighed less. I started putting on weight with a stressful job and an early menopause. Half heartedly tried the F plan diet. I knew about sugar and calories but didn't realise about carbs.
I wish the surgery had suggested a low carb diet when I was diagnosed with high blood pressure. I was close to 14 stone 90 kg. Each year I had a blood test and was weighed. I was ashamed of my weight. I did make sure it didn't increase. I discovered they hadn't tested my annual blood for diabetes since 2014 when I was called in about increasing cholestral. I asked for a diabetes test and started actively reducing wrong food. It was 69 and four weeks later 64. There is no family history of diabetes. I did ask the hcp why as a fat 70 year old with hypertension I hadn't been tested for diabetes. The hcp said I shouldn't be calling myself fat! In an email he expressed surprise that I appeared shocked at the 69 reading. Did I feel supported? Absolutely no way. I live on my own and was often sad. I did start losing weight by changing my eating. I'm very close to the weight I was when the menopause hit when I was 41 and want to lose a lot more. The advisors on diabetes UK and later the forum has been tremendous support.
 
Hello there

I have just read an article in the Balance magazine by Niall Anderson about psychological support. It is a very good article about the support for a diabetic which should not just be medical but a psychological condition too. All very well and good but how much psychological support did you get when you were diagnosed? I suggest very little unless you went private. I was lucky my wife, especially, and the extended family all supported me. Others may not be so lucky especially if they live alone.

It's my opinion that everyone is given support before they get diabetes and we should all change our mental attitude to it.

Recently, I watched, on television, old film footage from the VE celebrations in London in May 1945. Everyone was cheering, climbing telegraph poles or waving from the roof tops. The peace was not the only thing that they had in common: they were all slim , some would say skinny. T2DM was almost unheard of owing to poor diagnosis but mainly because no-one was malnourished. Nearly everyone ate wholesome food which they cooked themselves. They did not eat too much. They also exercised by walking their kids to school instead of driving them because most did not have cars. They walked to the posting box instead of driving.

Most of those cheering people would be regarded as deprived of food these days. No doubt they were stressed, but T2DM was rare.

From the 1970's, onwards T2DM started to take over as the primary form of diabetes. What caused it? I suggest that we all got used to excesses; too much food in general, too much junk food, too much lounging about watching television, not enough exercise.

When I look at my own case, in 1972 I was 178 cms and weighed around 61.5 kg. Nowadays after being diagnosed with T2DM I have had to go back to my 1972 weight to have any hope of achieving remission.

Most of my working life I travelled for my job and stayed in 5 star hotels and ate like a king, I had to work hard but i didn't have time to exercise hard. My weight went up to about 85 kg and most of it was around my tummy. I realised this when, one morning, in a five star shower I looked down and couldn't see my penis properly! My paunch was too big.

When I stopped travelling I followed NHS advice and got my weight down to 76 kg and luckily I could see that my penis was still there. I started jogging and walking again sometimes running 10 k per day. All of this was to no avail; the damage had already been done. The seeds of T2DM had been sown along with a genetic pre-disposition for pre-diabetes. Many people much heavier and, should I say, fatter than me do not get diabetes - so good for them and good luck. I think that my exotic and sometimes excessive lifestyle, which some were envious of, got the better of me. I did not, in my opinion, eat too many potatoes compared to some of my friends and family who quite often scoffed more than I did. Obviously, I did eat too many potatoes even organic ones and one croissant a week too many.

What has this got to do with psychology you may ask? Well, NHS advice tells you not to eat too much sugar, etc. It tells you that if you are overweight or obese then lots of nasty health problems will be conferred on you. Who wants to be told they are obese - it's an insult. Who wants to be told what to do, I don't as I am responsible for my own health. I want to be educated and told the facts and then make my own mind up, surely that is the responsible thing to do from a psychological point of view. I did not know that it is visceral fat that is the danger coupled with a genetic pre-dispostion - in my case. Had I known the full facts then I could have taken remedial action to prevent this cursed condition. Is personal health on the school rubric to educate our children?

