Successful strategies so far in dealing with depression and Diabetes

[SB2015]

I found it tempting to hide away over the last couple of months.

After 9 years of Diabetes I finally hit a wall as HbA1c reached the mid 40s and so no longer improved, spinal stenosis gave me numb feet over night, an MRI showing lesions on the brain and I watched my Mum die of Dementia. Depression descended.

Thanks to Rosie on here I eventually asked for help, but there was a one year waiting list for any talking therapies. I was able to pay for counselling and I thought I would be up front about some of the strategies that I have already found helpful in the hope that these may be of use to others. I know that there a lots of people for whom these will be unnecessary but if it helps some others then It is worth posting these.

Recognising the impossibility of perfection.
I had set myself unrealistic targets and was getting frustrated with the highs and lows of normal life with T1 which I was seeing as failures.

A strategy I found very helpful was to start to log events of hypers and hypos and to record the reason for these where possible, strategies available to overcome the problem another time, and to record whether this event was in my control, beyond my control or a combination of the two. It may sound simplistic, but I was amazed how many events I was beating myself up for which were beyond my control.

A useful piece of homework that made me reconsider my view of how I was managing.

More to come. I hope that it helps someone.

 

[stephknits]

Thanks for this, a really useful suggestion already. I'm sure many of us will find this of benefit, even if not depressed, we all go through ups and downs and are liable to get diabetes burn out at some point. 🙂

 

[Steff]

Thank you so much SB a really useful helpful post please continue soon lol x

 

[spiritfree]

Thank you very much SB. I think this might be good for me. I am always angry wuth myself when bg's are to high or to low. I will give this a try. Please continue posting with idea's which might help others, on here.

 

[Carolg]

I found it tempting to hide away over the last couple of months.

After 9 years of Diabetes I finally hit a wall as HbA1c reached the mid 40s and so no longer improved, spinal stenosis gave me numb feet over night, an MRI showing lesions on the brain and I watched my Mum die of Dementia. Depression descended.

Thanks to Rosie on here I eventually asked for help, but there was a one year waiting list for any talking therapies. I was able to pay for counselling and I thought I would be up front about some of the strategies that I have already found helpful in the hope that these may be of use to others. I know that there a lots of people for whom these will be unnecessary but if it helps some others then It is worth posting these.

Recognising the impossibility of perfection.
I had set myself unrealistic targets and was getting frustrated with the highs and lows of normal life with T1 which I was seeing as failures.

A strategy I found very helpful was to start to log events of hypers and hypos and to record the reason for these where possible, strategies available to overcome the problem another time, and to record whether this event was in my control, beyond my control or a combination of the two. It may sound simplistic, but I was amazed how many events I was beating myself up for which were beyond my control.

A useful piece of homework that made me reconsider my view of how I was managing.

More to come. I hope that it helps someone.

Thanks for taking the time to share this, and your type of recording. I think the recording method sounds great, and as well I can be my worst critic and beat myself up. Will think of that in the future.Good luck with your progress

 

[Amberzak]

Hi SB.

Exactly the same. For me it's anxiety rather than depression (did you know that they are actually the same parts of the brain working and are intrinsically linked).

I had counselling and it was the same as you: I was outing unrealistic expectations on myself then beating myself up when I 'failed'. I was worrying too much about the future, to the point where I was spiralling out of control when I went too high or too low. And blaming myself constantly when, as you say, often it's out of our control.

The breaking point for me was when I got the letter to say I have mild retinopathy. It's tiny. But it still caused me huge panic attacks, to the point where I actually walked out of class in college and I almost lost my best friend because I was interrupting his date. (I don't think I would have lost him, but our friendship was a tiny bit awkward for a couple of weeks after that. I think he and his boyfriend had an argument over it).

But I do feel so much better. Counselling definitely helps

 

[SB2015]

I am going to try posting things that I have tried each week for a while.
(Would this be better done as anew thread each time or just continue this one?)
I know that if I had been given these ideas all at once it would not have helped.

I shall basically use the homework that I was given each each week.

 

[Steff]

Id continue on this thread then it cant get lost

 

[New-journey]

I am going to try posting things that I have tried each week for a while.
(Would this be better done as anew thread each time or just continue this one?)
I know that if I had been given these ideas all at once it would not have helped.

I shall basically use the homework that I was given each each week.

I think this is so useful and best to continue on this thread so we can see all your strategies in one place. Thanks for sharing with us, know it will help me and many others. Good luck @SB2015 and well done for taking steps to get help, you have been through so much.

 

[Bloden]

I'm so glad to hear you're getting the help you need and turning things around, SB.🙂 And this is a great idea for a thread - I struggled for a long time with mild depression after diagnosis. It wasn't until I found this forum that I felt I started putting my life back together...it's taken a few years, tbh. I look forward to people sharing their experiences and helping each other out, cos, frankly, my GP and endo were absolutely USELESS.

 

[SB2015]

I was reminded today as I did my weekly review how effective this is for me.

Record and close the book.
With the improved technology available, such as the Libre, and triggers that made me want to ensure that I was on target all the time (that impossible target I set myself) I found that I was almost constantly worrying about whether I needed to change my basal rated, my carb ratio or my sensitivity. I had days with good profiles and then things would go haywire. Back to worrying.

With the counsellor we reflected back on what had made me so happy with my management in earlier years. I had developed my own recording system, in which I had a week to a page, recorded insulin, BGtime, events and basal rates (which vary throughout the day as I am on a pump). I recorded what I had been diong during the week and any changes to meds etcalongside any significant events. Once recorded I closed the book. On a Sunday morning, during the Archers Omnibus, I would change lancets, fill up meds box and also review my logbook of BGs from the previous week and look at any changes that were needed.