While we are on the subject, I am constantly being told by many in the medical profession that I am too thin and what would happen if I had to go in for an operation? It does not help me, mentally, to be told that I am too thin especially by the medical profession; only my GP has told me that I am not too thin. I am not under nourished and all my health check readings are now good except for my Hba1c which indicates that I have the blood glucose levels of a pre-diabetic, no I don't, as I am a diabetic and will remain so.

Many days of the week I weigh out my rolled oats for breakfast; 37 grams with 60 ml of whole milk plus water is around 30 grams of carbohydrate. I can do weight exercises after eating this and do 10 minutes stepping indoors and then run 6 k and come back home without feeling that I don't have any energy left or that I need a snack. My diabetic diet and slim weight have improved my resilience no end. Before I was diagnosed I would eat two large slices of brown bread and a large banana for breakfast before I attempted a run, after my jog I then had to snack on a couple of biscuits or a croissant to get my energy "back : some would not consider this to be excessive but for me it was. The result was T2DM.

It does not help my psychological health to be told by my friends that I should put a bit of weight on - I don't need to. I explain what would happen to me , as I would be back on Humulin again in no time. Often I see some of my friends and family eat too for their own good. I see some of the diabetics and pre-diabetics stuffing their faces just like I used to some time ago. I often feel like saying something to encourage those pre-diabetics or potential ones to stop eating too much and being excessive , but i keep my opinions to myself unless I am asked. Perhaps, I should be psychologically more forthright. The diabetic epidemic is upon us and we all have a responsibility to try to arrest it and reverse it. The government and the NHS are getting nowhere with this, so it is probably up to individual and communal action, at a level much closer to society in general, to find a solution.





mcuh
I'm a Clinical Psychologist - although I don't specialise in Diabetes. We have a saying: 'Parity of Esteem'. That is, we believe that psychological health needs to be taken as seriously as physical health. Certainly I think that psychological support needs to be available on the NHS to everyone diagnosed with Diabetes (even though often it isn't), given how significant an impact it has on our lives.

However, that psychological support doesn't necessarily have to mean lots of sessions with a psychologist or counsellor. For example, when I was in hospital a few years ago after a bad accident on my bike, the Mental Health Nurse attached to the trauma centre that I was in asked me a crucial question: "What is it about you that will slow down your recovery?". I was able to reply, "My competitive nature, as I'll want to recover quicker than anyone else!". The Nurse pointed out that that tendency could be dangerous, as trying to rush my recovery (by trying to make do without painkillers, for example) would put me at risk of complications such as pneumonia, which would be extra dangerous for someone with Diabetes.

So, perhaps the most important thing is for everyone involved in the physical care of people with Diabetes to have training in the psychological impacts of the condition(s).
 
Sorry Cliff - that's made me grin! I too am an impatient patient - never want to be in hospital since certainly on eg an orthopaedic ward such as I was on when I smashed my patella - pretty clueless about the overall requirements of a Type 1 diabetic. Huge example is knowing 100% my BG was not only sky high but so were my ketones so I needed to constantly drink water but also pretty constantly pee that water out, hopefully with some ketones to get rid of those buggers. With a plaster cast from my toes to my thigh, this meant bedpans - and female bedpans are now about an inch deep ......... useless - but that desperate to pee by the time I got one, thought sod it, will take too long to explain - you'll have to clean it up. One of the day shift did understand and off her own bat 'I've brought you one you can sit on properly!' 'Brill thanks, could you possibly just hold it steady on the bed whilst I hotch my bum onto it, please? They don't stay where they are now they're not stainless steel, do they!?' :rofl: (Biodegradable ?? reformed paper pulp.)

I always need the confidence reiterated that I still heal as well as a non diabetic.
 
Sorry Cliff - that's made me grin! I too am an impatient patient - never want to be in hospital since certainly on eg an orthopaedic ward such as I was on when I smashed my patella - pretty clueless about the overall requirements of a Type 1 diabetic. Huge example is knowing 100% my BG was not only sky high but so were my ketones so I needed to constantly drink water but also pretty constantly pee that water out, hopefully with some ketones to get rid of those buggers. With a plaster cast from my toes to my thigh, this meant bedpans - and female bedpans are now about an inch deep ......... useless - but that desperate to pee by the time I got one, thought sod it, will take too long to explain - you'll have to clean it up. One of the day shift did understand and off her own bat 'I've brought you one you can sit on properly!' 'Brill thanks, could you possibly just hold it steady on the bed whilst I hotch my bum onto it, please? They don't stay where they are now they're not stainless steel, do they!?' :rofl: (Biodegradable ?? reformed paper pulp.)