When I started to use the Libre and Diasend I went over to electronic recording which saved me time, BUT took away the weekly review. With the onset of depression this led to the nearly constant worry about what I needed to change as well as a lack of evidence to make these decisions.

As a competitive fencer I used a close the book strategy after each fight. Whether I won or lost a fight, I sat down and recorded what I would do against that opponent next time. Closed the book. I then warmed up for the next fight. The physical closing of the book was an effective way of moving on from what had happened and focusing on the next fight.

I have returned to my manual records, and to a weekly review. I record any significant events and then close the book. I then look back at these on a Sunday and review to see if any changes to basal rates and ratios ar needed. The BGs are colour coded, notes are added. A plan is made for the following week, which may include some fasting tests if necessary ( but these do not always get down as life gets in the way)

My manual records worked for fencing and for 8 years of diabetes, so why not carry on. Just because new technologies are available it does not mean it is always the best thing to use. I think that returning to the manual records and weekly review led to one of the biggest improvements in how I was coping.

 

[SB2015]

Ps. The weekly review is also a chance to celebrate success.
Greens ar on target, reds are hypos. The colours give a good visual reminder of how often premeal readings are on target, and he often I have hyped in a week.

have relaxed my premeal targets for now on advice of DSN, and whilst I time my delivery of insulin to match premeal BG and the content of meal I am not currently monitoring post meal spikes.

 

[trophywench]

Ps. l am not currently monitoring post meal spikes.

Funnily enough - I never have done! LOL

When EDUAD first joined DSF years ago now - I was astounded at how far he went in recording and analising his BGs. It turned out some other people noted stuff like post meal readings, SDs etc. Perhaps I should be doing that sort of thing too ? Started looking at my own SDs. Variable - from the sublime to the ridiculous. I wondered whether I ought to do more ...

Then I thought, why? Am I actually going to change either what I eat or how or when I eat it? or how I behave or what I think or believe ? and the answer to that was No. So I stopped concerning myself over it. I don't think I've led a charmed life up to now - but still I'm here, still nothings dropped off yet - and anyway people with apparently far better 'control' than me for a far shorter duration, have had stuff go wrong with bits of them - so does it actually make any difference to whether that happens or not, really?

I'm not convinced it does ....

 

[Rosiecarmel]

I think you're brave for going and seeking help. The 1 year waiting list is appalling! I'm glad you have found something that helps and long may it continue to 🙂

Your suggestions are great. I think I'm going to try them, too. I know I definitely set myself unrealistic targets with regards to my T1.

I'm looking forward to seeing what other homework you get given! Is it CBT you're doing?

 

[SB2015]

Hi Rosie

You may have spotted at the start of this that it was your honesty on here that prompted me to seek help, so thanks. The counselling is not strictly CBT but certainly draws on aspects of that.

If you, or anyone else, thinks that the logbook I have developed would be of any use I am happy to email it to you. It would s a word document and has changed over the years to suit my own needs, but it might be a starting. Just PM me.

 

[SB2015]

So far I have mentioned
- Recognising the impossibility of perfection
- Record and shut the book until the weekly review
More info above in this thread if you missed these

Here is another bit of 'homework' from the counselling that I have found effective.
Heads up
This was simple to implement and surprisingly effective.
I was leaving a counselling session still feeling a bit tearful. The task was to walk home noticing what was around and to smile at people if I ended up making eye contact. She described it as Mindful walking. I know nothing about mindfulness and would usually shy away from those things so was initially a bit dismissive.
I found that as I walked home (about 30 min) when I started to mull over things negatively my head was always down. I consciously looked up and noticed what was above the ground floor: the new contrasting greens on the trees, the Old Council House building with faded lettering, the flues on a new build that have not been aligned (the pedant prevailed), the dates of building a short terrace of houses. when I became introspective again I simply lifted my head again.
I avoided eye contact on that walk but have used the smile on other days, and usually people smile back.

Simple and for me effective.
I hope it helps

 

[SB2015]

Another week gone and another strategy to share.

I am ... more than Diabetes
When I first went to see the counsellor I had allowed the management of my diabetes to take over my life. I had lost any sense of perspective, set myself unrealistic targets and was swamped by a feeling of failure with any high or low BGs

With the counsellor I identified things that I was good at and/or enjoyed. We ignored anything to do with Diabetes. I was surprised at how many things I could come up with even limiting myself to the time since my diagnosis. She asked me to explain what I enjoyed about these things, and encouraged me to avoid qualifying comments about how diabetes negatively impacted on these things.

My homework was to transfer these to individual cards and use images on these I carried these with me and, when I felt myself getting cross or annoyed with myself over a low or high reading I simply looked through the cards as a reminder of that ther aspects of my life. I carried these with me for quite a while, even though I no longer needed to look at them.

My diabetes has been kicked back where it belongs, for most of the time, but the cards are there as a useful reminder that my life is a lot more than this.

 

[Amberzak]

Funnily enough SB, that's one of the things they did with me. Really helps

 

[stephknits]

Some really good suggestions here. I think it is difficult to get the balance right between taking good care of your diabetes and caring too much / or too little. When I feel like I can't be bothered, I always think of Northerner who says that if you can just take a minute or two out of your day to test and do insulin, then this will take a lot less time in the long run.
I realise the thread is largely about the balance being tipped the other way, but stuff on here can be useful strategies either way. Many thanks

 

[SB2015]

I agree Steph, it is a tough balance and easy to go off kilter either way, especially once the base gets wobbly.

This forum is great for all the help, support, ideas and understanding of all that is involved.