I always need the confidence reiterated that I still heal as well as a non diabetic.
Unfortunately I don't heal as well (or at least as quickly) as a non diabetic :(. Still, it just means that I have to take extra-good care of my health and fitness 🙂.
 
So, perhaps the most important thing is for everyone involved in the physical care of people with Diabetes to have training in the psychological impacts of the condition(s).

Quite right @CliffH

Treating the *whole* person is so important!
 
I have had at times quite serious ....hospital section ....mental health problems

My diabetes is without a shadow of doubt related to my emotional eating

Its only now after 3 years since diagnosis that my psychiatrist has referred me to the eating disorders unit but hes already told me that as I don't vomit or starve myself I will unlikely get much input

I think that's understandable given the fact that there are some seriously ill people battling with awful weight problems ....very very thin or very very large .....but its really annoyed me that its taken this time to be told , essentially......I am on my own

As for long term psychological input ......please stop kidding yourselves .....unless you have the money ....its simply not there on the NHS .......FACT ......as someone who has been at various points under the care of the mental health team its a case of a psychiatrist .....occasionally ....a nurse or support worker if you are very lucky for a year or so ......then its back to your GP .....and if you get unwell again ......back through the revolving door

There is NO long term psychological support on the NHS .....even though we know intensive and then regular " touch base " input is soooo important in keeping well and preventing relapse .....my psychiatrist reckons most of his patients either struggle with eating or are diagnosed with a non specific or specific eating disorder

I just accept , in terms of my mental health , that's the way it is these days . Even people with clear signs of PTSD following abuse , military conflict , trauma of accidents etc have to wait two years , sometimes more , for intervention .....in the meantime being kept head above water by their GPs .....its disgraceful but will never ever change , ever

I have so much respect for the local charities who try to offer a safety net for those who suffer but the vast majority of politicians and government organisations and even the NHS are full of it with regard to mental health support

My local GP surgery about 5 years ago had a big song and dance about the employment of mental health nurses during office hours ......I thought great , a regular opportunity to pull up a chair , chat and reduce the load on the mental health teams but still be monitored ?

Nope you have to book up a month in advance and are lucky to get a chance to do that as the receptionists ask intrusive questions that are in no way asked about physical issues .....once you do eventually get a slot its never a face to face .....soooo important for those with mental health difficulties to speak, in person to a supportive clinican .....but a 15 to 20 minute chat .....lol ....to just get told the NHS don't offer long term psychological support and this isn't the role of this service .......

So ultimately apart from a yearly check up , if you are lucky , I just don't bother with the psychological joke of a service offered in this country .....6 sessions with a counsellor at the gp surgery .....9 month waiting list ....very important that they are ....is great for someone going through a bereavement or relationship breakdown or job loss or retirement.....but not long term need of psychological support .....

These days I have developed a great relationship with my local MIND ......and when I just need to talk I phone the Samaritans or one of the more specific anxiety or depression related helplines .....its not ideal but its far better than wasting my time expecting any realistic help from the NHS ..it simply isnt there and I wish those in charge , including the politicians, would just come out and say it ...sorry , no money , no resources , phone the samaritans or pay privately

Mental health .....and in this case , psychological intervention .....is the most woefully underfunded of all the NHS branches

My lovely , kind mum after retirement would do lots of volunteer work for British Heart Foundation , Cancer Research etc but without being offensive to anyone out there afflicted by those conditions if you open a MIND centre on your average high street its hardly got people rushing through the doors wanting to offer their time or hand over donations

To sum up ....sorry for the long post.....I hope those that search for help for the emotional side of diabetes and the snakes and ladders , viscous circle of it all find it but I have given up trying to wake up a bear that's forever sleeping
 
Back
Top